301

cured in a very short time of most virulent diarrhoea, and

vomiting simply by the application of the " Electro-Gene-rator," of which he is the inventor. One of the poles of thegenerator was applied to the spine, and the other to the abdo-men, thereby keeping up a continuous mild current of elec-tricity through all the intervening parts of the body. He alsostated that he had cured himself of a similar attack, using noremedy whatever except the " Generator."

" I cannot shut myeyes to the great value of continuous currents of electricity inkeeping up functional action independent of the " digestiveorgans," and it is my firm conviction, from a long experience ofthe influence of " galvanism" on the system generally, that forcholera, in the stage of coldness, and even collapse, a strongcontinuous current (not shocks) from a battery through the

cramped parts would speedily restore the circulation and allaythe spasm, as every medical man knows that for preservingthe vitality of a limb electricity has no parallel. I have onlyhad an opportunity myself of witnessing its effects in five orsix cases of cholera, (one with severe cramp in both legs ;) inthese, however, the results exceeded my anticipations, moreparticularly in the effect on the urinary organs, and the simul-taneous ceasing of the diarrhœa. I have been induced to offerthese remarks in the hope that those of the profession whohave more frequent opportunities, from their connexion withcholera hospitals, &c., than myself of so doing, will give thesubject their attention, and test a remedy which has reasonand legitimacy in its favour, does not preclude the use of anymedicine, and is attended with neither trouble nor risk. Mr.Meinig’s apparatus is a most ingenious contrivance for the aidof medical science. The only thing I have found it necessaryto alter has been to substitute a rather large, thin metalplate to communicate the current to the abdomen, instead ofthe small disc usually connected with the poles of the battery,by which the current is diffused over a large surface, and awarmth produced that is most satisfactory.In conclusion, I have only to observe that Mr. Meinig has

(with a liberality that does him the greatest credit) placed atmy disposal any number of batteries that I may require, andI shall be happy to give my services (night or day) in assistingany of my professional brethren, by applying the battery forthem in any cases of cholera that may come under their care,so that they may satisfy themselves and the public as to themerits or otherwise of the apparatus.

I am, Sir, your obedient servant,Piccadilly, Sept. 1854. GEORGE SPRY, M. R. C. S., &c.GEORGE SPRY, M.R.C.S., &c.

CHOLERA WITHOUT PREMONITORYSYMPTOMS.

J. R. OLIVER, A.M., M.D.

To the Editor of THE LANCET.

SIR,—As a few of your correspondents appear to doubt thefact of Asiatic cholera sometimes commencing without pre-monitory cliarrhcea, I hope the following instances will be suf-ficient to show them that such a thing does occasionally takeplace. The first case I shall narrate occurred during the lastepidemic of cholera :-Mary H-, aged forty-three, a married woman, was sud-

denly seized with cholera during the morning of 2nd September,1849, while fast asleep in bed beside her husband. A suddenand profuse discharge of rice-water took place from the bowels,of so copious a nature as to completely deluge the bed. Collapseimmediately ensued, accompanied with such intense lividity ofbody, as to justify the remark of her friends, that she had gotthe " black death." Life lasted just one hour from the com-mencement to the end of the attack.In this case there were no premonitory symptoms whatever.

I saw the patient the night previous to her illness. She was

then in good health, and expressed herself to be so. The bowelshad been relieved during the morning; the appetite was good,and the system intact. Shortly after I left she retired to rest,slept soundly, and did not awake till the discharge from thebowels disturbed her. There was but the one evacuation,amounting, as nearly as I could estimate it, to two gallons.The second case occurred a short time since, and took place

in the person of a child two years old. The boy at the timewas enjoying good health, and playing in his mother’s kitchen.A sudden discharge of rice-water took place from the bowels,followed by vomitings, cramps, and collapse.

This patient recovered. The boy had no motion from thebowels for two days previously.

These, Sir, are the only cases of which I am personally cog-nizant ; but you may depend upon their authenticity. Theprofession at large, I have no doubt, can furnish many others.Allow me, however, to protest, in limine, against any man, or

bodies of men, laying down, in medicine, dicta of their own, asinfallible rules of faith. Each member of the profession, how-

ever great his experience may be, ought to remember that he is

but an unit in the great body corporate, and his experience alonea drop in the ocean, proving nothing. Truth, the brightestgem in the diadem of Nature, must be patiently and diligentlysought for, not in scattered and isolated efforts, but in a well-directed and concentrated research; each student of Naturefeeling himself to be, like Sir Isaac Newton, " but a childgathering pebbles on the sea-shore of the great ocean ofTruth." "

I am, Sir, your obedient servant,Kennington, Oct. 1854. J. R. OLIVER, A.M., M.D.

CHOLERA IN EDINBURGH.To the Editor of THE LANCET.

SIR,-Since the outbreak of cholera here, there have been, asfar as I can learn, 205-10 cases treated, of this number 150 havedied. As far as I can ascertain, the castor oil plan of treat-ment has not been generally had recourse to; in some few caseswhere this plan has been tried, it has failed entirely. Thecholera hospital here is, I believe, under the charge of Dr.Warburton Begbie. On the day of my visit to the hospitaltwo new cases were admitted. After trying to ascertainfrom the patients the period of their seizure, &c., Dr. Begbieordered the administration of a mustard emetic, and thendirected that the patient should have a scruple of calomel atonce, and one grain should be given every hour, leavingdirections that (if necessary) hot bottles should be applied tothe feet, and that the legs and spine should be well rubbed withturpentine. This plan seemed rational, and in accordance withDr. Ayre’s suggestion.

Dr. Dyce, who was sent to take charge of the cholera.cases in the Lunatic Asylum, Perth, tells me that, before hisarrival, the castor oil plan had been tried by the physician tothe Asylum, and had been abandoned as not being of theslightest use. Dr. Dyce treated all his cases by tincture ofrhubarb at first, and after that by administering the vegetableastringents, and with partial success. In a week or two Ihope to be enabled to send a table of the seizures, deaths, andrecoveries, with the kind of treatment.

I am, Sir, your obedient servant,Edinburgh, October, 1854. W. H. B.

THE WAR.

Dsrot INVALID CAMP, GALAM.,Sept. 13th, 1854.

BEFORE leaving England, you desired me to send some ac,count of the health of the troops, &c., and as I am left behindin charge of some of the sick, the army having gone, we believe,to Sebastopol, I shall endeavour to do so. The health of themen was good until they landed in Bulgaria, nothing of anyconsequence having occurred in the first division previous totheir encampment at Varna, where diarrhœa first showed itself,in some of a choleraic type. From hence they removed toAladyn, where several cases of low fever occurred; and to-ward the end of July and beginning of August, cholera of amost rapid and fatal form, at the same time nearly all themen more or less suffering from diarrhœa, appearing listless,without appetites, many falling out on any parade. even rollparade, and when asked what was the matter with them,the invariable answer being, " Looseness of the inside, head-ache, sickness, weakness, and want of appetite." It wasnow thought advisable to move us to a more elevated spot,the Aladyn encampment being rather in a hollow, and sur-rounded by low woods. This was done, and we went to

Gevrecleck, some high table-land about four miles distant,and in a northerly direction, and from its appearance itlooked most healthy; a large, clear, open space, with aplentiful supply of water. But, alas! we had barely arrived,when a man belonging to one of the regiments was seized withcholera, and was dead within a few hours. He had marchedwith his regiment. I dread to look back on our stay at thisplace; let it suffice to mention that men were reported sickat every hour during both day and night; in fact, there ap-peared to be a constant stream of corporals taking one or moremen to hospital; men were dying right and left from choleraof a most malignant form. I will imagine a case. A manis seen at the tent of a medical officer, complains of diarrhoea,having existed for some days, with loss of appetite, andweakness; he is sent to the hospital, and when seen again.

302

in five minutes, found in a state of collapse, blue, with allhis features altered, voice a mere whisper, constant sickness,cramps, and rice-water evacuations, and at first you couldhardly believe he was the same man that had been seen ashort time previously, and in from four to six hours he wouldbe a corpse. Fever still existed, and many of these cases

were frequently found in the collapse of cholera, it having comeon very suddenly, and so carried off. This state of thingscontinued up to the middle of August, when it began to occurat longer intervals; diarrhoea, however, prevalent the wholetime; some of which passed into dysentery; and now, also,fevers became again in the ascendent. It is not to be supposedthat the officers escaped; many had diarrhcea, some few choleraand fever; but on -account of greater prudence, fever anddiarrhœa, did not prove so fatal. The non-commissioned officerssuffered very much. Many of the medical officers also went

away on sick-leave, or incapacitated for work. Indeed, it wasand is, difficult to find men for the work. With us, every known,and some unknown remedies have been tried in the cholera,with but little success. Of those who have recovered, thetreatment in general, as far as I can speak, has been a mustardemetic, friction, solid opium and calomel for first dose, and thenthree grains of calomel every ten, or half a scruple every twenty,minutes. In only one case were the gums at all affected. Thosewho have seen the same disease in India say this form wasmore fatal and rapid. Here, though the collapse was alwaysso great, if they survived, the subsequent fever was often veryslight, and in some hardly perceptible; the sickness was themost persistent symptom; micturition was always followed byimprovement. Some men were so conscious of it, that nothingshort of the introduction of a catheter would convince themthat their bladder was empty. We have now been free from’cholera for some time, but low typhoid fever, followed withabscesses, diarrhœa, with or without blood; simple diarrhcea,dysentery, pneumonia, and catarrhs, are most frequent. The

days are getting cold, and the nights bitterly so.in looking for a cause for the former diseases, I think that

much must depend on the country being so wild and unculti-vated. There is always decay going on; all manner of animalsleft to decay and " stink" wherever they may fall; even alongthe shores of the lakes there is a most unhealthy odour, and theheat has been most intense, acting on its boggy margins, as onall damp ground. Otherwise, how could we have disease in sofine a country? The mode of living, no doubt, has much toanswer for. On first landing, the men had capital cocoa servedout to them. With this they were not satisfied, but begged forcoffee, which they got, but in a raw state, so that they had toroast and grind it, without roasting machine or mills. Thelatter they do between stones, &c. Now they cry out aboutit, but there is no further change. The allowance of meat is1 lb., consisting sometimes of beef, and at times of mutton,and now and then salt pork; also a portion of rice-bread orbiscuits, grog, and sometimes porter, for which they pay 11 d.per pint. But they will not be content with this, but buy allsorts of horrid things, and eat unripe fruit off the trees, withwhich the country abounds. Illness, death, and persuasionhave not the slightest effect on them; they will even strollaway from the hospital when in for diarrhoea, and eat away atapples or pears. The ambulance corps have already done goodservice. I fancy the waggons the best, as the carts haveseveral times been upset, perhaps because the drivers are notyet used to them.

P. S. Cases out here are placed in tents, and consequentlyunder very unfavourable circumstances. The cold is tellingdreadfully on all cases in hospital.

THE CHOLERA.

RELATIVE to the progress of cholera in the metropolis, wecondense the following from the " Weekly Return" of theRegistrar-General for the week ending September 30th:-

Of these 223 were under 15 years of age; 409 were above15 and under 60; 121 were above 60 years old; 1 the age wasunknown. 165 are stated to have died from diarrhoea.

It is thus very evident that the cholera is now rapidly de-clining in London, the deaths by it having fallen from 2050 inthe first week, to 754 in the last week, of September.The present epidemic eruption began later than the eruption

of 1849, and it has latterly been more fatal; but the aggregatemortality will yet probably be less than it was in 1849 ; for thedeaths by cholera in that year down to September 29th were13,098, while the deaths in the present epidemic down to Sep-tember 30th have been 9707.Our attention has been directed to some errors in the Re-

gistrar-General’s Returns of last week and a few weeks back.With respect to the first, we may observe that it was, as ourcorrespondent remarks, a "clerical error," which was soondiscovered by the printer, and corrected accordingly. The

proof was right, (we have reason for knowing,) and so was oneof the copies we ourselves received. It was so evident, too,that scarcely any mistake could arise, as by reference (if neces-sary) to the tabular portion the truth would be at once dis-covered. Relative to the other mistake, the reference of ourcorrespondent has not been sufficiently definite to lead us todiscover it on a cursory examination. In justice to the officialdepartment concerned, it should be remembered how muchmore work is thrown upon it during such an epidemic as thepresent, and that no additional hands are brought into opera-tion. We think it surprising everything is as accurately andas punctually carried on, as it is well known to be; still, wequite agree with our correspondent that merely clerical errorsare often " very erratic in effect," and should be noticedaccordingly, to avoid further trouble.

......

We have received Dr. F. W. Iiichardson’s pamphlet, inwhich the opinions are expressed, that " the Iteport on theTreatment of Cholera [of the College of Physicians] is themost mean and meagre that was ever issued from any RoyalCollege or scientific body;" that "the Asiatic cholera is ascurable, even in, cases of collapse, as any other disease ;" andthat "the plan of treatment I have adopted, and found moresuccessful than that of Dr. Ayre’s, will prove equally service-able in the hands of others." This plan is to administer anemetic; to repeat it every ten minutes, if necessary; to givecalomel in ten, fifteen, and twenty grains, every ten, twentythirty, or sixty minutes, and a piece of ice or a teaspoonful ofvery cold water every five minutes.

Medical News.

ROYAL COLLEGE OF SURGEONS.-The following mem-bers of the College having undergone the necessary exa-minations, were admitted Licentiates in midwifery, at themeeting of the Board on the 3rd inst :-

BENNETT, EDWIN, Dorchester, diploma of membership datedFebruary 27th, 1852.

JONES, JOHN, Dnffryn, Merionethshire, August 5th, 1851.MAY, EDWARD HOOPER, Tottenham, April 21st, 1854.STEDDY, EDwARD AUSTEN, Chatham, April 3rd, 1854.THORP, HENRY JOHN, Maldon, Essex, June 23rd, 1854.VISE, AMBROSE BLITHE, Holbeach, Lincolnshire, April 21st,

1854.

APOTHECARIES’ HALL.-Names of gentlemen who passedtheir examination in the science and practice of Medicine, andreceived certificates to practise, on-

Thursday, September 28th, 1854.MILLER, THOMAS CORNE, Bedworth.O’CONNELL, PETER, Waterford, Ireland.PATL, JAMES THOMAS, Southsea, Hants.TREW, THOMAS NEWLAND, West Indies.

INAUGURATION DINNER OF THE LONDON HOSPITJ.T.MEDICAL COLLEGE.-On Monday last about 200 gentlemendined together at the London Tavern, to inaugurate this new

medical college. The company consisted chiefly of the medicalofficers of the institution, the teachers of the school, formerand present pupils, governors, and well-wishers of the LondonHospital, and a few visitors, amongst whom we noticed thePresidents of the College of Physicians and of the College ofSurgeons, and the Master of the Apothecaries’ Company. Mr.

I Luke, senior surgeon to the hospital, was in the chair, and

* The Rational and Successful Treatment of Asiatic and English Choleraand Epidemic Diarrhœa, &c, &c. London and Woolwich. 1854. pp. 18.