IMAGE EVALUATION 
 TEST TARGET (MT-3) 
 
 1.0 
 
 I.I 
 
 1.25 
 
 |50 '""— 
 
 ^ us, 
 
 M 
 U ill 1.6 
 
 Photographic 
 
 SciGncBS 
 Corporation 
 
 m 
 
 «- 
 
 «(v 
 
 c\ 
 
 \ 
 
 ^ 
 
 ^\^\ 
 
 -^v*^ 
 
 ^J^ 
 
 ^<h 
 
 23 WEST MAIN STREET 
 
 WEBSTER, N.Y. 14580 
 
 (716) 872-4503 
 
 m^ 
 
CIHM/ICMH 
 
 Microfiche 
 
 Series. 
 
 CIHM/ICMH 
 Collection de 
 microfiches. 
 
 Canadian Institute fcr Historical Microreproductions / Institut Canadian de microreproductions historiquQS 
 
 O 
 
 ;\ 
 
 !* 
 
Technical and Bibliographic Notes/Notes techniques et bibliographiques 
 
 The Institute has attempted to obtain the best 
 original copy available for filming. Features of this 
 copy which may be bibliographically unique, 
 which may alter any of the images In the 
 reproduction, or which may significantly change 
 the usual method of filming, are checked below. 
 
 L'Institut a microfilm^ le meilleur exemplaire 
 qu'il lui a ote possible de se procurer. Les details 
 de cet exemplaire qui sont peut-dtre uniques du 
 point de vue bibliographique, qui peuvent modifier 
 une image reprc uite, ou qui peuvent exiger ure 
 modification dans la m^thode normale de filmage 
 sont indiqu^s ci-dessous. 
 
 The 
 to th 
 
 The 
 poss 
 of tl 
 filmi 
 
 D 
 D 
 D 
 D 
 D 
 D 
 D 
 D 
 D 
 
 D 
 
 D 
 
 Coloured covers/ 
 Couverture de couleur 
 
 Covers damaged/ 
 Couverture endommagde 
 
 Covers restored and/or laminated/ 
 Couverture restaur^e et/ou pelticulde 
 
 Cover title missing/ 
 
 Le titre de couverture manque 
 
 Coloured maps/ 
 
 Cartes giographiques en couleur 
 
 Coloured ink (i.e. other than blue or black)/ 
 Encre de couleur (i.e. autre que bleua ou noire) 
 
 Coloured plates and/or illustrations/ 
 Planches et/ou illustrations en souleur 
 
 Bound with other material/ 
 Relii avec d'autres documents 
 
 Tight binding may cause shadows or distortion 
 along interior margin/ 
 
 Lareliure serree peut causer de I'ombre ou de la 
 distorsion le long de la marge interieure 
 
 Blank leaves added during restoration may 
 appear within the text. Whenever possible, these 
 have been omitted from filming/ 
 II se peut que certaines pages blanches ajouties 
 lors d'une restauration apparaissent dans la texte, 
 mais, lorsque cela 6tait possible, ces pages n'ont 
 pat iti filmies. 
 
 Additional comments:/ 
 Commentaires supplementaires; 
 
 a 
 
 Coloured pages/ 
 Pages de couleur 
 
 □ Pages damaged/ 
 Pages endommagees 
 
 n Pages restored and/or laminated/ 
 Pages restaurees et/ou pellicuiees 
 
 I — T./' Pages discoloured, stained or foxed/ 
 I '^ Pages d6colorees, tachet^es ou piquees 
 
 □ Pages detached/ 
 Pages detachaes 
 
 I T/^howthrough/ 
 I M Transparence 
 
 I I Quality of print varies/ 
 
 Orig 
 
 begi 
 
 the 
 
 sion 
 
 othc 
 
 first 
 
 sion 
 
 or il 
 
 D 
 
 Qualite i.n^gale de I'impression 
 
 Includes supplementaty material/ 
 Comprend du materiel supplementaire 
 
 □ Only edition available/ 
 Seul 
 
 D 
 
 jle Edition disponible 
 
 Pages wholly or partially obscured by errata 
 slips, tissues, etc., have been refilmed to 
 ensure the best possible image/ 
 Les pages totalement ou partiellement 
 obscurcies par un feuillet d'arrata, une pelure, 
 etc.. cnt 6td film^es d nouveau de facon a 
 obtenir la meilleure image possible. 
 
 The 
 
 shal 
 TIN 
 whi 
 
 Mai 
 diffi 
 enti 
 beg 
 righ 
 reqi 
 mel 
 
 
 I 
 
 This item is filmed at the reduction ratio checked below/ 
 
 Ca document est filmd au taux da reduction indiquA ci-dessous. 
 
 10X 14X 18X 22X 
 
 26X 
 
 30X 
 
 7 
 
 12X 
 
 -I6X 
 
 20X 
 
 24X 
 
 28X 
 
 n 
 
 32X 
 
The copy filmed here has been reproduced thanks 
 to the generosity of: 
 
 Metropolitan Toronto Library 
 Canadian History Department 
 
 The images appearing here are the best quality 
 possible considering the condition and legibility 
 of the original copy and in keeping with the 
 filming contract specifications. 
 
 L'exemplaire filmi fut reproduit gr&ce i la 
 gdnirositi da: * 
 
 Metropolitan Toronto Library 
 Canadian History Department 
 
 Les images suivantes ont 6t6 reproduites avec le 
 plus grand soin, compte tenu de la condition et 
 de la nettet6 de l'exemplaire fiimi, et en 
 conformity avec les conditions du contrat de 
 filmage. 
 
 Original copies in printed paper covers are fiSmed 
 beginning with the front cover and ending on 
 the last page with a printed or illustrated impres- 
 sion, or the back cover when appropriate. All 
 other original copies are filmed beginning on the 
 first page with a printed or illustratbd impres- 
 sion, and ending on the last page with a printed 
 or illustrated impression. 
 
 The last recorded frame on each microfiche 
 shall contain the symbol — <»► (meaning "CON- 
 TINUED"), or the symbol V (meaning "END"), 
 whichever applies. 
 
 Maps, plates, charts, etc., may be filmed at 
 different reduction ratios. Those too large to be 
 entirely included in one exposure are filmed 
 beginning in the upper left hand corner, left to 
 right and top to bottom, as many frames as 
 required. The following diagrams illustrate the 
 method: 
 
 Les exemplaires originaux dont la couverture en 
 papier est imprimis sont film6s en commenyant 
 par le premier plat et en terminant soit par la 
 dernidre page qui comporte une empreinte 
 d'impression ou d'illustration, soit par le second 
 plat, selon le cas. Tous les autres exemplaires 
 originaux sont filmds en commen^ant par la 
 premiere page qui comporte une empreinte 
 d'impression ou d'illustration et en terminint par 
 la dernidre page qui uomporte une telle 
 empreinte. 
 
 Un des symboles suivants apparattra sur la 
 derni&re image de cheque microfiche, selon le 
 cas: le symbols — »- signifie "A SUiVRE", le 
 symbols V signifie "FIN". 
 
 Les cartes, planches, tableaux, etc., peuvent fitre 
 filmSs d des taux de reduction diffdrents. 
 Lorsque le document est trop grand pour itre 
 reproduit en un seul cliche, il est film6 & partir 
 de Tangle sup6rieur gauche, de gauche d droite, 
 et de haut en bas, en prenant le nombre 
 d'images ndcessaire. Les diagrammes suivants 
 illustrent la m^thode. 
 
 
 1 
 
 2 
 
 3 
 
 1 
 
I' 
 
 a 
 
 ...,^.. 
 
^^''-^ 
 
 lOROKTO PUBLIC UBBARV 
 
 i' 
 
 / 
 
 4-:* 
 
 T.8iEATS;SE iYN C'llOEEKA^ 
 
 an Br. <Slcpiic»v^^: 
 
 E X 1' K A C r E D F K O M il 1 S W O B K EMI i L E D 
 
 
 HEALTHY AN 
 
 ND DISEASED i'ROi'^Sk'its OI^THE BLOOD. 
 
 F.»r the lile oilhc flesh i" tliB Blood.— Lao nicv.i xvii, 21, 
 
 PRINTEI' ATTllE /\VI1U(>'1' OFFICF, 
 
 ... '.''. 
 
IKLLiy^' 
 
 ^0\^«5 
 
 OCT 6 1932 
 
PREFATORY NOTE. 
 
 —- ^«- 
 
 W.THiNa few days an interesting work, bv the celebrated Dr. W".ri;0. Stevens late of Santa^^^^^ 
 now of Londo... ha/been received by a gentfeman of th.s city, ^om the Co sul ot tl.e ^^ "^t^/ ^J'^^^^^*^ f^"^„ 
 don, entitled " Observations on the Healthy and Diseased Properties of the Blood lUe lollowing 
 extract from the letter accompanying the work. 
 
 Lo.NDo;^, 14th July, 1832. 
 
 1 send you by the ship Hudson a parcel to your address containing Dr^ ^^u u":' ched oreS'aJuX'n 
 ties of th J Bloo^d , with i Treatise on'cholera in the latter F^ o« the ^f^'^^^-^^^V'^^.X' d p^nd d u ,"n a" 
 here; and the success which he relates a. l'**""? ,f "^"''^ ^/"-'f "^"'^'^f „ [f,^^^ ^efing inVerested in such 
 true. I beg your acceptance of the work; and 1 think that if you. "> any soc'm 'cj^""^ "^ . ,dering a 
 matters, were to republish in the United States tlic part which relates to Cboleia, it w ould be renaering a 
 
 great service to the community in general. ^ ^^^^ ^.^^ ^,^^ ^^^,y y„„^^^ 
 
 Thomas AsPiNWAtt. 
 
 Having pyH,,e work i„.. ;|,o h»<U «fI>r,U.««»^^^^^^^^ 
 New-York, September, 1, 1832. 
 
 i\»\i 
 
 |«|®ic 
 
 THE author of the following remarks on Cholera, Dr. Wi.^-M Steve^s-s Sva\?tr±tio"'°thathV. 
 ed a high reputation as a bold and successiul surgeon^ Jiuwhroo^sf dSff the P^^^^^ of the yellow 
 
 father ^.s eminently dist^ngu^she^^^^ 
 
 Se'S^'?^ c£n'd!2ts^,^e^U^ giSt attentt Ja.n.n. U. pn^fession ^ ^^Hi^r!^^ 
 ly in London, and, according to the statements herein contained have^^^^^^ Sri reasoning, its value must 
 lera with signal success. Like every mode ^[^'^'^^'Z^li^f.fv.^^^^^^^ »f trial 
 
 finally be determined solely by careful and exact observaUo of its results. " ^^^^^^ /heartily approve 
 by thLe who have the -n-J-^^^^^^^^^^ Medical Wssion 
 
 of the republication, 
 in Great Britain . 
 
 AtKXAXDSR H. Stevkjh, 
 
C H () T. E \i A 
 
 -.^j^- 
 
 When (liii dinease, which is geiitniUy believed to 
 be of Asiatic origin, bur«it out at a lute purioil li-oni 
 itii uiiial lioiindiiiic's, and exieii'ltil its ravages to- 
 wards ihu WLSt. it was sciurallj- belirvcd (o be less 
 •meiiabii; to trea .incut than it rtaliy is ; consequent- 
 Jy it spread for a time an alarm ali ivtr Kiirupe. Al- 
 most every f!;overniiiciit was in arms a;^ainnt it ; a:id 
 the whole medical talent of the day appeared to be 
 concentrated for the iMirposc oi' investiviatiii!^ its na- 
 ture, and jireventing the mortality iVoin this now but 
 destructive pestilence. 
 
 It is well linowii, that those pr.ictitioners in this 
 country who had f )rrnerl}- seen the ClKilera in Indi- 
 a, remained, in general, most obstinately pertinaci- 
 ous fifihtir former opinions, both with respect to 
 its nature and treatment ; whilst others, wIm had 
 nr)t yet bound themsdvea to any theory, a'ld were 
 well" aware that noihinj;; hr.d been done in tiie East 
 towaid lessening- the njortality, wore eager in tluir 
 endeavours to find out some mnre firtunate method 
 of tre.ilment than those A^hich had Iiitlu.rlo been us- 
 ed witli so liitie success in other countries 
 
 It would be, however, but a loss of time to enu- 
 merate the varioas remedies whic'.i were propi)sed, 
 tried, and found to be useless. NA'hcn the C'lioler.i 
 first appeared oa the isolated .sh,)res of tliis islan>l 
 white wine whey with spice, hot brandy and water, 
 cajeput oil, ))ep(ierniinl, laudanum &c , wero otiici- 
 aliy rccommetided to the public b> one Hoard of 
 Health ; w'hilst another piessed into the service all 
 the remedies wliieh had ever been ti'inu;ilit of, and 
 recommended the wliolc to the profossi in in a con- 
 fiscd mass. They approved ofriul hot irons to the 
 wpine, and blei'dini;, together witii the internal U.-.0 of 
 o^)iu;Tj nnd eracti.v, James's p iwdeis, caiomel, <-'a\- 
 enne pepper, chailt and biaraly, ice, quinine, s///.';, 
 acids, fyc , i5'C. Hut noswilhsfanding aU this, tiic 
 mortality continued, as iiii;;ht natur.dly have been ex 
 pecfed ; for such remedies so enipirir-iUy used, cin- 
 ;iot e\rn mitigate the fymploms, inueli less cure the 
 diser.se ;* — and as a general rule, 1 firmly believe 
 that there would have been fewer deaths if the pati- 
 ents had been kept in a warm room. tiJlowed plenty 
 of cold water, and then left t;> the care of a ;^ond 
 nurse. There are however, sonic excejition'* to this 
 rule ; and from wh it I have now seen, my c"'nvio- 
 tion is. that when f'hnlora is taken in time, and pro- 
 perly treated it is, in tlic majority of cases, aiin!"!ft as 
 easily cured as cither the common typhus or the 
 marsh fever. 
 
 The. tacts wiii;.'U I had prcAii.usly ».!a(ed relative i 
 (he ell'ects of salts on the idood, npi'vared hir a timi 
 to have been alnxist for-otlen ; but. in pn. portion a 
 the danger dreu m :ir, tiiey were ngahi reeurred tr 
 and warmly reeommendci by soim , as at least wnr 
 Ihy of attention in the treatment ofi.'holcra. 
 
 'When it had been fairlv p:oved on the Continent 
 that the praclife which had been use.! in India wa» 
 of no value. Sir Astley Cooper, Dr. Prout, Dr. Kl- 
 liotson. Dr dairies Wilsm, Mr. Tra\ers. an 1 some o- 
 Iher (aleiiied individuals, who consider their proies- 
 sion as something imu'e than a mere trade, (ipenly ex- 
 pressed their opiiiion.s in tavour of t!ie saline treat- 
 Tiiciit ; and that, loo, in a manner which renders 
 it impossible forme to fm;". words to express how 
 araleinl I feel to these, and some other scientific in- 
 dividuals, who ha i the ^food sense to perceive that 
 the diseased condition ol the. blood had been too 
 uch overlooked, not merely in Cholera, hut m oth- 
 er diseases. • ji • 
 Previous to the aj)pcaranc(? of Cholera in linn 
 country, the follosvin^ paper appeared in the Mediv.d 
 GazoUe for September 3, 1^)31 : — 
 
 ' O.t (he Si'itn «f the Blon h nnd EJi'ic' of Salint 
 Mcuiciucs.in M:!i';;naiii iJinccufcs. 
 ' We have been informed, on the anthnrity of Dr. 
 Harder, a physician to the curt of St. I'eter burgh, 
 who aeeonipanicd the Crand Dnlchiss llele;ia to 
 J]n;;'.and, that his countrvman, Dr .lachnichen, of 
 rdir.cow, has demonstraied ' th-.it healthy blood 
 contain.', a notable qeantiiy of free acetic acid, which 
 as w.dl as tlie natniil pi.rtifm of its serous lluid, is in 
 a striking proportion lost in tlio blood of Cholera pr- 
 tients; but that these siibslances are to be regained 
 in nearly their ri>zht propoitimis in the fluids inun- 
 ciatingt'ba priii.x' via;, in Cholera, and voided by the 
 vnmiiiims ami alviiie evaonalions in that disoriler " 
 Wetiiink il due (o our Russian correspondent t. 
 make this announcement, the ratiier as it is intended 
 to correct wliat he regards as an inaccur.icy on our 
 part, though we are free to confess that we are by no 
 means c.'ovinced even now of the err.ir lying with us. 
 We cannot louierstand how a.-etic acid can remain 
 fvec in a solntin-i Mhiidi eoi-.Uiins soda: neither, as 
 th'-: addition cd" acids l)':;c^vens the blood, do- s it seem 
 probabh that the reni.)val cd' such agents should also 
 !i;ive the eiTecf. of rendjring that lluid more dark. 
 It is pot our intenli'oi, b.owever, to enter fiu tlier up- 
 on :: o,ue'>tion, for the satisfactory discussion of which 
 
 *Thcse observalitns apply onlv to the irmhmid recommended by the Boards of Health ; in some other 
 rcspect.s, the conduct of the present board appear.s to me to have been highly juda-ious ; and it London has 
 hitherto been saved from the awful scenes which h.avc o.n-nrre 1 in P.iris. &c., it has been in no mer^i degree 
 owinr to the active an! nr ;,-"r .oeasu.e.? that wer.- used !o prevent it. I te.,r however, th.-it tnc danger is 
 not vet passed ; ard from wb.U 1 have seen latclv.thcro is rer;soa to dread that tiu? motropchs is at this mo^ 
 
 msr-t «;uinbcrinr^ on a volcano of oeitilence.' 
 
•,i(«''. relative i 
 ;iixh1 lor u liirn 
 n jiriii'iiiiidii u 
 ]n rciuntil tr 
 iis iit least wor 
 .'liouru. 
 
 tlu' Coiitintiit 
 111 in India was 
 
 I'rout, Dr. i:i- 
 •is, ail 1 soino o- 
 liT tliL'ir jirolus- 
 rade, <i|)cnly ex- 
 lu; saliiii.* ircat- 
 I- which renders 
 
 ex;.rcss lunv 
 er scii'iilific iii- 
 lo perceive tliat 
 
 1 had been too 
 kra, but in oth- 
 
 ''luilfra in Mm 
 1 ill the Medii .il 
 
 ';Tic' of Saline 
 
 I.VPf/SfS. 
 
 nnlh"rity of Ur. 
 Si. I't:tfi"biirf;h, 
 liess Ili'leiia fi) 
 Jachnichen, of 
 : healih}' blodd 
 ctic acid, wiiich 
 irmis Huid, is in 
 :l oi" Cholera p;-- 
 •o to he rcqaiiied 
 tiic I'liids inun- 
 id vni(h-d hy the 
 1 that disorder " 
 :nires|)ondent t> 
 as it is intended 
 acciu'.icy on our 
 liat wr are by no 
 •or l^iiii; with us. 
 icid can remain 
 oda: neither, as 
 Mid, docs it seeiii 
 c:ii.s slioiild also 
 liuid more dark. 
 ■liter Cup tlicr up- 
 ciissiou of which 
 
 ; in some other 
 id if London has 
 1 iio mer.n decree 
 lat the danger is 
 :il;s is at this clo- 
 
 ne ki:k nat^nali: b*a >»e .l.U lake lh« < pi ortmn-' foc, U'. in ^^^^■'^y'>'''-""^''.''\'f'*\*''^^^^^ 
 
 U .t .lluJd. 01 br.n.ln.:- beforo our reudcr* the .tate- V.y .ka.h. 'A .. c.xr.,uum,. the bk.od .^ « >vf e. d • » 
 
 .1 .:,.... ...ill. ..... -.i-.i (., ( I tlxi^e who had dit d I I il.i- vtHow levi.r, uu. <.oii.« 
 
 in tlio wholo Uii-n- > I o.i-.i. i"'"> '» ""• "'l^f';* -'"^ 
 V( ins wa, cou-i-ic;. :\ i ;.i.:i,ii.:" Iroiu Us i.ulural »car- 
 ]et. or Modena led, i .aoi.iti black. I iiavc Iri^nuci.t ' 
 )v tilled on. i'.la-.> •..>:.! ih,! bl icii lluid tAm I'Viu 
 'he iiearl, and ai.oMu r with liie i'lafk vomit tuK«.. 
 fom Ihehlouiaeh. 'i i.e\ v.. re both so u.diUc 11 • 
 iiloodof healih, r.i.d re.-enibU'd iKch <'thcr so com- 
 pletely, tlial It Wrt.s alnio.t inipn-sibi" to distiiiRUUb 
 tlic oiie frt II! the oilur." 
 
 ' 'Ibe oxviicn <d the air ir.ul no el!cct whatever m 
 rrdde.i:.- "ihi. dark Ihiid •, but on addini; a sinftll 
 i:iiaiilHV of any of tho lu utial i-alts, even to this black 
 blood, file red odor was iii:iuediat*!!> re.slond; and 
 Dr .'^levins lielieves that certain saline ii(;ent«ha\e 
 a specific ( llVct, when a.ln.mi^tered dunuK de, in 
 
 i."ient« of iJr. i'lcvens whose vicw.s With regard to 
 ihe. .stKtr of die blood ill inaliKoanl di.'ianes appear 
 Uiu> to merit inoic ftttentioii than tliey ha\c re- 
 ceived, and which are. to u certain estent, though 
 itidiiectly, >:rengtheiied by some of the pUeiiouitna 
 whieli tile Cholera lias [ue^eiited in the north ot Ku- 
 
 '• ill our number l>eforo last wc published a leltir 
 from Dr. ll.nrv. in which he :.ays --Two phyticiaiY, 
 (llermans,) V'senheclt and lirailow, slated publicly 
 and lirmiv vcierdav. in my pUMi.ce. at tho -Medi- 
 cal t'ounVi!, that diirinj,^ the lueceui'.j; eleven day!) 
 thev had tnat>:d, at the Custom lioiise iiosp.ta', 
 thirty C hole a i-atienls, of whom Vn-ii liml not lo.'l 
 viic' 'lheygi^e two t.ilih; sjioonfuls ol coninic. ta- 
 ble salt, inVi'x onnco. of hot water, at once, (die' o;,f 
 ta!'!e sjon^ifiil 'l/'^i ';iiTu7(.'r hii.rline i-old ivtiy hviir 
 ufUrwn7(i.' 'l'iieva;wav.she^-.iii by bleeding." A n- 
 ii.ilartreiitinent has aUi". been tried with »ucce-s at 
 \Var-.aw. by ;Mr- f iarle;--wul loo.-t ot our readers 
 will r, coKeet, tlut Ihis is neither more or less than 
 the practice which !i is been so warmly recomniM d- 
 <■(! by l)r, Mevens, m tonlv in ^ello^v fe^er bi:l a.so 
 (reas.niii-; IVi.m :>.'.al.\L'y) ui iho cure oi all other ma- 
 lii^nant aiMase.-.;' and' iifter reprint in;.; the fir.-l pani- 
 ^iaph from the paper wiiieh liad be. n re.id iit ^ ine 
 Coile-e of I'livsMNans, the editor oli.serv* s :-' ..ow 
 Dr. Ht'. vei.s ho'.d.s the .saline male: iab; of the b.. Oa to 
 be the cans..- of it^ved color, and ccr.ain o-Jscr pro- 
 perties essential to lite. He does not, mJee.l, idui- 
 tilv the saline wilii the colnrini; matter; on the con- 
 Ifiuy hecnnsidcis the latter (/■* a mere nnin.al (^ifC 
 irhirk is n<ilii!\tli>i hlur.':. but i.-hich possa^fC:* lue p- 
 culiar propnlv <')'-<lrilAiv,'; a red cvdcr -nU as-j,if 
 tiun of He nrutru! fulit. lie .nlso cni..sukr.s the sa- 
 line in^-i-eilicnts in the blood as the cause el its li'iah- 
 tv r.ie assumed -round that the fibiiu and tlie a!- 
 
 IV. o:i (iii- iisMiiKi .1 t,- "■^"■■.. •■- 
 
 bumenare naturally solid, and tb.at the ttm.ency to 
 this condition is counteracted by the saliiu; impre;-- 
 
 atiou , ., - • 
 
 ' '• Nature," sav-s Dr. Stcvenn. - uncs nothing- isi 
 ain; and ail tlie analv.ies of the blood have proved 
 'lat, in health, it invaiiahiy contains a given pr.'po - 
 ion of saline mailer. This is not r.c.;iden:r., ; lor it 
 
 nation 
 
 I i; V.w. 
 
 Tain ; arid 
 that 
 
 tion .,. o - . . 
 
 is as cssenliiil. and exists ps invariably m lieaifl'.v 
 blood, as cither the fibiin. the albumen, or 'A\?. color- 
 in"- matter. Arterial mast evidently contain a larr- 
 cr^ proportion, or at le;)st a strontrcr .'ialiiie matter, 
 than \enous blood; for all the soliil-^and most ot '.he 
 seci-ciions, derive their saline matter from a'te:-i;,l 
 blood. Kuttho serum <A' evci the y.nnus bio; d 
 which i.s left con'-dns a proporticn <!f thirteen ounct s 
 to the. thou.^and of the-c. salt.-, ind?pe-idently of v,-h;t 
 is lo; t !)y evaporation. Si; . Wc well k--,ow ho\v nc- 
 tivo the.sc salts imivs chemical aaents;: ar.d Ihc.^c 
 iigcn'.sarc so constantly found in the blond, and iii 
 h'ealtiiy b!..od their proportion is •'•o eNa':t. that wo 
 arc forced to belirvc that they arc placed there for 
 some important use. !,ut the importance of tins sa- 
 line impregnation has been almost entinly overlook- 
 ed, fi-om the p^rr.Rt attention that has b,M n paid both 
 by iihvfdcians and philosophers, to the touch less ini- 
 prutaiit coloiiiinu- nialttr." 
 
 Of .all the in9;redi,'nts. Dr. Slephnns .■"■.pear- to con- 
 sider the sa'iue matter of the blood as by far the most 
 esscn'ia! to its healthv state. Any (^f the other in- 
 rrr lients nviv lir- din' inishrd. and still the vila! (iuki 
 yyill perform' its function. ,• but when the salire. im- 
 prep-natiou is lo.-;l. or greatly lessened, as he.itates it, 
 to be in maligi-.aut disomies, the blood hccoir.rsblnck 
 
 reitiedvio" that di-eased ;Ualc of the blood whicii it 
 uuifoi-udy met with in thi- , and piobubly m all olhor 
 iiiilit-naiit di;-.\=!is. . 
 
 • It appears th:d Dr. I^f-vens first cnnnienccd tUi« 
 l,raclice with a solution cmitainin- two parts o inc- 
 rialo of '-nda and one of nitrate of potass. An ol.j«f 
 tion to this mixtur.^ was. liia' when feiveu in larg« 
 rlos,.;itwas apfc to disairree willi the stomach; uva 
 fin. iiiLT that other saline a-- ntn possessed, jn an cepuil 
 de-iee.the same jr. pel•;^ of remedyiiiK the dikea.rrt 
 .state ol the blood, thtsowcre occasionally employeJ - 
 the carbonate of soda, tor example, was preterrcd. 
 p.u-ticularly when then- were any sii^ms ot acidity in 
 the stomach, and the tart.iriscd soda was t^eneraliy 
 inveiiwhena pun alive was required. Lnderilu* 
 'practice, the. r.sul'l i-;, st.'.cd to have been incompa- 
 i-iib!y nuu-e successful than it w.,3 under the old treat- 
 
 ''The resemblnnce'lutwecn Cholera nnd ccitaiii 
 
 mail 
 
 -nant fornni of fevcr. boih as to their phenomena, 
 and, il some <;i the latest accounts be correct, like- 
 wise as to Iho treatment which proves most succes.s- 
 fiil, is very strikin.,'. Even in those cases in w hicli 
 there i-; no' excitement, and <.r course no increased 
 r.ction to ho rediiced, the remnv.d of a small quanti- 
 ty of b:,)od is oqnailv bcneneial in both, hy relieving 
 tiieovirchan.-vd heart. and enabling it to circulate 
 with more ease -hat which is left. JJut in the ma- 
 I'-rn.ant fevers of the \Vest Indies, much more com- 
 luonlvlhan in Cholera, there is p-eat increased ac- 
 tion, a^.d. the l.^ncot is then ii-.ed freely. As early a* 
 possible after Ihefiist blc-din-. the patients arc tree- 
 |y cv-'eunted by means of gome active purgalive. Ai 
 so-in a.; the excitement i:' 'oUiTiciently reduced by 
 thn'-e r.-.rans. which it n;ene-.ally is in less than twen 
 ty-fourhours. the v.seoftho saline mixture is com- 
 menced. This method of tre-atment, which Dr,Ste 
 yens has the nieilt of havit^t' fi''^*- proposfed, i» gam- 
 in"- "round in the West Indies, i^'C, 4"C- 
 
 'Jtapn.'ars certain that the mortality fron' fever 
 hasbf^eu'kscined in tiiose islands of the U est In- 
 dies in which this tre^iimont ha-, been fairly adopted j 
 and it seems to us, that analo2,-ical rcasoniuKr as wHl 
 j-s the statements ofDr- liarrv and Mr. Scarle, would 
 fully instify a trial of (he same method in Cholera, 
 Thl^'liist is. indeed, so yirulr.nt a pestilence, aud io 
 manv perish in the first stage of collapse, that no 
 treatment which human ingenuity can devise will 
 prob-ablv do more than rob it of a certain portion ot 
 Its moi-t.ility: but should even this limited benefit 
 be obtained" by saline medicines, exhibited o""'" 
 l^^;ncip!es of remedying' the rnorbid condition "i tha 
 blood connce<ed with its blackness, it will b« chiej- 
 Iv o\v'n<^ to the ststrmeuls cf Dr Steven on an snal- 
 
 A 
 
»goin »ul»jcct; lor Ihougli hi* paptT, as we have "said, 
 >ia» never bet-n piilili^iicd, yei <'ur account ot it has 
 made 1)14 d<ictniif:ii extiiisivfly knowu, and will tliua 
 kad to tlieir conliruiutiun if true, or their r«-)rclion 
 if foUe. 
 
 « Causr of the lird Colo, oj Ike litood.' 
 
 * As coniu'ctcil with the aliovo subject, we may 
 hy before our v.idc « tlic following' cmnmuniratiou. 
 c:xtracte(i fniin an Auiericuii jnunial. It is u litter 
 I'rom Dr. Stwall, the Professor of Aiiatomj an. I Phy- 
 nolo;,'y ill the Uiiiversitv of Wushiiijjion, which we 
 find published in the Boston Journal for December 
 last;— 
 
 ' " The cause of the red color of the blood has Jong 
 been a subje t of keen discussion ainony, iihysiolo- 
 ^ists. and nothing has hitherto a))|>cared upon (he sub 
 ject at all satisfactory, and a^^ainst which powerful 
 objections could not be brou;^lit. 
 
 *"Dr. Stevens, an emim^nt physician of St. 
 Thomas, has instituted an eKperinienlal inipiiry 
 into this subject, which has led to some iiovt I 
 and interesting results. Froru his e.\pcriiniiit it ap- 
 pears — 
 
 ' " 1»<. That the blood oihrs its red color m 
 iirely to the presence of the saline matter irliinh 
 is invariably found to i-.vist in it irhile in a healthij 
 alite. 
 
 ■ •' 'My. Th'it the dark color of cnioua blt<od 
 itrisesfrom the presence ofcirbonic acid, ichich, like 
 every ot'iirucid, livns the blood black. 
 
 ' " 3dly. T/iat lite oxytfen A\fthe atmosphere can 
 only affect Uie color of the blood ina.vmicU a.s it po>- 
 sesses a powerful affinity for carbonic acid, uiltich 
 it takes from the blood t,y attractinti it through the 
 delicate membrane that linen the broncliiat vexsets and 
 air-cells of the lungs. 
 
 ' " 4thly. That tlie removal of the carbonic acid 
 from the blood by the action of oxygen does not pro- 
 dwe a change in its color, u/i/css there be saline 
 mitter actually present, to impart to it the arterial 
 tint the moment the carbonic acid is ri-moced. 
 
 ' " 5thly. T'tat acids, alkalies, elenricity, and 
 every thing which deatr^tys the neutrality of s iline 
 inatter, gives to the blood a dark color 
 
 '• Whatever practical inferences or change in the 
 treatment of diseases these experiments may lead us 
 .to the idea that the red color of the blood i» owing 
 to'the saline matter which if contains, is entirely 
 new: and no one can deny to Dr. Stevens the merit 
 flif having been the first discoverer ol this interesting 
 fact, lie is still prosecuting his inquiries; and Ins 
 researches upon this and other subjects connncted 
 with it, promise much to the profession. 1 hey will 
 soon be laid before the public in detail. 1 have had 
 the pleasure of witnessing a number of Ur. Stevens s 
 experiments, as performed by his own hand, upon 
 the blood; and so far as I have had an opportunity to 
 examine them, they have been performed with great 
 care and accuracy, and were entirely satisfactory. 
 
 'We are aware that Dr. Stetens himself is about 
 to publish on this subject ; yet, as there are some 
 parts of Dr. Sewall's letter which 've do not clearly 
 comprehend, and as every thing relating to the blood 
 and the treatment of malignant diseases possesses 
 «-rc:tt interest at this moment we have applied to 
 that gentleman for information on certain noints ; 
 ghoufrf we .succeed in obtaining this, we shall lay it 
 before our readers in another number.' 
 
 In answer to the above, the following communica- 
 tion wai sunt to the Editor of the Ga/tttc 
 
 ON TIIK TIIFATMKNT OV JIAI.IO^IA^T D'»»:All.i 
 
 To the Editorofihe London Medical Oazttte. 
 
 SiH,- As I have never seen even one case of Indi- 
 an Cholem, of.<.m>e i can only judge of the (reul- 
 mei.t of that disease by reasoning from m.aloify, be- 
 twixt this ** other malignant fevers which 1 nave ao- 
 tually ..een; hut probably I wa. not lar from the truth 
 wheii I stated, that the practice which 1 had found so 
 us.ful in (he malignant lever., ol ilu: Western world, 
 wo.dd be e.iually Miccessful in the tna mento all o- 
 ther forms of malign.mt disease ; & perhaps, also, ut- 
 ter the treatment fias been fairly tried, the ""H""- "» 
 the practice in all malignant diseases will ultima el> 
 be nearly the same. 1 can no;,- add, that the same tieat 
 mrnt'whichl have recommended iii the yellow lever, 
 ii . lias been most extensively used, and with eipial 
 succ.iss, in the treuimont (.1 those malignant forms 
 of the n.ar.h fe>er which were huinerly so fa- 
 tal to the (ienesee country on the soutlieni side of 
 I.uke (J.itario. 'I'liis country is so Hat that the l.rie 
 Canal runs through U for u)mai<ls "' .-^'-^^'-'.^J' 'f.l'". 
 wit'i. nt even one lock. From being so flat it is lull <d 
 marshes : and .lnn:ig (he hot months, there are ma- 
 ny of the districts in that territory nearly as^ sickly, 
 and until lately, nearly as fatal, as the marsh fevers 
 of Sieni Leone. The result, however is now veiy 
 dilVerent, partic.ilavlv at lloche»ter, and other places 
 in that country, wh.;re the alkaline carbonates, ice. 
 are now u,ed in pk.ee of the calomel, or the mere 
 i.Mi-rative and bark treaimcnt, which were formerly 
 Inipiovrd in these localities with s() little success. 
 
 •The sick! e.s of the stomach which is so general- 
 Iv met within the eoniim'ue.'ioent olall those levers 
 Ih.f are produced by the specific aerial poisons is pro 
 bablv (he etr. ct of the poison itsell, winch is thiov n 
 out of the circulation.-and cau.ses "•'■'*•'<";"'"'';: 
 gastric organs, in the same manner that t"'t'"'-;<"_^ 
 antimony produces nausea and vomiting, when vv e 
 inject a su'all portion of that agent into a vein; when 
 proper remedies arc used, that sickness at the sto- 
 mach which begins with the disease soon V^^-^J^ 
 way but the peculiar irritation ot the gastr c or- 
 ganl which com'..s on at a later period, »"'' which i, 
 .>ten so distressing in the last stage, is evidently m 
 these fevers produced in u great measure ''J' "" ^^- 
 cess of acidity in the stomach, 'ih.s may per la s 
 arise from the decomposition of the saline mgie li- 
 entsof the blood by the • irvous 7; electric find 
 which appears to exist to excess in all fevers, but par 
 ticularly lu those of a malignant character. Alter 
 the decomposition, the acids of the salts may be at- 
 tracted into the gastric organs, where t'>t'y^^';\. ' 
 excess, and act as a source of 'ntensc irritation 
 This, however is in part theory ; ^"t there is no 
 •lucstion of the fact, tiiat there is mail the malignant 
 fevers of the new world, particular y in the last .stage 
 of these diseases, an ex. ess ot acids in the ahmei ta- 
 ry canal,which extends from the very tip ol the tongue 
 to the very verge of the anus. When we apply at 
 this period of the disease a piece of litmus paper to 
 the foul or red irritable tongue, the test is red lened 
 almost instantly: & when we apply the same paper 
 to the fluids ejected from the stomach, it is reddened 
 almost as suddenly as if it had been 'I'PPe ^ ' 
 a pure acid. In fact, even the matter of blaclcvom 
 (which is merely an internal eftusion of the black and 
 dissolved blood) receives such an addition of fixed a- 
 cid in the stomach that it etFervesces Ireely with the 
 alkaline carbonates. ^t. • » „„ ... 
 
 'The excess of acid which produces the intense 1 - 
 rifatioii in the stomach, is not the acetic, for even flu 
 iimlter of the black vomit lia» no sour imell. I hii 
 
 ms^-''% 
 
IIEAIKl 
 
 ]aztttt. 
 is« of Inili- 
 fthe trtal- 
 iiialojfy, l»e- 
 li I iiuvc liC- 
 III (he trutli 
 lUll touiiil su 
 ti^'ii world, 
 u'lit of iill ti- 
 ps, ul.iit, at- 
 u^ (ititliiii! uf 
 I ultimately 
 1' sumc treat 
 ellow li'Vcr, 
 Willi c'i|Uiil 
 
 ;llilllt I'olllli* 
 
 crly so fa- 
 i;rii siilc of 
 at the Krie 
 viiUy milesf 
 t it is full of 
 ere are nia- 
 y us sickly, 
 larsh fevers 
 s now very 
 )ther jilaces 
 (onutes, &c. 
 r the mere 
 .TO fiinntrly 
 i> success. 
 
 so general- 
 those fevers 
 lisoiis. is pro 
 ;h is tliritwii 
 itidii ill the 
 t taitari.'.ed 
 [T, when we 
 vein; when 
 1 at the sto- 
 tin pusses a- 
 e i;ustric or- 
 mil which is 
 evidently in 
 e hy an cx- 
 lay perhaps 
 ine inj^redi- 
 lectric fluid 
 vers, hut par 
 ter. After 
 
 may he at- 
 hey exist in 
 sc irritation 
 
 there is no 
 le malignant 
 he last s<af^e 
 he alimenta- 
 of the tongue 
 we apply at 
 nus paper (o 
 is red Jencd 
 same paper 
 
 is reddened 
 1 dipped in 
 'hlacK vomit 
 he black and 
 on of fixed a- 
 ely with the 
 
 le intense n- 
 , for even the 
 mell. Thii 
 
 exceM of Rcid ij prohahly drrifed from th« saline 
 matter of the blood ; and as the muriate of soda ii the 
 principal saline iupredicnt in the blood ; sol believe 
 that the muriatic is in fever the acid which exists 
 ia the greatest excess in the stomach ; ♦ but whale- 
 vcr the source of this acidity may be, it is, as I have 
 iiaid, at this jieriod of the disease, the true source ol 
 the intcnbc burning, and that local irritatioti, amount- 
 ing n some cases even to inflammation, which is the 
 real cause of the x.wtro-enterite of Hroussais. This 
 species, however, of the cnterite cannot be cured oi 
 ther by gum water, taken internally, or by leeches 
 applied to the pit of the stomach. The irritation is 
 produced by a chemical cause, and can only be re- 
 moved by chemical means 
 
 'It is at this period of the disease that the alkaline 
 CKibonates are of such infinite value : when we give, 
 for example, tho carbonate of soda, the fixed acids of 
 the stomach are immediately neutralized by the alk- 
 ali of the carbonate ; a large quantity of carbonic a 
 cid is evolved by the mouth, and the irritation of (he 
 itomach disappears almost as fast as if it had been re- 
 moved by a charm. 
 
 'By this (rca(ment we not only remove that irritn- 
 ("ou and severe burning ill the stomach whieh is so 
 distressing to the patient, and even so destructive to 
 the gastric orpns, but we gair another point, which 
 is, at this period of the disease, of still more import- 
 ance than the mere removal of a local irritation. The 
 fixed acids arc, as I have said, immediateiy neutrali- 
 zed by the alkali of (he carbonate. The muriate of 
 joda, and the other natural salts of the blood, are in- 
 stantly formed in the stomach itself. Now we know 
 that these salts do enter the circulation ; we also 
 know that they mix with, and become a part of the 
 circulating blood ; we know that they change its 
 
 1)roperties and remedy 'ts morbid condition ; we 
 enow also that they add to the stimulating power of 
 the circulating current , and enable the heart to keep 
 up its action. 
 
 ' In consequence of this addition of saline matter, 
 the kidneys and the other secreting org'ans continue 
 to perform their functions. The skin docs not be- 
 come yellow, nor the breath fetid: neither is the 
 mortality one twentieth part so great as it had been 
 under the old modes of treatment. Infact,the suc- 
 cessful results which have already followed the use 
 of the above practice, prove that the saline remedies 
 are the agents of all others the best that we yet know 
 of, for the successful treatment of malignant diseas- 
 es. 
 
 'When there is an excess of acid acting as the 
 source of destructive irritation in the gastric organs, 
 the treatment with the alkaline carbonates is decid- 
 
 cdly till' best ; and iIioiip flp,rnt< are ai drndrdly lfi» 
 worst, the « fleet of which i^ in diirct opposition to 
 that <if llu" alkaline salts. When there is no exr« ■-» 
 of acid in the stoinath, as sometimes occurs in fevti < 
 that are more mild, the carbonates enter the circu- 
 lation unchaiiKcd . and we know that when they are 
 mixed ou( of the body, even with the blark blood ta- 
 ken from (helicnrt "f "those who have died of the yel- 
 low fe^rr, tluy ri.ltlcn its coI'T as much as (he mu- 
 ri:i(P I't si)du, lir any of (he <Ftlier sd'onpr salts. I 
 have also .stutid, that all (Ik' ncids blacken tl-i' color 
 of the blood so r..iii|il. t.lv, (li;il w ith tlu addition of 
 a little waltr* <\«n lir.dihy arleriul i)ln{id is iniiiiedi- 
 ately converted into a lluid exactly icsuobliii^ the 
 black vomit. 
 
 'The dark color of (he blood, which we observe in 
 the bei'iniiinn of pi stilential le>eis. is the rflett of 
 the poison oii the \ ital fluid; but ilio hlarkurss in the 
 lust stage of these -liseases is produced Itx) Iht lohsuj 
 the sfiliiic iiigipiliinlx,^ wlncUl can prove are be- 
 yond all question the true ciiu.'-e of the red color of 
 healthy blood. The meic tact that tho hlood has a 
 (lark colcir in allthe f^ers which arise from poison 
 has been longknown hut the '.MUses of this dark co- 
 lor have hern but ill understood Anattemp/ to red- 
 den.thr dark color of the bhick Mood in fever has been 
 with some practitioneis. the chief object in the plan 
 of cure ; but ignorance of the real properties of the 
 vital fluid, has led to errors which have been even 
 more fatal than those which now generally cxi;.t a; 
 the consequence of the doctrine of iiiire solidisin. 
 .\cids redden the blue of vegetable colors ; and these 
 agents have been extensively used by a certain class 
 of physicians to redden the blood in various diseases 
 on the supposition that they contain an excess of ox- 
 ygen, which they would give over to the black blood 
 "nnd thus redden its color, The fact is. however, 
 that though acids redden the vegetable colorii.g mat- 
 ter, they com])lct«ly destroy the red color oftlie 
 blood ; yet these arc the very aireiUs that in fever 
 have been thrown so unmercifully into an orgu ), al- 
 ready burning from an excess of acid, on purpose, 
 tts they say, to redden and rcviviiy the color of lUv 
 dark blood, 
 
 ■i shall afterward have occasion to bring forward 
 some melancholy proofs of the fatiil eftects of.the acid 
 treatment, and to show that, in some places, it has 
 been already used to a fearful extent The calomel, 
 and some other modes of treatment, have done much 
 mischief,* but the acids have been the agents of all 
 olliers, the most destructive in the treatment of the 
 yellow fever, and other diseases that really possess a 
 malignant character. 
 
 *We are indebted to Dr. Proiit for the discovery that the muriatic is the acid that is chiefly generated in 
 the morbid conditions of this organ 
 
 tThe above paper was written previous to the appearance of Cholera in thi< country. The blood in this 
 disease has since been analyzed by Dr. O'Shaghnessy, Dr. Turner, Dr. Thomson, of Glasgow, &c. They 
 all agree in the fact, that there is a material diminution of the saline matter. Dr. Thomson however, makes 
 the diminution to be less than any of the others; but the cause of this has been ably pointed oirt by Dr. O'- 
 Shaughnessy, in one of the late numbers of the Lancet. 
 
 ^'i'hc calomel practice, in Cholera, hud been tried at Warsaw, and found to be of no use. even before the 
 arrival of Mr. Searle in that city, Notwithstanding this, he conin>enced with his favorite remedy ; but, ac- 
 cording- to the latest accounts, he had been trying the saline treatment with the most marked success . The 
 calomel practice appears to have completely failed, even in the hands of Mr. Searle, who is known to have 
 been one of its warmest advocates. In one of the lafo numbers of the Journal Unirnsnl ct Hebdomadaire 
 we find it stated in a letter from M, Londe, the President of the French Omraission, now in Polaiid, that 
 * The principal means used here against the Cholera, are 1. Calomel in .strong doses, (from 8 to 20 S"- ^f^ 
 
 hour, or even half hour.) It is administered here in the Hospital do Bagatelle by Mr, S ?n English Phi 
 
 tycian. In this Hospital the mortality is frightful.', 
 
 I 
 
H 
 
 hitok from thi Iom (if iln taline in-n dicuts, oxygen 
 ]% not ultrartcii into the ciifiiliilii''i I'l Ihu Iuii^k aitfir 
 fheieiiKiv.il of ihc cirlj .nic aciJ ; it liivst, if it l)C at- 
 tracted lit Hint pcrioJ. "W-i 'lin ,lnuiKC»t oxy.u'i lum 
 no niiTc ellccl m ir l('.niii- llie lIuiU bliuicl lluiii it 
 hail in reJdciiinn Hie l''""-''^ '1"' t''''* '''^^ '"'''' "*'"'" 
 line trirtttiT, un.l nf ccursi' ii> rrd cumr h'oin uunici'- 
 ^lllnindi^tillta wutcr. V.t. tlimmli tliis pvactii'.! 
 b\n b.'L'Uttlrcaily \vi'i;;lte.l in the I ul.uicc ami (nun, I 
 wanting, wr arc nnndyid alii>i)''t iluily l»y tlic rec.ita- 
 iiicrulntiimufnieati.* fur o\^-','fii;»tin'^ t!u- l.laclcblr.o. . 
 r>xyKcnalin|j;thc liliinl Imwov.'r. in n no n>c m »uih 
 ra^ci, for the blood can only bo rrddi-ix d l.y saliiio 
 rrmtdiffl. C'alomil fiiul antinimy nay Irct tlu; sto- 
 mach, and add tot'.io .iill'crin'. il the jiatiunts. A- 
 f idi and opium rnnv and do diirktMi and dcslniy tlii' 
 md color of the biood; liuL whin tlic i.-d cohu' is lo-t 
 an in bad frvcr, it (.an ' nly ho rcMori d l.y th- isc (" 
 thone reiutdics whicli .uo. inrculay, in its Ucalliiy 
 itr»ti-, the true cause ol 'Hh ivdiioss. 
 
 •It may b.-. casilv asccilainod, hy th.- litmus paper, 
 wlicthrr' there be "or he net, in Chohia. :\n (•\c(!.«ts(f 
 acid either in the blood (-r in th.; fluid cjoit.-d lr.;m 
 ihc Knstric orpans. If thorn bean oxctss ol ai-id. 
 then the alkaline carbon ito-s arc th(> rr medics, oi :dl 
 other*, the moiit likelv to be useful ; i» then- he no 
 excess of acid, thci the luiNiuic of muri;ite ot sod.i 
 «nd nitrate of potass uiav pi"h;iblv !;c preferred; nnd 
 «9 all parties ai;rec in adiiiiitin-; (hat. durin2;lb(dirsf 
 utacc of Cholera, the b'.o.d is not only di-euHcd. hut 
 blitck in color and thick in it i coris^tonce, I am, 
 therefore, inclined lo believo that, ii)i./r>- fill cin'tnii- 
 stances, thenon-puri::('tirr sili;ie vinhrnifH are he 
 remedirs, of all oth,'r», Ihu m"-t lilcdn to bo nHfJnl; 
 for they not merely redden llio color of tho blood, 
 but,by"iiicreasini; thclliiidity ofils solid inar^-diOMts, 
 nndaddins t.i its stinuil.iiinaf pr^M-er. they will ren- 
 der the blood iTioiv fluid, and. of course, better btlod 
 to serve the imp<ntant function's which it is intend- 
 ed to perform in the livin'.!; -.v-toni. 
 
 ' I will afterward lirini? forward so ne very stroni; 
 facts to prove, that tlie aerial poisons which act as 
 «he remote cause of the essential levers, do not pro- 
 duce their cfTect bv any direct impression on the 
 nervous sy.stein; on the contrary, thcv appear, like 
 the oxygen otthe air, to be ;.itractod into (ho circu- 
 lation, and produce their ellVcts oi the so.ids of the 
 svstcm entirely thrnuuh the medium ol the blond. 
 The diseased state . f th"blo:.l is th.: immediate 
 cause of fever— the disfias -d e.ction in the solids is 
 merely the efTect. I ha • .• seen cuscs in which there 
 vfAi no excitement fr.Mn I'vsl to last; yet these very 
 ■cases, in which the solids were not iniurod, cveu in 
 the least, were of all others the most fat i . 
 
 ' \11 the fevers from pois^m arc ironerally preceded 
 
 by nstaKe of torpor; lor the first elVect of the poison- 
 
 ed blond is to paralyz ' the heart, and indeed the 
 
 whole of the vascu'ar organs. The continuance oi 
 
 this cold stac^e, is in prop' riion t>t!io quantity or the 
 
 rirulcnce of the poison that hus been taken into the 
 
 system; but in all such cases, reaction is the road 
 
 ov which the anim.d oconomv marches to health, 
 
 and the first duty r-f the. p'.ivsicim is dccideaiy to 
 
 brinK on reaction, or fever as speodilv as he can. 
 
 When this is efTected. shonld thi reaction run hiih, 
 
 he excitement maybe rodncod bv tn > hsc ofthe 
 
 lancet, and the typhoid symptoms, which sometimes 
 
 nlUrnard occur, may probsblj bciucienlcd by the 
 
 Hill) tcfpiciit use otth« carbonate ofiodii, and other iu» 
 line nadicinifl, which wo know do peiixess the pow- 
 er iif preventing; that black and dis.-olved state of 
 thebloicl. which is, in reality, in I'l v( r, the true 
 cause of the nervous as well an the other bad symi- 
 
 lUUJS. 
 
 'The difui.ihle stimuli proihur their i fleet in some 
 cases, bvn dirtctatid transitory impression im the 
 nervous" svsum; but. .is ali'Ludy slated, the saline 
 ai'enl* enti-rtlie circulation, mis; 'Viih, and bz-conic 
 ■par, of the binod. The Mood is lb" natural stimu- 
 lus if the heart, and the i.etivo non-purt-ative saline 
 ni'dicine.s decidedly add lo its stiiiiuiatin;^; ^1(>wer: 
 till St', when •.•,i\c!i (iirly in Chidera, and i;i active do- 
 ses, \\ ill by incveasin',' tin; stimiilatini; power of the 
 > il.il fluid, enable it to act with more force on the 
 vastii!urorp;ans and in this way rou'-c the p.iticnts 
 from (hilt cidil lit.orstane of torpor^ in wlueh it ap- 
 p. ;irs they t;eiierally die. „. ^ . ., „„ 
 
 ' Krmi/what I hav;r seen oft'ieir enects in other 
 dieases. 1 have Utile dimlU that, if the saliiu niedi- 
 cliies be f.iirly tried, the n:(iitai;ty from <,'ho,era will 
 be con-idtrably le.^s than it has liiiberto licen; but to 
 s:iv thetruih, 'I do not anticipate mueh advantage 
 frem eithrr the saline or any I'i'aer remedies, or iie- 
 lieve (hat ihev -.vill he fairly tried, rr -enerally !nc- 
 cossfiil. so (oiij; as thev are i.^edby pructitioner.s 
 •.vbo believe that fever is a ncrvmis impression, and 
 who believe also that all our retnedies in that disease 
 act merely by sympathy, or some my-terious a^'cncy. 
 on tb<! neivi's of the stomach. _ 
 
 •It is well known that many practitiouers^ lia\e 
 Inn" been in Ihe habit of usin;-; (lie saline mcdicmes, 
 pi-^i( iilarly as piir'jatives, in the tre;;tment offever; 
 'indin.inv mHI continue Muir use, merely for the ve- 
 ry ';ll|.^"tan(ial reason (hat they lind them iisclul, 
 'I'he true reason, h.-nvcver. why these remedies are 
 60 (U cidedly superior to all others , in thii trcatmc'iit 
 of this dise'ase.* has not, I believe, been R-enerally 
 understood; and therefore these medicines are often 
 combined with acid- . eiilomel. or oilier advers.- .yid 
 powerful a-ents, which i-revitit the j'ood dlcct that 
 would otherwise have followed the judicious use ot 
 the active saline a-eii(s. when nivon on a ste.idy 
 nriiiciple, and used only at certain pern ds of (he di- 
 sease , where they can do no harm, and when there 
 is almost a certainty of their Uoin-;- pioil. 
 
 ' I know it will l)"e asked, why have tho <;dric and 
 other acids been successful in scurw. w.'.erc the 
 blood is darker Mian it is in health ! 'I'o this it may 
 be answered, that (he scurvy is not, like the ciiolera 
 or (he vellow fever, a disease that causes death in a 
 few hours , or a few days, and theretoro medicines 
 that may be used without causinc; immediate death in 
 the one, cannot be used in the others with emial im- 
 iiunity My own conviction is, however, that there 
 Is no (me disease in the whole eatih-ue m which 
 the profession has been so much misled as in the 
 -ery disease now under considcnition. Uurmg a 
 residence of twenty years in the West Indies, 1 have 
 only fcn one case of scurvy, and that case was de- 
 cidedly brouo,h( on by the excessive use of citric 
 acid which an American gentleman had been recoin- 
 ni-nded to use as a preventive a^-ainst the yellow te 
 ver. His own conviction as well as mine, was that (he 
 seorbutic symptoms had been brought on by thi^acid. 
 This was immediately laid aside, and, under the use 
 
 -M kno^r one r...pcctab!e practitioner in thi. eouutry, who has been using the chbuate, of pota.^ 
 !»!» Ri«« T*ari with grcit advantaRs'in the trealmtnt i^f tvphui. 
 
 C-)r the 
 
 of (he carUi 
 three wceki 
 10 kee the c 
 salts and thi 
 I would rvc 
 neper, on I 
 McdicdChi 
 
 for mm. 
 
 ' It has 1(1 
 a common t 
 conlouiu' a 
 sameness ii 
 occasionally 
 Xtu* and in 
 ditrereiit fri 
 The one i» 
 mere monn 
 a severe lo 
 other, hov. i 
 cd by the e 
 in the sytiti 
 blood, .'ind 
 the body, 
 remedies _v 
 not only i: 
 other 
 
 'The As 
 fatal discas 
 dicious tre 
 morbid poi 
 of this cou 
 most cntiri 
 were it at i 
 numerous 
 others, wl 
 fused to ta 
 brandy ant 
 fit, on pur 
 possible, 
 dent, the » 
 verc as tlu 
 though th< 
 brandy a> 
 just as Wl 
 day, than 
 oil. 
 
 • There 
 history of 
 formidabh 
 the yellow 
 proijuceb 
 of heat to 
 when the 
 below a c;; 
 poison of I 
 mornin^io 
 yellow fei 
 appears tl 
 can prodti 
 the roiddl 
 plains oft 
 the contao 
 plying tl 
 m every t 
 if it once 
 main her* 
 bnt to fut 
 mortality 
 poses a 1 
 
 * Nami 
 
 is««tii 
 
il«M^ 
 
 left hy Ihi 
 
 mil iithur if 
 tsa the V)OW 
 veil sliite of 
 (I-, the true 
 r bad «jrm- 
 
 nVct in some 
 • ssidii on the 
 il, ilir- saline. 
 
 unci liccoriic 
 tnnil Htirmi- 
 ;^;itivc saline 
 idn;:; ^)l>wt'r; 
 ill ;i;;tivf! do- 
 liuuci" ofthc 
 
 (nrof; on the 
 
 the )-t''»^»<'< 
 
 I which it iip- 
 
 Vects in other 
 siiliiij nicUi- 
 
 <,'ho!t ra will 
 ) bcin; hut to 
 I'h n:lviint»gc 
 >c(Jiij;:,or he- 
 :;;tiii'nv!ly sno- 
 
 liriu'iitionLTH 
 jirt'ssii'n. and 
 
 II thut lUseaRe 
 'lidus ii^cncy. 
 
 itioiKMS have 
 mc moilicines, 
 iiirnt of fever; 
 !y lor lhi> vc- 
 (f tlicoi nscl'nl, 
 .: roiiiodicH are 
 the treatment 
 >een Ronerally 
 lines arc ofti'n 
 r iiilvrr'.i' and 
 io<l clici't that 
 tidicioiis use of 
 n on a steady 
 ■ri( ds (vf the di- 
 uid when there 
 [id. 
 
 tho ritricand 
 y. wl'.erc the 
 I'o thiH it may 
 Ice the cholera 
 uses death in a 
 foro ine licines 
 lediatf death in 
 with ('niial im- 
 I'ver, that there 
 l'ic;'ie in whicli 
 isled as in the 
 tion. During a 
 t Indiesj 1 have 
 it case was de- 
 e use of citric 
 lad tieen recoin- 
 ist the yellow fe 
 ne, was tiiatihe 
 it on by the acid, 
 dj under the usf 
 
 f potam for the 
 
 • 
 
 ! 
 
 •f the carbouata o( loda, be nai cuni;>letely riirtd in 
 three week* To thuie, however, who are dt!i|)o>^ed 
 tokee the conlratt betwixt the ellcctii of the neutral 
 lalti and the citric acid, in the treatment of tcurvy, 
 1 would rccouimenil the |ieruital of Mr. Cameron * 
 ni<.|ier, on this <li>eai>e which they will find in the 
 MedicoCbiru.gical Review, in one ofthc uuu»bcr< 
 for 182!). 
 
 ' It ha» long been, and I am snrry to ob»er\ c still i* 
 t common source of error, jaiMi ularly in fever, to 
 cnnlnuiu' a similarity in certain syniiitonis with « 
 •anicness inUiiid. The sixuadic cholera, whieli is 
 OCcaiiionally nut with dnrinj; the hotnionths. Imtli in 
 thin ami in other countries, in evidently as tut.dly 
 different fiiMii the InJian Chokra as east is from wcot. 
 The one IK a syiiipiu' . tic alliction, followed by a 
 mere iiionii'iitary e a aemciit, arising in pari fin in 
 a severe loeul init.ilion in (he i;itslric oi(;ans; iho 
 other, however, in a most malignant disease, priilnc- 
 ed by the existence of asiieeifie. ;>nd viinknt iioJM.n 
 in tlie syoleni, which contaminates every drop of the 
 blood, and excites diseustd uc'".. in c.eiy solid of 
 the body, t-iich beini! <he fact, it is evident that 
 remedies which arc successful in the tiie, may be 
 not only inert, but even actually injurious in lliC 
 other 
 
 •The Asiatic Cholera i.'»,as wc well know, a iiio,t 
 fatal disease, and will iei|uiie both an active and ju- 
 dicious treatment to oveicome the evil effects of the 
 morbid poison; while the sporadic or plum cholera 
 of this country maj-, 1 believe, in most cases, be al- 
 most entirely left to itself to work ilsown cure; and 
 were it at all necessary, the cases which are riow so 
 numerous in most of the journals, miftht be faced hy 
 others, where the patients were obstinate, and re- 
 fused to take any otne: remedy exce|,t a liltie warm 
 brandy and water, which was given during the cold 
 fit, on purpose to brini; on reaction as .soeei'ily as 
 possible. In one case, which 1 saw lately by acci- 
 dent, the symptoms for the time, were quite as se- 
 vere a.s those described in the various journals; yet, 
 though the patient refused all remedies except warm 
 brandy and water during the cold stage, he was 
 just us well (perhaps even better) on the followirg 
 daj-, than if he had taken 125 drops of the cajeput 
 oil. 
 
 ' There is one circumstance connected with the 
 history of Cholera which renders it a ninth more 
 foimiiiable disease in northern latitudes than cither 
 the yellow fever or the plague The poisr.n which 
 produces the yellow fever requires a i^iven decree 
 of heat to enable it to exist in the a(ni.'v| here; and 
 when the ihermometcr cither rise., or falls al-ove or 
 below a given rasiffc, the placue disappears. Put the 
 poison of Cholera is not rendered inert hy (he first 
 morn inir of frost, as is the case with the poison of 
 yellow fever in the United States of America; for it 
 appears that this poison like that oftlic smnll pnx, 
 can produce its fatal effects almost a* certainly in 
 the middle of winter in Itussia. as in the burniita; 
 plains of the Torrid Zone. When once iutrndured, 
 the contagious poisons possess the power of multi- 
 plying themselves; and, as the Cholera poison acts 
 in every tempeniture, it is more than probable that 
 if it once finds its way into this country, it may re- 
 main here as a fatal scourge, not only to the present 
 but to future generations This, as well as the great 
 Btortality caused by the poison of Cholera, im- 
 poses ft solemn respontifoilitj on those who are, 
 
 oral least ought lo b«, th« guardlafti •(»»»« ?"»>«»• 
 
 ^".JlVrcent 1 have merely given . f'«.™' ;«;;»^,*; 
 but the bame subject Will be con.idrred »'*;«»« 
 n» re n, detail. Ihe above ha» been « r.tten n ha.t. 
 nul may probably contain more error. «»'•»""•• 
 should t^he' treatment, however, vvhtch has been^o 
 u.elul in the malipnau disease* r,l «h«; m- ^ Worl^^ 
 bef.nnd, even in the shuhtesi ^^K^"' '''J""?, jh! 
 
 sulTeriugs ordimini.h f^« ""'L'-'f If .jl^T.V" 'aid 
 other divisions of the ghbe. I shall then " "r*"' 
 forthedisid^c which I now fee '" »PP^"'.^"S ^^^^ 
 fore the profession ns the advocate "f.^*^,*^'"";* !, 
 muchinoppo.ilion to the com.i.rn "P'"'""*.?; '" 
 present day. That this may be put down to .U pw 
 Dcr ttcccuut, isthe wiihot, 
 
 Sir. youv obedient servant, 
 
 .Stplemhcr '- '831. 
 
 \ n.nv :, .. unserve, that «hcn the paper was rtfttl 
 
 at ft', I'oiicKeofl'hvsicians, abi ni fifty copie* ol I 
 
 were hastily piinled, and m<Mt of ihem were <lutri- 
 
 billed chiefly amoi.Kst my friceds in this f'^^^^J 
 
 Three or four copies of it were also sent to rails, 
 
 and the same number to seme of my f"*.' ''* I" V^.t 
 
 many. The experiments and (acts contruicd in thU 
 
 ,n,,,Jr, aswell astle .eviews of it ^' "^l'.''*^ fP' 
 
 peared in this er untry , were tn;r.s'i»»fd mto »h« 
 
 Weech and Cerman journals, and circu ated by /"f" 
 
 all over Europe. It is. therefore, not '"'P;;''»^"5'«' 
 
 that it was this which led the two German ph^. 
 
 cians* to the use of the saline treatment in Cholera. 
 
 'ihe muriate of soda was the reii-edy on which thest 
 
 gentlimtn rhiifiy relied ; and vy way of htyiDf a 
 
 theory of their own, they usrd it bs an r met C. and 
 
 cave It in the becii.nirjrin fvch quantilir* UM it pro 
 
 duced vomiting, after which they used it in uroaller 
 
 quantifies; and to this in all probability they wcr« 
 
 er.tirelv indebted to their great success. 
 
 Il- 1{?S1, these genthmen I nd charce el the t ui- 
 tcm heusc Hospital at St. Petorphurph. in winch 
 there were in all t'.i-.ring the epidemic, thiity cases 
 of cholera ; and of this number they lost three ra- 
 lients. and twentv-reven recovered I inerf.on this 
 fact on the authority of Sir WiViam Crichtrn: who 
 states also, that at the n.-nuest of the Emperor, he haa 
 communicated this practice to the army physiciai-» 
 in ro'and. 1-y whom it hr.d been frv.nd to be very ad- 
 var'.ta;:eons f . , , . ^ 
 
 About n-.esrme time. Mr. Pe.ir?e fried this treat- 
 ment at Wi.rs.iw. He I'sed it in ciyht CH^es. and in 
 everv r-e of Ihem he succeeded in brinjr.ngon r»8C- 
 ti-n." Ar.ftefthem, howe- r. died xffeswai I,— nrt 
 from cliob ra. I lit niider cirii.m^tur.ccs "i the n.rft 
 gross rcElect rn the invt rf ibeir atfTcePt*. !\.r. 
 ^•ear:e. at (bat peried, eonsiderfd the nu'irtr of go- 
 da ao a viilwMc r(7nrry; but when he had an eprof- 
 <n-;tv afterward of giving the saline treatment n fair 
 trial at Irer'in, in place of doing this— by which h« 
 would proiablv have drne much good, and gpintd 
 grert credit to himself— be returned to his old ca.o- 
 iTie! practice: but (he destructive effects of this were 
 so ohvioMs, that the German physicians corapellod 
 him to discontinue its use in that capital. 
 
 As noon as it was genera'ly krowu that 'he Chole- 
 ra I. ad made its nprcamnce in ibe n rthof Frir'i'nd. I 
 wrote to a physician in Sundeilnnd. recrmmendifi|f 
 him earnestly to give tl>« non-pnrgatiT« nc titral limits 
 
 * Namely, the (wo that are referrtd to in the letter of Dr. Btrry . 
 ) B«« the Suppl«m«ntarf numb«r of the Medical Gaactte for .Tawu 
 
 .Tawubry lik. 18<t2, 
 
lO 
 
 r' 
 
 a fail- tii;il, m any oaii':. \vhi.'re eillior luuiseU" or his 
 fVieiiUs might have an oiiportunity "fusing it. Soon 
 afterward 1 sent him a second letter ; hut from that 
 day to Ihi- I have not rectivcd an r.n.v.vor t!> ciUior 
 41)e one <<r till' nthcr. Hiji reasons (w siich conduct 
 are best linowii to liimself lie h.ul prcvicusly pre- 
 tended to L'e tny IVictui, and, so far a; I aiu awaie of, 
 Ihad never :;iven liini the slightest olVcncc either iu 
 word or deed. 
 
 Wlmn the t'holcra made its apjiearanrc in this me- 
 tropolis, I did every t'.Mii;; in my pinver to induce ii'y 
 medical frien:!s who were in practice to try t!ie sa- 
 line treatment, and some of them did give it a trial 
 in a few instances; but it was either in (he most 
 hopeless cases, or in the very last stage of the dis- 
 ease; consequently, the result made no very (avora- 
 ble impression. Others used the saline treatment in 
 milder cases; br.t they combined it at tlie same timo 
 with opium, brandy, calomel, and other improper 
 agents J consequenily, the good that was gained by 
 the one was lost by the others. 
 
 About this period, cases were published almost 
 daily in the various journals, statin:; the successful 
 result of the saline treatment; but still all '.his made 
 no impression, either on the Board of Health, or on 
 the generality of practiJicners. Those \>ho believed 
 that tliolera was produced cither by a nervous im- 
 pression, or a local inilanunation. would not try the 
 saline practice, because they could not see on what 
 principle it could possibly do !>;ood. Sonic would 
 not try it because it was too cold for the stomach: 
 and one philosopher of tlic right old breed, who ap- 
 pears to be ignorant of eveiy imjjrovement that has 
 been made in the profe»i<Mi for the lust fifty years, 
 when he was told that in Cholera there is a deficien- 
 cy of saline matter in the blooil, declared that it was 
 all trash, —and even if the fact were true, he could 
 believe it just as possible to make up for a want of 
 the bile by throwing ox-gall into the stomach; as cre- 
 dit even for a moment that salts could be of any use 
 by entering the circulation, and acting on the blood.* 
 Ill short, almost every one that I met; with luid a the- 
 ory or a practice of his own, which he was deti aii- 
 ned to supjioi't, and was ctjually ready to throw cold 
 water on every tiling like improvement that was pro- 
 posed by another. 'I'liere were, however, some bril- 
 liant exceptions to this ruk. 
 
 In the beginning of April, I received a visit from 
 Mr. Pout, a medical fentleman in Albany-street, 
 •who called to inform me (hat the Cholera Had broken 
 out in the prison at Cola-Uath Fields, and that he 
 had been requested by Mr. Wakefield, tl'.e surgeon 
 who had charge of the jirisoii. to say that he would 
 be glad to show me the cases; and from what he had 
 heard of the sidine treatment, he should be very wil- 
 ling to give it a *rial— the more so as he had now no 
 longer any faith m the common remedies. 
 
 On the" receipt of this messagfc, I inimcdialcly went 
 to the prison; and after some conversation with ^Ir. 
 AVakefield on the subject, he noi (i.Iy agreed to a- 
 dopt the saline trciitm'cnt, but invited mo to attend 
 the cases along wiHihim. Tie consented also that 
 Mr. Crooke, a vo\i!ig medical geiit'eniaii who had 
 lived with me for several years in the West liulic-s, 
 s'',mld be allowed to remain constantly In the prison 
 to see that the mcdecines were laithtully administer- 
 ed, as well as to take notes of the cases. 
 
 Tlie following is an outline of the practice which 
 was pursued, not only in the prison, but every where 
 else where 1 have had an opportunity ot treating the 
 
 'Ki^rsV. The (reatii ent was generally commenced | 
 
 with a Seidlitz powder, which was given vith a view , 
 
 of lessening the gastric irritation, and partly lor l.ic ^ 
 
 purpose of removing tht ciiseased secretions from the ^ 
 
 Intestinal c;uial. . •. n / i,:„k ' 
 
 H..,-Uy When the stomach was irritabb., (>vnicn ; 
 it -■meraliy was,) a large sinapism was immediately 
 applied to the epigastric region, and where the pa- , 
 tienti were cramped in the extremities, frictions 
 were used with hot flannel. The pain produced by 
 the spasms in the muscles were not only reli; veel by 
 the frictions, but by this and the app ication oi si- 
 napisms to various parts of the body, the quantity ol 
 animal heat was increased, and this, 1 need scarcely 
 ay, is an object of great importance in the treaiineiit 
 ofCholera. 
 Thirdly. A pow(?cr containing j 
 
 Carbonate of soda, half a drachm, j 
 
 Muriate of soda, one scruple, \ 
 
 Chlorate of potass, grs.vij. ! 
 
 was dissohed in half a tumbler of water, and given i 
 soon after the Seidlitz. In severe cases, the above 
 powder was administered every halt hour. In those 
 that were less severe, it was used every hour, and lu 
 some malignant cases it was given every fiKecn mi- 
 nutes. In shoit, it was : iven more or less frequently 
 according to the circumstances of the cio, and con- 
 tinued until the circuhdion was fairly rcstore:el; it 
 was then given at longer intervals, and when the re- 
 action was completely established, it was left oil by 
 
 de;'-rees. . • ■. 1 1 ji 
 
 Fourthly. Whrre the stomach was irritable, tlie 
 use of the above powder was occasionally suspended 
 and common etiervcscing mixtures, or small doses ot 
 the common soda pov.d.-rs, wi'h an excess ol the 
 carbonates, were frequcitly used, until the irritation 
 was lessened, and then the carbonate of soda wi li 
 larger doses of the chlorate of potass were generally 
 given without the addition of the muriate ot soela, and 
 frequently iu such cases the chlorate of potass was 
 glv.Mi by Itself, in doses containing ten grams each. 
 
 Fifthly. A solution of muriate of soda was also 
 thrown up into tne intestines, at as high a tempe- 
 rature as the patients could well bear this saline 
 
 "sixthly. In two very severe cases, which occurred 
 out of the prison, the p.atients were put into a hot sa- 
 line bath with evident advantage. It is well k""^". 
 that a hot saline (laid is a better conductor of heat 
 than fresh water at tho same temperature; but, inele- 
 i.eudent of this, apart of the saline ingredients n'ay 
 Lo absorbed from the skin, and the patients may a so 
 be benefitted by res|.iring the hot saline vapor. It is 
 but fair to state, however, that this means, which 
 was evidently hcneficiid in the cases m which it was 
 tried was proposed by Mr. Marsden, one of the sur- 
 „c ;ns to the Free Hospital in Greville-strect. 
 
 Seventhly. Seltzer wafer Avas allowed ad libitum, 
 wl'un the patients expressed a desire for something 
 to drink A strong infusion of green tea was also 
 occasi<nial!y used, in severe cases, apparently wit- 
 advantage. 
 
 * Such physicians as this arc justly entitled to the -'"Siu- ^y^"ch a cer .n^rac Urn n^ 
 in Moliere's inimitable comedy of l;;^^^^^^:;::^:^-^;^:^^: ^no^ ane^ens, e(^ que,,amais il 
 Kulu :^:;ei:d.:^: ni' ^n;;:;^ ^ il^^lStS if ;xpli"::,ce. dcsVetendues de notrc .iecle. touchantla 
 circulation du sai.g, e( autrcs opinions demcme lannc. 
 
 Eighthly 
 
 to keej) a I 
 
 where the 
 
 W'cll know 
 
 collapse Ci 
 
 ning and s 
 
 of the tw 
 
 coldest: fi 
 
 as an exci 
 
 independt 
 
 force, wii 
 
 through t! 
 
 greatdeg 
 
 Now, wli 
 
 low, as it 
 
 air which 
 
 small qua 
 
 black veil 
 
 air, and c 
 
 of the su( 
 
 Ninthb 
 
 dismiss t 
 
 least, se\ 
 
 of the c; 
 
 Cold-Hat 
 
 been at tl 
 
 of this. 
 
 Tenthl 
 
 use one ] 
 
 least fnt 
 
 state of ( 
 
 on'!, <'ro;i 
 
 and one 
 
 tal in Gi 
 
 after ha\ 
 
 danger f 
 
 panied \ 
 
 Eleve 
 
 the salir 
 
 this; for 
 
 struetiv 
 
 good ; bi 
 
 to be gi 
 
 considei 
 
 last stag 
 
 i.ig feve 
 
 .loweve 
 
 thirty i 
 
 VA ater, i 
 
 ^ rectum, 
 
 vantage 
 
 ; Whe 
 
 ties of r 
 
 casiona 
 
 such ca 
 
 small p 
 
 Whe 
 
 we arc 
 
 ticnt al 
 
 course 
 
 the mu 
 
 rate, or 
 
 d lately 
 
 • every 
 
 three d 
 
 be broi 
 
 cnmuK 
 
 fail. w< 
 
 a not be 
 
 the \fi 
 
 The 
 
 ought 
 
c practice which 
 ,biU every wP.cre 
 ity of treating the 
 
 rally coramenced 
 given H'itha view 
 [id partly (or t!ic 
 icretions from the 
 
 i irritabh., (which 
 was immediately 
 and where the pa- 
 •emities, frictions 
 I pain produced by 
 t only reli: ved by 
 application ofsi- 
 Jy, the quantity of 
 s, I need scarcely 
 :ein the treatment 
 
 a drachm, j 
 
 :ruple, | 
 
 vij. ! 
 
 water, and given i 
 c cases, the above ' 
 lulfhour. In those 
 every hour, and in 
 n every fifteen nii- 
 'c or less frequently 
 the c.T '.', and con- 
 fairly restored; it 
 s, and when the re- 
 1, it was left oil' by 
 
 was irritable, the 
 isionally suspended 
 us, or small do'^cs of 
 h an excess of the 
 , until the irritation 
 lonate of soda with 
 tass were )rcncraliy 
 muriateof soda, and 
 orate of ^1otass v;as 
 ig ten grams each. 
 . (if soda was also 
 at as high a tempc- 
 ell bear this sahne 
 
 ses, which occurred 
 ere put into a hot sa- 
 lt is well known, 
 ;r conductor of heat 
 :iperature; but, inde- 
 linc ingredients n'ay 
 lie patients may also 
 >t saline vapor. It is 
 t this means, which 
 asesin which it was 
 Kdoii, OIK. of the sur- 
 revillc-strcct. 
 
 allowed ad libUum, 
 iesire for something 
 
 green tea was also 
 ases, apparently wit' 
 
 oner gives to his son, 
 qui me plait en lui, ct 
 •lens, et que jamais il 
 trc licclc, touchant la 
 
 11 
 
 Eighthly. It was considered essentially necessary 
 to keej) a large ftre, both night and day, in every room 
 where there was a patient with Cholera. It is i.i-w 
 well liiiown that in by far the majority of cases, the 
 collapse commences beiwixt two o'clock in the iimr- 
 ning and .six A. M., or, in oMicr words, at Uie period 
 of the Iwentv-four iiours when *he atmosphere is 
 coldest : froio which it appears that external cold acts 
 as an exciting cause to the state d asphyxia. l>ut 
 independent of this, we have seen that the degree of 
 force, with which oxygen can remove carbonic acid 
 through the medium of a membrane, depends, ma 
 great de^jrec, on the tempc .iturcof the t\v<> fluids. — 
 Now, when the teniperature of the blood is so very 
 Fow, as it is during '.he state of collapse, and if the 
 air which tlie patients then breathe be also cold, the 
 small quantity of carbonic acid wiiich exists in the 
 black venous bhiod, will not be attracted by-tlie cold 
 air, and consecpiently this of itself may be one cause 
 of the sudden death. 
 
 Ninthly. It is necessary to be very careful not to 
 dismiss tlie patients as cured until they have been, at 
 least, several days completely out of danger. Two 
 of the cases which proved fatal in the prison, at 
 Cold-Bath Fields, were lost from our not haviiu^ 
 been at that time sulli( ; ntly aware of the importance 
 
 of this. , ,, , 
 
 Tenthly. The patients ought not to be allowed to 
 use one jlarticle of solid or indigestible food, for at 
 least Jivt days after they have recovered from the 
 state of colkipse. We nearly lost more cases than 
 on-;, <Vo;n the too early use of solid indigestible food; 
 and one womun, a nurse in the London Free Ilosjvi- 
 tal in Greville-street, actually died from this cause, 
 after having been considered as com))letely out of 
 danger from a most violent ,'ittack of Cholera accoiii- 
 panfed witli collapse. 
 
 Eleventhly. Those who put their patient:; under 
 the saline treatment, ought to trust almost entirely to 
 this; for if they use calomel, brandy, or other de- 
 structive agents at the same time, they vill do little 
 good; but above all, not one particle of opium ought 
 to be giveo internally; for, from what I have seen, I 
 consider this to be as fatal in Cholera^ as it is in the 
 last stage of either the African typhus or the season- 
 i;ic fever of the West Indies. Where the sfoniaeh, 
 lowever, is extremely irritable, about twenty-five or 
 thirty drops of laudanum, diffused in a little tei)id 
 ^\ater, may he injectc',: with a small syringe info the 
 rectum, not only with impunity but considerable ad- 
 vantage. 
 
 When the stomach is very irritable, small quanti- 
 ties of milk with carbimate of soda, may be given oc- 
 casionally; and when we use the saline powders in 
 such cases, they ought to he dissolved in a very 
 small prrtion of water. 
 
 When the case is exceedingly malignant, or where 
 we arc called in late in the disease, and find the pa- 
 tient already in collapse, we ought then to have rc- 
 , course to the most active measures. An ounce of 
 the muriate of soda, with half a drachm of the chlo- 
 rate, or the muriate of potass, should he given imme- 
 diately in cold wafer, and repeated, if necessary, 
 every half hour, until the patient has fi-kcn about 
 ftiree doses of this strong solution Should reaction 
 i be brought on by this, it may then he kept up by the 
 ' common sal ne powders: but shou'd tbi- pYiifMriort 
 fail, we may tliosi, a^ a lasf re-ource. giv.-' tlse patient 
 ■.notbcr ch;>ii.;e fcr life, by i:'j(.ctii;ar a <:.]'an' f]-ii-l iivId 
 the veins. 
 
 Tiie ejections, and every other souicc Oi impurity 
 ought to be immediately removed from the room 
 
 where the patients arc ; and the intected ward. 
 1 ou'd be fumigated at least twice a day ^v• J gun- 
 powder, and every panicle ot suspicious clolh.ns. 
 
 beddii!"-, &c., should' be boil- a. for at least half au 
 hour. 10 a strong solution o( common soda. 
 
 'lb. so v\ ho are recovering from tl>e disease are 1 - 
 able to a relapse, and such cases are general^ fata! 
 but from what I have seen, my belief .>, 'I'f «n'^^ 
 who luivecempletelv r.eovered, alter having had the 
 Ciu lera once, Uave an ui.munity from any lutuie at- 
 
 *1l,:';il:;: 'is':i";-Une of the treatment and mea,,s 
 which were used: lii- following is. 1 I cLeve, a l.ui 
 f Uitcment of the outliOL- oi the result ;— ■ 
 
 The three first cases which occurred In the prison 
 
 vere treated by Mr. ^^ "'^V'^' '^"V ' f C- Z tbev 
 - u ith oi)ium, brandv, the hot-air bath, c^ c. , but t .cv 
 uliaie.:it.eravery li.ort lUnoss. Almost^ .inmed.- 
 ate'v alter this, anoth<!rcase was treated m .. s..n, 
 h.r wav by anot'u r practitioner, who had been .ent 
 favio the'i^riso , dur.n;; the n,-ht^, '".consequence f 
 ISIr. \\'akefic.!d beiiu>: unwell at the time. 1 his gen- 
 tleman was not then aw.'.re that any "^^ l";;,'i"" .^i"' 
 been n<!opted in the mison J''^^"^^»"» * ", V* 'f, ' 
 .erumlani artan. with brandy. <TH1u>, a'"' [''.•^''^ ' '"J- 
 t!,c result was, tl-.at thi. patH;;:t vu.s past ='•' » !'=;YJ, 
 recovery befoieeilhevMr. \> akefield or n^ >elt saw 
 Hm in tlie m.uning;-con.eque:,t!y. m t^hctmir cases 
 
 thatw.ne treated in the prison in that waj tlicrc 
 vere four deaths and not one recovery unc.er fbe 
 common ])r.actice. . , . 
 
 li may be proper to state that previous to the be- 
 -rinr.ino-of A.nil there were no bowel complain s m 
 The i.riM.n, an'd the vn h.^le of the pri.soners were theii 
 as healthy as they generally are at that sefuon of he 
 vear. The first ease that was r. ported to the Loa,d 
 of Health ocenrred on t!:e 5th H {>V"'?,7/''« ^'J'"^ 
 fv..tment was commenced on the 8th There were 
 ill a" a» that i'eri< d about one thousand t'.irce bundled 
 souls in the prison; a.d from the 8th of npnl to the 
 cessation of the lir^t epidemic, there -.vere at lei.st 
 one bundled ie.,li\ idual.s who were evidently more or 
 less, under the intlmnee of the poison. 
 
 In about fifty of the above cases, the patients weie 
 atf;icked with'a bowel cmiplaint and most of them 
 bad, m-..eor less, irritation at the :loioach. 1 he 
 fluids that we;e ejected, were gencraHy deficient m 
 bile; and the bowel ccmiplaint was attended with the 
 fo!lov,ii):i i»eculiaritic.^;:— ■ , . i • „ .„<. 
 
 First.' The iue lii.ation to go to the night-chair Came 
 on more suddenly than it generally does ni cases ot 
 common diarrhcea. 
 
 Pec-ndlv. The ejections wore less bilious than in 
 common dianlKoa': and opium, chalh, astringents, 
 
 i\ /■ _ 1 :.. *.., ,. r. r^t ^Lnivi infill 
 
 •Vc. whicli are genorally u 
 ]i!iwel comi)!:iints, v.ere 
 
 (ul in ca^^s of common 
 no use in checking the 
 
 o((^\t•i t '.'inpijini:', ,.*.*'.' - ^- , 
 
 dianho^a. which occurs when the patients are under 
 the influence of the Cholera poisr.n. 1 hc-^e remedies 
 were ehieflv u.srd in c.^'s vJueh occurred onto the 
 pn.en; but" fh.'V evidenfiy had no eftect in checking 
 the sp<cifie ejections which are produced by the 
 Chohra iioisoii: and this 1 presume was the cause of 
 ,Ih> diavrha i wbieli ocrurred in the fittv eases in the 
 prison to which I refer, "l he whole of these were 
 im.nediatelv put under the saline Ireetmert, ar( this 
 .ii.nnarf.i to rive :in inr.-icdiata cLctk to tne di-tase, 
 ■>-.d I 1 el'cve it «-a-! owing t'l iiu- saIhm- renK-dies. m 
 vv'll -- to 'he eireuvnsr:'tice of their being cnnstantJy 
 ^ . :^ ., „..„.„, ro,,;,,,- ,.t wMl i;.kencareof.fiu-.t n«>t 
 ... ,i ;-,. i-.--:-..-^ .v}r: \<- v< ■■:■[■'■ ■ coa^^niiCiuiV, 
 though they were constantly breathing in an atraos- 
 
12 
 
 (inert ««Ripl«t«ly ii-nprcgiiatad with the |/i'^s»a, yot 
 uot oB« ot thctn Vas Ui»t. 
 
 There were also about thirty-one similar cases, iu 
 which the above symptoms were sti'.l more distiiicUy 
 walked, and in muny ot thi:no the bowel complaint 
 was more or less accompanied with cramps. I'hesc 
 were all treated in the same way with the non-purga- 
 tive salts, and in three, four, or five diiys, every one 
 of them were sent from the observation ward, as we 
 believe! at the tune, completely out of danger, lam 
 lorry, however, to be obliged to add, that t\\ oof these 
 ca«e» which had been unfortunately dismissed too 
 •ooD, and sent back as cured to the cold wards of the 
 prison, were attacl..ed with collapse during the nisht; 
 and before they could ap;nin be put under the sanne 
 treatment, their stomachs were >o irritable that they 
 fiould scarcely retain evcnateaspoonfnlof water; and 
 both these cases proved fata! in a very short period 
 from the comuiencement of the collapse 
 
 In Rddition to the eighty-one individuals already 
 referred to, we bad about nineteen cases iu tlie pri- 
 son, where the patients were either attacked with 
 the disease, and got into a state of asphyxia in the 
 cold wards of the prison during the night, or where 
 the stomach was so irrit-ihle in the first s age that it 
 could not retain the stronger salts. In a' most every 
 one of those cases the disease assumci.1 a most ma- 
 lignant character. These were all treated with ilie 
 energetic non-purgative saline remedies; and in the 
 nineteen maiignai.t cases to which I now relVr, we 
 had eighteen recoveries, and only one death; cinsa 
 quentiy, the total n-iraber of patients, who were all 
 evidently under the influence of the Cholera p;»ison, 
 was about one hundred, yet in those cases where we 
 trusted almost entirely to the saline praeticc, wc 
 had Only three deaths, and iiii)ety-se\ en rfccoveiies. 
 
 Jn corroboration of the above slatement, I will iu- 
 Bcrt here the following letter from Mr. Wakefield, 
 which was published m the Medical Gazette for 
 April 28, 1832. 
 
 ['In further illustration of the treatment which has 
 teen adopted in the cases of Cholera which have oc- 
 fcarred at Cold-Bath Fields, we insert the following 
 coramnnicRtion from Mr. Wakefield, the intelligent 
 •nd highly respectable practitioner who has the 
 medical charge of the prisoners.'] -Editor of the 
 
 haviriK uccn similar oasftJ in the e«mm^ricam«ii-. 
 transtormod rapidly into a state of collapse, ray con- 
 vicLi n is that every one of those ;»atienti were more 
 o- less in serious danger; and I bijiieve als.) that, had 
 they either been Ictt to tnomsalves or improperly 
 troated, the mijority of thesa cise^i would have rutt 
 into a state of c:);'ai)5e, Perhaps iu a taw hours; in- 
 deed 1 h ivo little &.>XJ\. th.it th ', onL'-ii.ill ot tUata 
 wou'd h ive been l;ist under the i)raciico which is ge- 
 nc'-.iily ad'«pted in the treatm;nt of this disease. 
 
 'in iependently of the numerous cases where the 
 inJividu.ils were laboring under thj premonitory 
 sviaptoms I have now had twenty-five cases ot deci- 
 de 1 Ch^ilera. where the patients were in a state ot 
 collapse; and in justice to Dr. Stevens, who suggest- 
 ed the uie of the saline remedies, as well as Irom a 
 sense of what I owe to the pu!)lic, I conceive it my 
 duly to ^tato.that after havin.; seen both the old and 
 "-"new treatment fairly put to the test, 1 am lully 
 CMivinCv;J. ♦hit the saline practice is mit only the 
 most scientific, but decidedly the most successful 
 that has vet been .; '.opted fiir the cure ot Cholera; and 
 fr.im what 1 have se in, my conviction is, that it this 
 trea'..iont be fairly ani ex:ensively tried, the mnrta- 
 litv from Cholera will b.> greatly dimmished. './hen 
 used It an early period, ic either prevents or arrests 
 the provr-ss oi the fatal symptoms; and even whcri 
 Ihi-* tivatmiitU is not used until a later peri.,ci ci the 
 d'is-asf, its ellocts are distinctly marked: and I may 
 saf'lv su- that 1 have seen several most malignant 
 casx's recover Irorn the state of v..llapse under the s.i- 
 line tr. \traent. where the patients, 1 doubt not, would 
 have di.;.l uailer any other practice. 
 
 ' We have n.iw upward ot twelve hundred persons 
 in this prison; and IV(mi the commencement of the 
 disease up to this date, there have been nearly one 
 hundred cases where individuals have been more or 
 less evidently laboring under the influence of the 
 Cholera poison. Tweuty-five ot these assumed the 
 n^ali-nant character of the disease, bavin- the majo- 
 rity of the symptoms described m the printed docii- 
 ment issued by Dr. Macann. Four of the first cases, 
 as before .•bserved, were treated in the cimimon way, 
 and every one of them died. All the others, howe- 
 ver wer > immediately put under the use of the sa in© 
 practice as recommended by Dr. »•«:;«"''; ^"l"."^"* 
 the whole nuirtber who have been thus treated, we 
 
 ' Lansdowti-Plaee. Brnnswick -Square, 
 April -Jo, 1932. 
 • 8iR,~^So much has already been written on the 
 tubject of Cholera, that I should not now appear be- 
 fore tne public, but from a conviction thai the facts 
 which 1 am about to state, if generally known and 
 properly authenticated, (which they can ensilybe,) 
 must be usf l^ul to those of the profession who in fu- 
 ture may »■■ cal cd upon to treat this new, but most 
 malignant disease. 
 
 'The first case which I saw, occurred on the olh of 
 this month, in the prison at Cold-Hath Fields. Three 
 other* quickly followed, and were immediately put 
 under the common treatment: these four patients di- 
 ed, aftc a short illness, with all the symptoms ot 
 Cholera distinctly marked. 
 
 ' Soon after the commencement of the disease, a 
 nnraber of the prisoners were attacked with marked 
 symptoms of derangement in the L'l'stiic org.iMt; and 
 tss ail of these cases occurred in the infect...! part of 
 the prison, it is more than probable from this, as well 
 Ri the genera! appearance of the patients, that the 
 dinrrhcea with which they were attacked, was the e(- 
 fwt of the poison which' produces Cholera From 
 
 hrve'oniTha'^'three deaths from Cholera, and two ot 
 "k sc were rases of relapse. I may state also, that 
 within the last lew daj s I have had one most raahg^ 
 naut case in the New Prison at Clerkenwell, where 
 the patient was in a state of complete eollaj.se before 
 I .aw him. flis extremities were cold ; h.s pulse at 
 the wrist was entirely gone; he ''^^ the h,h"fr» 
 voice, and his tongue was icy cold 1 h s man, like 
 those in the other prison, was immediately put under 
 the 'ialine treatment with the happiest clfects, and I 
 consider him now in a state of convalescence. 
 ' 1 am. Sir, 
 
 ' Your obedient Servant, 
 
 ' H. \V\KBriier,D ' 
 
 It has been observed, late !y, by individuals who 
 are .nill anxious to cling i- 'heir tormer opimons. 
 that the above cases occur: -^ at a pc«'"^'» .when the 
 d s-iso was on the decline in this metropolis, fhese 
 .r.'^ntl^mcn for-et, however, that London is not a vil- 
 hn-, and that though the disease was then decreas- 
 
 " in Southwark, Tlotherhithe, ^c. 
 
 ing 
 
 e, <yc., where it first 
 com^'cncpd, vet at that period it was only bej^inning 
 in that part of the metropolis where the prison is 
 
 licuat: 
 
 !d There is also one tm.st important tact 
 
 i t- 
 
l» 
 
 illapsa, my con- j 
 eiitj vrerti mare I 
 
 aUo tliKt, had I 
 or iiujiropcrly ' 
 
 would luive run 
 
 1 taw hours; in- 
 iL'-ii.iir ot tiiam 
 lici which is ge- 
 his disease, 
 uses where the 
 i»j preinDuitory 
 ivec:»ses of tleci- 
 ere in a stata of 
 IS, who suggest- 
 s woll as Irom a 
 
 conppive it my 
 l)0!h the old and 
 test, 1 am fully 
 i is not only the 
 most successlul 
 •e of Cholera; and 
 on is, tliat if this 
 tried, the mnrta- 
 linished. vVhen 
 revents or arrests 
 and even wherj 
 ter i>eri.<d of the 
 rked; and I may 
 most malignant 
 pse under the sii- 
 . doubt not, would 
 
 ; hundred person! 
 riRnccraent of the 
 ! hcen nearly one 
 we hcen more or 
 
 influence of the 
 heso assumed th* 
 havinw the majo- 
 the printed docii- 
 r of the first cases, 
 the common way, 
 the others, howo' 
 le use of the saline 
 tevens, and out ot 
 
 thus treated, w« 
 holera, and two ot 
 ly state also, that 
 1 one most raaUg 
 lerkenwell, where 
 ete collaj>se before 
 
 cold; his pulse at 
 
 had the Cholera 
 I This man, like 
 lediatcly put under 
 )iest cflfects, and I 
 palesceace- 
 
 t Servant, 
 
 I. \V\KErrBt,r> ' 
 
 Y individuals who 
 r former opinions, 
 X period when the 
 iietropolis. These 
 London is not a vil- 
 I was then decreas- 
 .^c, where it first 
 was onlj' bei^inning 
 ?here the prison is 
 r.«t important £»ot 
 
 ■srluch the stiid individuals forget to notice, namely, 
 that almost every one of those patients, either in or 
 out of the prison' died, who were treated in the sune 
 quarter and at the same time with the remedies re- 
 commended by the Central Hoard of Hoai'h; whilst 
 the fact is equally certain, that almost every one 
 of those casBj rec()verec<, which was treated , either 
 by myself or others, with the non- purgative alkalins 
 salts. 
 
 There were other individuals, even lately, yfaohid 
 to little respect for thiiir own reputation as to d^ny 
 that Choler* ever existed in LonJiin; and those arj 
 equally in error who beiieve, at prjsent, that this 
 disease has ceased to exist merely beciusj the BotrJ 
 of Health may not think proper to puJlislia:! acc.iu.it 
 of the cass-'s: but the truth is, that in ni.uiy parts of 
 London, the cases, at this mmnent, ;iie as numjiom, 
 a!id jus.t as viiu'.ent, or perU.ips even more so, tliaa 
 those thai occurred at an ea.liir pc: ioJ 
 
 In the first irruption of Cholera which occurred In 
 the prison of Cold-Bath Fields, the disease was con- 
 fined entirely to the males. It cnu^nMC^di in the 
 be'^innin-'-of" April, and thj last case was dismissed 
 cuTed on"the SJlli of th.} same month. From this pe- 
 riod lip to the 3J of .lune, there were no new cases; 
 hut on that day it broke out a second tiins. In this 
 instance it commenced amon'zst tlie feni,;!es, and soon 
 spread almost a. I overthe whole ostablishnent, and 
 is now at this moment much more virulent, and I am 
 sorry to add. raoro f.ital, th.m it has ever been at any 
 former period. In the first cnse that ocsurreJ, the 
 woman was attacked on the night o: thuSJ.anJ died 
 on the 5th. Her sister, who attenJed her, was 
 next taken ill, but recovered under the saline treat- 
 ment. 
 
 feoon after the commencement of this secomd ir- 
 ruption, I called at the prison, and there were then 
 foiivcaies. These were under th;! saline treatment, 
 and as they were all doing well, I fUd not return.— 
 On the 21st of June, however, I rec ived ft note from 
 Mr. Wakefield, requesting me to meet him at the 
 pri'^on as soon as possible When 1 went there, I 
 ff ■ about twenty p.fients with Cholera, and out of 
 thi ; ..umber five were, actually dyinnp. There was 
 one obvious canse for this, which 1 do not feel myself 
 at liberty to point out, — suffice it to say, that it ori- 
 ginated from either a mistake or neglect on the i)art 
 of the nurses who administered the medicines. 
 
 A saline fluid, similar to that which had been used 
 at Leith, wa? injected in two case^, into the veins; 
 but ihe one died i-lm.ost immrdiately, and the oth^r, 
 though h p. rallied for a time, yet he also ultimately 
 died.* 
 
 From the commencement of this second irruption 
 there have been, in all, abnm ei,!i;hty-onc cases: many 
 of these have be ■ oi'the most malignant description f 
 Out of this nnni ,t there have been thiiteen df'th.-. 
 and the other sixty-eight have cither recovered or 
 are now apparently nearly out of danger; but new ca- 
 ses are liraiight into the infirmary almost everj' hour. 
 They are all of them, howov.;r, now under the most 
 energetic trentinent, and I sincerely trust (hat the 
 mortality of the disease will be arrested in its pro- 
 gress. 
 
 \Vhen the Cholera was first rasrin'r in the prison at 
 Cold-Bath Fields, the disease broke out about the 
 
 same time amongst a •olooy o/ilmetfUit H&Tub*, wW 
 resided in the neighborhood. The first cases war* 
 put under the care of a physician, who had charge 
 of a Cholera hospital in that part of London . 'I hesa- 
 patieiits were first bled, and then most scientificalljr 
 treated with opium and brandy: but the result was 
 such, that the other Italians who were taken ill about 
 the same lime, refused to be treated by the Cholera, 
 physician; and fortunately for themteivos sent for 
 islr. \Vhitinortf, an intelligent practitioner, who live* 
 in that neig.ibnrhood. This gentleman had seen th» 
 elficts of tne saline treatment in the prison, and af- 
 terward trusted eutirely to this, m every decided 
 case of Cholera which he attended. Since then he 
 h.is had in his own private practice about thirty Cho- 
 lera patients, chiefly amo.ngst the Italians, and out of 
 this number he has lost only two cases, end tared a- 
 bout twentv-oight; and this surely is no common oc- 
 currence, particularly amongst the poorer clastes, 
 v.hL'ie we uo not always see them early, and where 
 we are not certain either that the medicines which 
 we proscribe are properly administered, or that they 
 are not occasionally used at the same time with other 
 improper agents which counteract the beneficial ef- 
 fects of the alkaline salts. 
 
 The first case which Mr Whitmore lost, was that 
 of a v.-oraan whose husband had just died from Cho- 
 lera and this patient had not used the saline powders 
 which he had ordered. The second unsuccessful 
 ca<e. was that of another woman in the same place, 
 who was attended by Mr. Whitmore and another 
 physician. In this case effervescing mixtures were 
 given, made with muriitic acid and carbonate of so- 
 da; but this experiment did not succeed, and the wo- 
 man died after a short illness. 
 
 The following case is one of those which occurred 
 in Mr. Whitm^-e's private practice. It has already 
 been published in the Medical Gazette, but as there 
 are some tacts in it which may not be without inter- 
 est, I shall insert it here. 
 
 CnOLER.A WITH ABORTION, BLACK DIS- 
 CHARGE FROM THE UTERUS BECOMING 
 FLORID UNDER THE SALINE 
 TREATMENT. 
 
 ' To the Editor of the London Medical Gaxetle. 
 
 ' Sir, — I am induced thus ))'.ihncly to communi- 
 cate a recent case of Cholera successfully treated by 
 th'! a^Mne ■prartice. and under circumstances whicli 
 inav. perhaps, render its recital not altogether uniii- 
 terrsting to the urofession. 
 
 ' May ]2tli. — I was consulted in the afternoon, by 
 Mrs. L-, ajt. 42, the mother of twelve healthy chil- 
 dren, the eldest twenty-three tind "he youngest three 
 years old. Supposes herself about three months ad- 
 vanced it! utero gestation; comjilains of diarrhooa of 
 two or three days' standing, with A'reat prostration, 
 an(i cramps in her lower extremities. Pulse infr*- 
 quciit, and feeble. 
 
 'Ordered R Mist. CretfB, f.4 oz.; Tinct. Opii, mi- 
 nuni s xl . capiat 4tam partem statimet repetatur pott 
 
 snigulas dejectioiies. 
 
 In the evening her daughter came to say her mo- 
 
 * Should I liave occasion to try this cxiicriment a2;ain, I shall certainly add a portion of the chlorate of 
 potass lo the other ingredients. The muriate of soda answers very well for a timcj but it it too apt to rtiv 
 otr bv the bowels ; md then the bloo:{ is swamped by the large quantity of water. 
 
 t The moBt awfully virulent cases which I have ever seen, occurred in so0i« individaals who had be«a» em- 
 ployed to scour the blankets, &c. from the difter«nt wards, 
 
 
 
 TusT7 
 
 
 ^y 
 
^^ 
 
 \ 
 
 14 
 
 ther had taken all the mixture without experiencing 
 ftny benefit; indeed to her former symptoms were 
 superadded vomiting of a violent character. 
 
 'Ordered the mixture to be repeated, with the ad- 
 dition of Tinct. Catechu, f. 1 oz. 
 
 •13th, 6 A. M.— Mixture all used, but the patient 
 is considerably worse. Has passed a very restless 
 night; countenance much sunk; voice peculiar, and 
 little more than a whisper; stools fa:culeat; a bilious 
 fluid was also ejected from the stomach, and com- 
 plains of a bitter taste in the mouth. 
 
 •Ordered Pulv. Cretoe, C.c.Opio, I scruple: divide 
 in Pulv. iv. to be taken in the same mannei' as the 
 mixtures were directed 
 
 « Noon.— The powders have all been taken, with- 
 out the slightest improvement in any one symptom. 
 Stools liquid, and now, for the first lime, oi a rice- 
 water color. The fluid which she vomits, however, 
 is still bilious ;tonEue flabby, coated, and cold; pulse 
 scarcely perceptible atthewriiit; complains much 
 of headach. 
 
 •RLiq. OpiJ Sedatl scruple ;Ammon. Carb.lscple; 
 SyrupiAurantii.rC scruples; Aqua;, 5oz. misce, 
 capiat Coch. i i. secunda q«;uiue hora cum Acid. 
 Tart. gr. xv. in statu efl'ervcsccntiaj. 
 
 • 10 P. M.— No better. Some dischaige from the 
 uterus of black blood, with bearing-down sensations 
 as if about to abort. . , . ,, . , , 
 
 '14th, 7 A. M.— Miscarried in the night; appears 
 to have been very correct in her calculation as to 
 her period of gestation. Purging and vomiting not 
 at all relieved; extremities cold: pnljie gone, and ap- 
 pears to be fast approaching to a stale of dissolution. 
 Ordered a Seidlitz powder to be taken directly, and 
 repeated at pleasure; also one of the following pow- 
 ders to be taken in twenty minutes alter the Sseid- 
 litz, and repeated every hour. 
 
 •RSodjfiCarb. 2scr.; SodaeMur. 1 gr.; Potassa; 
 Oxymur. gr. vii misce 
 
 Noon.— Vomiting has ceased; purging less f:e- 
 quent; pulse begins to be perceptible, but small, 
 g\ow, and tremulous; some return of heat on the sur- 
 face One Seidlitz powder has been taken; also four 
 of the other powders; all of which have been retain- 
 ed These were ordered to be continued. 
 
 • 10 P M —Nine of the above powders have now 
 been used, and retained. Considerable reaction has 
 tak'^n place; voice and countenance much improved; 
 pulse liO, and begins to be more full. Lochia bei^in- 
 nineto be flondin appearance, and of the usual 
 nuantity. Only one dejection smce my last visit, 
 f^owders ordered to be continued every hour, l rom 
 this time she rapidly improved, and is now out of 
 
 ^mIYs" worthy of remark, that the eldest daughter 
 and the husband of this woman have also been at- 
 tacked with diarrhoea and cramps in the extremities 
 for which Pulv. Crette C c. 0,.io was given, with- 
 out art-ording the slightest relief;. After persisting 
 in their usefor some time, and as the symptoms 
 were evidently becoming worse, recourse was had 
 to the above salin.- remedies, and spoedy ieco>eiy 
 was the almost immcdiUe result. 
 
 ♦You will observe, Sir. I was very tardy in put- 
 ting these patients un.ler the saline treatment; but 
 I must beg to observe, that this did not arise from a 
 eonvictiononmy part that they were not cases of 
 
 Cholcra,'for, perhaps, a better marked case than the 
 lir.s-t was never witnessed ; but 1 was anxious to try 
 whether, while bile continued to |)a.s into the duo- 
 denum, the dianha-a and vomiting could not be ar- 
 rested l)v '.inv other nu%insthan the saline medicines, 
 as recoiiimended by Dr. Stevens which 1 had seen 
 used with so mnvh success m ihi; prison at CoUt- 
 Uith I'iekls. 1 think, however, you will a-ree with 
 m'e, that I gave chalk and opinni (the usual reme- 
 di.V; a M-iv fiir trial in the above cases. 1 am he 
 more partiJnhu- m pointing out this, as my belief 
 noroisthul the non.purgative a kaline salts are, as 
 Dr S. asserts, mmo useful in ivlievms the sickness 
 at the stom:ich, and ebet'kin- the diiirha-a than 
 common astrin'rcnt or ahsorhont me.licires. 1 may 
 also obsei-A e, that these ca>cs .show that tr.e rice-wa- 
 ter evaetiiti'.'iis are not invarid.ly present in the ear- 
 h sta-o oil'ie Indian <;hn|era; andlrom whatl have 
 Jeen of this malif^nimt disnase lli.M.gh 1 b.hcveUuit 
 no treatment will be suooes^lul m every rase of co - 
 lapse, vet mvth..ron-l. conMCt.on is, that a much 
 (-realer nnmbiT of patie.nts Will he saved by the sa- 
 line treatment th.r: by any other practice that has 
 vet be n tried. , _ . , 
 
 " '1 have been thp more induced to cnmmnnicate 
 the above facts, as I observed that .,thers (even the 
 Central Board of Hoalth) are stdl rocommending the 
 use of medicines which have been lox;'; "xeil, ,fnirly 
 tru:iL mul found to be not onlu w.it/t.-.s but actually 
 i)ijurious. 
 
 « I am, Sir, 
 
 ' Your obedient Servant, 
 
 'HkNUV WHITMORE. 
 
 Cold-Bath Square, May 21, lii32. 
 
 '1 mav add, that on last Sunday night, just before 
 n>idni"lit, I was called on to att.nd another female, 
 who resides in the same parish, and .at no great ins- 
 tance from the above patients 'Ihis woman had 
 been sufVering for two or three davs (n,m v<nu ing 
 and purging, but when I .aw her, for the first I me, 
 she was in a state of colhq.se. and w:is also exceed- 
 ino-lv cmaciate;l from previous bad living, hhe was 
 iinmediately put underthv. saline treatment ; reaf^'''"' 
 soon came on, with ^leneial anunulment in ao t he 
 symptoms. Kver since she has continued to im- 
 prove; the Uidnevs are again acting, and I hau now 
 great reason to hope that sho may recover, hhc is 
 however, in a very low slate, not merely from the 
 effect of the disease, but also from previous ill 
 health. She is sullering also from great mental an- 
 Kuish for the loss oftwo children, one of whom liail 
 died on Saturday and iho othe.-on Sunday, the same 
 dav that she was herself attacked. I did not see ei- 
 ther of those children, but both of them were repor- 
 ted as having died from conliimed Cholera. 
 ' Thursday evening, 9 o'clock.' 
 The case last referr.Hl to in Mr Whitmnre's com- 
 munication, is the patient on whom the saline treat 
 ni.Mit was first tried in the l>ec llo.MU'al in Greville 
 street; she b is sin.s" been dismissed cured, and is 
 now in hetter health than she had been previous to 
 
 'Sooii'aft'er this case occurred, seven other patients 
 wereadmi:ted int. th. same hospital, s.k of them 
 were fr.nn Hine-cnrt, SailVon-hill, and ojk- from 
 IlollLi-n; two of the nn-ses who attended these pa- 
 tients were also attacked. These patients wore at- 
 
 ..iuled l.v Mr. Whitmore, Mr Marsd.ii. and my- 
 seli-onsman, who was hronaht t.. the ho.,- t:.. m 
 the last stage of collapse, died soon after admission. 
 
VO 
 
 case th:\n the 
 \nxiniis to try 
 into the duo- 
 ild not be ar- 
 iie mciliciiies, 
 eh 1 had seen 
 ison lit Cold- 
 rill ai^ree with 
 e usual renie- 
 es. I am the 
 as my belief 
 e suits are, as 
 >i the sickness 
 iirrha-a, than 
 ciiu'ti. 1 may 
 at t!ie rice-wa- 
 sont in llii; ear- 
 ni what I have 
 . 1 b.'lievethut 
 rj' rase of col- 
 !, that a much 
 vcd by the sa- 
 ictice that has 
 
 n communicate 
 licrs (even the 
 ommendintnthe 
 n;^ iiHf.il, fitirly 
 hS but actually 
 
 rvant, 
 Wmr.MonE. 
 
 gbt, just before 
 another female, 
 n no ^"jreat dis- 
 bis woman had 
 
 fr(/m vomiting 
 ir the first time, 
 vas also exceed- 
 iviu!?. Hlie was 
 .tmcnt; reaction 
 mint in all the 
 inlinued to im- 
 
 iind I have now 
 3C0Vcr. She is, 
 uerely from the 
 [Mil previoU'f ill 
 j;reat mental an- 
 ^ne of wimm had 
 Sunday, the same 
 
 1 did not see ei- 
 hem were repor- 
 Cholera. 
 
 rVhitmore's cora" 
 i the saline treat' 
 >pi!;\l in Grevillc 
 ed cured, and is 
 been previous to 
 
 vcn other patients 
 lital, si\- of them 
 II, and OIK' from 
 ttended those pa- 
 patients were at- 
 Tarsdeii, and inv- 
 .,( the hosj;'tL.'. in 
 n after admission. 
 
 We also lost one of the nurses, a very siuut woman, 
 who was attacked most violently, on tlie Ulst o 
 Mav She was put under the saline treatment, and 
 oniMondai', the -Uh of June, was f;o far recovered 
 from the state of collapse as f be coii,.ideied()Ut )t 
 durer. The same evcnint;, about >even o clocic, 
 shc'was attacked with a violent cr.uni) in the s.i- 
 mach, which was probably followed by mflanimut. m 
 and organic disease in that organ. Alio- this ;he ir- 
 ritation was so ;;reat, that even cold water could not 
 be retained, and she died on the evenini; ot the ()th. 
 After her death it was ascertained, that almo:,l iin- 
 medialely before she had been attacked with the 
 cramp in the stomach, she had eaten a ivliole lobster 
 (probably a bad one,) which had been bn>u^ht iti to 
 herclandestinelv bv one (d' her companions. 'I his 
 woman, however, and the man, to whom I have re- 
 ferred, were the only two patients tiiat were hist in 
 the above hospital, ii-oi.i the i)criod they commenced 
 with the saline remedies. And 1 regret tluil in the 
 lir.'it case which we lost we did not inject the saline 
 fluid into the veins, nor try the clfect ot a veiy lar-e 
 
 ... *• • ^ il.-. I.. . tU ^. I 
 
 dose of a saline solution j^ivm 
 
 iniernally ; for tli.s I 
 believe may be used, not only with impunity, but 
 with great advai.tajie in such cases, 
 
 The above case., occuired in a hospital into which 
 the patients are generally brought very late, and of- 
 ten in the very worst foiiiis of the disease; yet had 
 it not been i\,v the imprudent conduct of one ot the 
 nurses, out of ten maliL'iuint cases of Cholera wc 
 should have saved nine: but, even as it was, out of 
 the.-e ten, eight patients were saved ;and ihis is very 
 different from the result whichattended the common 
 treatment in the same hospilal, lor under that, I bc- 
 lieve, more than (nie-half died. 
 
 1 may here ..'serve that the saline treatment was 
 adopted in thin hospital in direct oppositu.n lo tbe 
 opinion of the medical gentlemen (.f that establish- 
 ment. The remedi^^s j.reviously used had not l)een 
 so successful as exj-ectcd, conseipieiitiy the saline 
 treatment was adoj)ted. Mr. Whitmore, who lives 
 in the neighl)orh;,(.d, was called in for the express 
 purpose of seeing tliat the plan was propeily pursu- 
 ed. This gentleinan reijuested me to attend the ca- 
 ses along- M-ilh him. which Idid. Mr. Mai>den, the 
 surgeon to the establishment, also ai tended the cases 
 with us. 'this gentleman was evidently opposed, at 
 first, to the saline practice, and, perhaps, the more 
 so, as the treatment had been in some measure forced 
 upon bin. by some of the governors oi the hos|)ital, 
 I bad, liowever, the satisfaction of hearing Mr. Mars- 
 den make tbe follovving manly declaration m the 
 presence of fi.ur other medical gentlemen. lie sta- 
 ted firmly, " that no pcrs.ni coidd have tbonght less 
 of the saline treatment than he did, until he had seen 
 it tried; but after what he had witnessed in that es- 
 tablishment within the last fifteen days, that a man 
 must be more than a skeptic wh.> would ,.iuse to 
 admit the evidence of his own senses; and from what 
 he had now witnessed, he was willing to admit that 
 the saline practice was doi'idedly the most success- 
 ful that he had seen died." 
 
 The saline treatmeiit has now been used, in that 
 part of L(nulon, in abnut two hundred r.nd twenty- 
 six cases of Cholera. Out of this number there have 
 been alxjut twenty deaths, and u[)\vard ot two hun- 
 dred recoveries, "it is true, however, that many of 
 these were not cases of collapse; l>.r this, where wo 
 saw them early, was generally prevented, by the im- 
 mediate use of the saline treatment; lot from what 
 1 have seen, my conviction is that, if these cases had 
 been treated with the common remedies, the ouc- 
 
 halfof them would have been lost. Or, when wo 
 compare the result even in the most malignant *^"'^'* 
 with the average mortality not only in London, Dui 
 in other places, ii will be found that the balance is 
 greatly in favor oi'lhe saline treatment 
 
 I m'ight bring forward many additional facts on 
 this sui'iect, hut I trust that 1 have already said 
 quite enough to induce any impartial j)ractitioner to 
 give the saline tn atnient a fair trial in Cholera; but 
 as 1 have said before, my belief is, that there must 
 he a very material change, both in the theory and 
 the practice of medicine, before either this, or any 
 other treatment, will be generally successful. 
 
 I should feel myself wantii g in a proper scmjc cf 
 jrratitiidc were I to omit this opnortunity of expres- 
 sing the deep obligatitn which 1 leel to Mr. Wake- 
 field, whose crmduct has been beyond all praise; 
 and were it not (or this gentleman, it is very proba- 
 ble that I should not have had an opportunity of try- 
 ing the etlcet of this practice in the treatment of 
 Cholera. I bad previously made several attempts 
 toward giving it a trial, but in some of them I met 
 with such discouragement, that I was compelled to 
 give it Jip almost in'despair. 
 
 I must also take this (>pjiortunity of returning my 
 sincere thanks to the magistrates of Middlesex, for 
 the liberal and kind manner in which they have been 
 jileased juiblicly to express their approbation of the 
 success of the treatment that was used in the prison 
 which is under their care. 1 have also to thank 
 them f(u- their kindness to Mr Crooke, who having 
 seen the saline treatment extensively used in the 
 West India fevers, was anxious to see it get a fair 
 trial in Cholera. When the first opportunity occur- 
 red he relinquished, for a time, his studies as a stu- 
 dent; and though he had a firm belief that the dis- 
 ease was contagious, yet he cheerfully volunteered 
 his services, and remained almost constantly in the 
 prison, both day and night; and to his unwearied at- 
 tenti(ui to the sick, but above all to the exeniplar;r 
 conduct of :Mr. Chesterton, the governor of the pri- 
 son, I believe we were indebted, in no small degree, 
 for the success of our practice. 
 
 I have also to express my thanks to Mr. Whit- 
 more, as well as to Mr Maisden, Mr. Spencer, and 
 other gentlemen, not only for their having given this 
 practice a trial, but also tor the manner in which 
 they have expressed their conviction of its superio- 
 rity to the methods of treatment in general use. I 
 mav add, that the candid and manly conduct of Mr. 
 Wrikefiel I, Mr. Marsden, and the whole of the gen- 
 tlemen whom I have met in that quarter, is to me 
 some consolation for the illiberal and unfounded at- 
 tacks to which every individual must expose him- 
 self who ventures to appear bet, ue the public, even 
 when be is actuated by the purest motives, or when 
 that which he states i"s most strictly correct. But 
 as I have formerly said, truth, whatever may as- 
 sail it, will ultimately maintain iis course, and those 
 who attempt to impede its progress, though they 
 may succeed for a time, yet they will at last find it 
 as hopeless a task as it would be to prevent the 
 inount:iin torrent from finding its way to the sea, in- 
 to which it is ultimately to be received. 
 
 ON THE INJECTION OF SALINE SOLUTIONS 
 IN CHOLERA. 
 
 The injecting of medicated substances into a vein 
 is neither a new nor a difficult experiment, and when 
 we once find out the proper remedies to use for cu- 
 ring a disease, the mere act of throwing it into the 
 ves'ieU is exceedingly simple. 
 
'-JJBfc^-.' ^■-IW^' 
 
 16 
 
 Th« op«rMi«u oi iDjeciln2 m ta)in« tolution into 
 the veins in Cholera «-a«, 1 believe, fir»t proposed 
 by Mr. Smart, in a letter which is dated Cranborne, 
 November 11th, and published in the Medical Ga- 
 aetteliir the 2(ith of November. ISai. Mr. Smart 
 appears to have had but little faith in the cnmruon 
 remedies J for he asks, * What are ^encbection and 
 calomel expected to eifectl means, the best adapted, 
 in my opinion, to linally cxiinKuish the stili dicker- 
 ing Hame of life!'— and after alluding to the action of 
 the salts on the blood, as stated m the pajier which 
 was read at the Collct;e of Physicians, he then adds, 
 • I would therefore propose, not only to try the in- 
 jection of the above (namely, the saline) remedieo 
 into the veins, but also the transfusion of pure blood.' 
 Mr. smort also announces his inltntioii ot tryinj; the 
 saline injection, should circumslances reiulir it ne- 
 cessary. 1 must observe, however, that in his hands 
 >t would not have been sncces...ful, forhe appesus to 
 have but very confused idea- vinthis subject, and be- 
 int; misled, as it would appear, by tiu; ojtinioiis of Dr. 
 tClanny, he actually proposes to inject carbonic acid 
 at the same time, into the fiins. He also .recoia- 
 mends the use of brandy and opium, so that what he 
 would have gained by the saline injecliims in the 
 treatment of Cholera, he would have lost by the car- 
 bonic acid, the opium, and the other improper reme- 
 dies which he proposes to use. 
 
 On the 3d ot December, that is a week after the 
 above letter had been published, a similar prop.nsal 
 was made by the Editor of the Medical Gazette, 
 tinly this better informed individual did not recom- 
 mend the injection of carbonic acid into she veins, 
 for the purpose of giving an arterial coltir to the black 
 blood, which is so invariably met with in cases of 
 Cholera. 
 
 REMEDIES TRIED AT SUNDERL.\ND IN 
 CHOLERA— OTHERS SUGGESTED 
 
 * We mentioned last week, that a hog;shead of 
 brandy, already mixed with laudanum in due pro- 
 portion, had been furnished by government for the 
 use of the Cholera patients at Sunderland We re- 
 gret to sav, that little benefit has been derived as 
 yet from this, the volatile oils, or any other method 
 of treatment which has been tried; nor has any thing 
 occurred to throw any additional li}:ht, cither on the 
 nature or treatment of the disease. The inhalation 
 of oxygen has been tried in several cases without 
 any apparent advantage; the pnlse, indeed, rosea 
 little during the inhalation of the gas, but immediatc- 
 iy on leaving it oft, ;rie sinking of the pulse was 
 mmd to be greater than before its use. Some ni- 
 trous oxide was in preparation a few days ago, and 
 ere this, we doubt not, has been tried. We must 
 confess, however, that we entertain little hope from 
 this class of remedies, because the lungs do not act 
 upon that portion of oxygen which the air naturally 
 contains, it having been long ago ascertained, by Dr. 
 John Davy, in India, that only from one-fourth to 
 one-third of (he proper quantity of carbonic acid 
 wat found in the air expired by thrrse I 'oriug under 
 Cholera. A galvanic battery has been rdered to be 
 lent to Sunderland, and the effects of this mn.st pow- 
 erful agent are to be ascertained. The experiments 
 ef the late Mr. Finlayson, at Ceylon, thcugh too limi- 
 ted to warrant anv general inference, were certainly 
 nth a» to justify further trial: in one of his patients, 
 wfco was "Moribund," a galvanic cnrreht from a 
 •0^1 battery wm passed through the ehtst, the man 
 iaim«dlat«I-v re'jri'td, and uKimately recovered Tbt 
 
 same gentleman also states, that in (tvn out of three 
 cases, the functions of the lungs appeared to be res- 
 tored by stimulating them with ammonia, volati- 
 lized so as to impregnate the atmoophere with itt 
 fumes. 
 
 ' ll'e eai-nrxtly recommend a trial nf injecting me- 
 dicated sola, ion.i into the veins, particidurlij some of 
 the neutral sulti, «s muriate of soda. No one who 
 ever saw a leech disgorge its black blood upon salt, 
 can fail to have obsiTved its instant conversion into 
 1 bril iant scarlet. That the clange of color carries 
 with it a correspondina- change of character, we do 
 not venture to assert: uut it is at least worth ascer- 
 taining; and wc think that the views of Dr. Stevens, 
 ns to ilu- oflrct of salts on the blood, to which we have 
 ropcilcdly culled attentiiin, ou^ht to be put to the 
 te^t as spci'dily :is possible. It affords no mean claim 
 to the iiivcstif^^'tif.n of these doctrines, that a man of 
 Di- Front's hich character shou'd have declared the 
 essay containing them, and which was published in 
 this journal, to be one which, spite of some imperfec- 
 tions, seems to contain the germs of discoveries of 
 the last importance to mankind' 
 
 In the paper which was read at the College of Phy- 
 sicians, 1 had stated that the iiMuia! .salts of iho 
 hood woie not merely the c?Hse of its red or arterial 
 color, but iinc; chief 'ciiH«e of its stimulating po\yer. 
 'I'hfcie were some v.ho denie<ltbat this was the fact, 
 hut did so without taking the trouble of performing 
 a single ex))ciiment with a view of putting to the test 
 whether the facts Avhich I had stated were correct or 
 not. There are others, however, who have gained 
 great credit to themselves by having acted differ- 
 ently. 
 
 In a paper which was read at the WestminsterSo- 
 cietT, on the 3d of December, and published in the 
 Lancet of December 10th, 1H31, Dr. O'Shanghnessy 
 states that 'about lhre« months after Dr. J^teveis's 
 researches -ind experiments were iaid before the pub- 
 lic,' he had injected a solution of certain salts into the 
 veins of inferior animals, and loiind that they not 
 merely give a florid color to the darkest blood, but 
 enabled it to increase the excitement in the whole 
 system, by adding to its power of stimulating the 
 vascular organs. From these facts. Dr. O'Sliaurrh- 
 ressy inferred, that as the Cholera is more rapid in 
 its p^.^aress than the yellow fever, that benefit rnic.ht 
 be derived, in certain cases, by injectir.f; a solution 
 of certain salts (fircctlv into tii.^ v;;ins. The salts, 
 however, which I5r. O'Hhau;i;h!!0ssy ri'cnniiiirnded 
 have not vet been injected into the veiii'=, for rt that 
 period he leconiineiuled the oxygenated s.ilts in pre- 
 ference to those tluU have been used, fr' m a belief 
 that they arterialized the blood by cnnirnnnxating 
 oxvgen; but this opinion he has since retra< tod with 
 a degree of candor which does him great credit — 
 There are, however, more important facts <han one 
 for which the profession are under fireat oblis,atiors 
 to this gentleman, who has already commenced a bril- 
 liant career, and we have much to hope from his fu- 
 ture labors. 
 
 About a week after Dr. O'Shaughncssy's paper had 
 been read, another letter was published in the Medi- 
 cal Gazette. The following is an extract:— 
 
 ' EXPERIMENTS ON THE BLOOD. 
 
 « 7'o the Editor of the London Medical Gazette. 
 
 SiF,— The notices repeatedly inserted in the Me 
 di«al Goiettf of certain opiniono advanced by Dr. 
 
I on( of thrM 
 red to be re»- 
 fionia, volati* 
 dere with itt 
 
 injecting me- 
 [ilarlij nonie of 
 
 No one who 
 ind upon salt, 
 Diivtrsion into 
 r color carries 
 meter, we do 
 t worth asccr- 
 
 Dr. Stevens, 
 vliieh we have 
 he put to the 
 no ineati claim 
 that a man of 
 e dechircd tlio 
 i-i published in 
 nme imperfec- 
 discovericB of 
 
 loUcfie of Phy- 
 al salts of I ho 
 red or arterial 
 lihitinp: power, 
 i was the fact, 
 ; of perforrainR 
 ttinRtothe test 
 kvere corrector 
 10 have trained 
 » acted differ- 
 
 /eslminsterS^o- 
 nblished in the 
 O'Shauffhnessy 
 
 T)r. Ktevei's's 
 before the pnb- 
 lin salts into the 
 I that they not 
 kest blood, but 
 it in the whole 
 itimn'ating the 
 Dr. O'Slianrrh- 
 s more rapid m 
 it benefit miaht 
 it'w.fr^ a solution 
 ms. The salts. 
 ' rcconiKirnded 
 ;inf:, for rt that 
 ted salts in pre- 
 , fr' m a belief 
 enniinnn'calins; 
 ' i-e)ra< tod with 
 
 pTeat credit — 
 t facts Mian one 
 real oblis,atiors 
 mmenccd abril- 
 npe from his fu- 
 
 ?ssy's paper had 
 led'in the Medi- 
 ract: — 
 
 BLOOD, 
 
 ifl/ Gitzettt. 
 
 ;rtcd in the Me 
 vanned by Dr. 
 
 Rt*Tf n«, rtfifivtllr.)? the tfrectt of ionie of the nentral 
 m!(i 03 the blood, Lave ratural!« directed atteniion 
 to this point, atn time n'hen tbi' fuiliiie of allorilina- 
 ry method* of treatment in Ch<>l«rii bin alinnKt una- 
 voidably led praclitior.crg to inquire, wlietlu-r tlieic 
 to-yet any untried expedient wiiicl'i tni^lit by possi- 
 bility b« u.itful. About a m-^'Uh u;o. baviu; piMcu 
 
 17 
 
 dra\''u bioiicl, j mix- 
 obtaininp; Ihu ii:nv 
 
 red Kucressive supplie* ol'ncwlv 
 tditwilh different i^nhstancts, 
 ^vtll-known general result of reiulcrinjj; llie fl.iid dark 
 ftad thick by means of »tio:>K «ciJs. mil of a bni^lxt 
 »Ciu-'ct !t/ means ilf the neutral «.il(s. The tiiiusiiioii 
 fi'om thuMiuIenahueofvoiMius to a vi-nniii- n tv.icwi- 
 C»?»ng tliiit of arterial blood, is ceitainly a li'miirlculilc 
 pTieiiomcnon; and those pri'sent agreed, th.i' if any 
 tbing ««ai to be hoped for fi-nni elFcctiiig a siinilar 
 chaii>;e in ur;;ent cascft of ClioltTa, it was most ra- 
 tionally to lie attempted by direct iiiji'Ction into the 
 Tcin«— a process which Mr. Arnoit und^'rlcoU t • 
 perform, photild circumstances occur to render the 
 j^PncecdinR fvasiibie,' &c. &c 
 
 The above letter was written by Dr. Macleod ; 
 ftnd it i» to be regretted tint tbi.'* proposal was not 
 *ooner put into practice , for if it had, tlicre is little 
 rfoubt tlial many individuals would have been saved 
 who have since fillen victims to the dmease. I'ut, 
 unfortunately, the benefit which has since been deri- 
 ved from the saline treatment was prevented for ft 
 tiraej partly by acircum^itance alioaoy r ferred to ; 
 for the EdUor ofthc iMi'dico-Cbir. Review not only 
 denied tnv statements in the public journals, but he 
 candidly "confesses th.at previously to their publica- 
 tion he had senia copy of the Trinidad documents to 
 l3r O'S .for the express purpose, .is he says, of pre- 
 rcntinc; this gentleman from leaning to my side. 
 
 'J'he propo.tal for iiijectiiia; a saline fluid into the 
 rein* was first put in pn'.ctice by Dr. Latta, of 
 J^eitb. We are not informed at what date it was 
 fir«t tried; but the letter commnnicatinq: the first in- 
 formation on this subject to the Central IJoaid of 
 Health is dated T.eitb.' May I5lh. 18.32. The result 
 of Dr. L::tfa's experiments is well known. It has 
 a'sri !)cen since (lied by others. In these also there 
 lias been some recoveries*, and several deaths; but 
 J sincerely trust th.m the fiilnres in fulure will be 
 less frequent. The -Mbiimen which has been used is 
 Jiltocethor unnecessary, for the blood in Cholera has 
 mnr;' (rinsisfence than the blood in health. The 
 «har"i-p'^inted si'vei" instrument whieh is generally 
 uttached to Read's nppiratus is too sharp at the 
 piint to be introdnred with sa'ety into a vein; and 
 my coiniction is. also, th.it the sa'ine fluid which has 
 been used is too Hrn'e ii ninntity and not snfficient- 
 Irsfrons;; andthis, in all probabili'v, has been one 
 chief cause of the many failures We know it to be 
 a fact, that when animals are killed in a state of ex- 
 bsuation. or immediately after they have been taking 
 very hard exereiset, a very lar^e "portion of salt is 
 then required, on purpose to preserve them from the 
 putrefactive process, and when the blood, as i n 
 Cholera, i« not merely deficient in saline matter, but 
 is also in a diseased condition from other cause. It 
 is then essentially necessary not onlv to supply the 
 blood witk the natural saline ingredients which it 
 
 has lost, but to tbrfiw into the torrent k lar^«r yv^ 
 portion than usual, for the purj>osc of enabling it ff. 
 resist the destructive effects of the morbid poison' 
 
 1 hnihjectioii, however, of ssline fluids dircetlj- 
 iiito tl'.o blo[\i is a* yet only in its infancy. I Ivav* 
 n I daubt that i: will be the means of »aving many 
 livi's ; but it wilt seldom be required where the pa* 
 tients are seen early iti the disease, and proprrlv 
 trcatLd ; consequently, where one individual will 
 be preserved fioin Cholera by this operation, a llion- 
 sand will be s.iveJ by the internal use of the ener- 
 getic nonpurgative salts. Tbcr.* is one point of 
 view, however, in which I consider Dr l.atta's ex* 
 p.rimfnts as possessina; an intense value — and that 
 18, inasmuch as they ailord the most unequivocal ev- 
 iJunce in favor of the o|)inions with resji- ct to the 
 cllL-efi nf salts on the blood, which were first pulw 
 lie'}' communicated to the profession in the paper 
 which was read at the college of Physicians. 
 
 When the Cholera is left to i t»ell, or even where 
 it is treated in the beginning with improper remedies 
 if is almost incredible, to those who have not seen 
 it, how rapid!) it runs its course to a fatal termina- 
 tion ; but it is cqiiallv incredible, when the diieasa 
 is propel !y treated. Iiow very soon it may f ften be 
 nrrested in its rapi I progress. I have f*en, in some 
 of the very worst eases, where, when a few doses of 
 the saline mixture could be retained in the svitera 
 for a sufficient time to enter the circulation, the fa- 
 tal symptoms were almost immediatelj' arrested ; 
 and even when the collapse has cnmmeneed, after a 
 short period, the pulse can be felt beginning to creep 
 animal heat begins to be evolved, and thotigb tlie 
 patients continue weak for a time, yet they gradu.;.!- 
 jy recover from the state of collapse. 
 
 In two of the most malignant cases which I liavfl 
 seen, there was no premonitory diarrhoea : and in 
 one of them the bowels had not been open for three 
 days previous to the attack ; consequently. Cholera 
 is not merely an excessive diarrhoea, for neither the 
 bowel complaint, the rice-water ejections, vomiting, 
 nor cramps, are essential to this disease ; and wher« 
 these svmptoms do eiist, they are merely the e^ 
 fects of the poison — for they are merely accidental ; 
 but a »u(I(fen coldness ofttie blood, and of count of 
 the whole bo-y. without nry obvious cause, if, pn^ 
 haps, the best characteristic symptom of this ptstir 
 leulial disease. 
 
 In the first sfaffe of Cholera, the ejectiong are, l« 
 general, passed with great force ; but as the dite Sf 
 advances, the intestines become cold, and freotent* 
 '7 so torpid, th.at even hot saline enemata can oe re- 
 tained with great, ease : consequently in such e»' 
 SOS, there is no necessity for plugging the rectanDi 
 as recommended by Dr. "Clanny, 
 
 The rice-water ejections, which are (generally pan* 
 sed ST copiously in the first stage of Cholera, are, 
 likp every other secretion in the body, derived en* 
 tirely from the circu'ating current : and as the e«« 
 lorins: matter of the blood is. perhaps, the only in- 
 gredient which is not drained off in this way. it nat* 
 urillv follows that a given qn.-.utity of black Cholert 
 blood most be more dense, and contain more eolor* 
 ing matter, and less aeruna, than is met with in th« 
 
 t The following is one of the many facts which may be bron>xht forward to proye that the stronjer eaKe 
 are essentially necessary in the treatment of Cholera. I saw one most interesting case of a fine little gtrt, 
 about nine years of age. where the physicians who attended her had trusted the cure merely tothe ea»lH»" 
 Bate of soda combined with landannm. Under this treatment, the stage of collapse came on »n enddenlf, 
 «nd tn such a degree, that it waa judged oeeeiMry to inject • ealin* floid into tbo veiiw< Tbi* irat doaoi 
 and the child roeovered. 
 
 * 8m WiUoB on tb» BIaoA 
 
-nfi; ■■mr\ ^^dlt. «■*»., 
 
 
 Sat the arterial bloodf P*^"/""* ]"* *':i;c£*on a. grlaKcfnot oplv Id C h.-Iera*: but al.o .n the mal r 
 ^V?^ have .ee„ tbat.i„ tjeearly .^v^of^^;;^ '"^fJiJ^^S^r^A^t^^lS^- ^1^^^ 
 
 teK:;.5^s.^r^-H- Stride l^s^x;^'Vi;«^a^i:^n:S^f^ 
 
 »„d forcible .%.ntract.on .. Fp»;'f''»y, «^»;»*1 Xids. fute collap.e Jnearly twenty four hour.. Wh.« 
 
 poisoned or acrid quality '5/frL the bodv Thi he r.-«ction commenced, th« tfr.t ••« «hat he mad. 
 
 which are in thi* way re nored from »''«, """J^ *,"5 l^^^u speed was to be(c for some .all mackarel. At 
 
 urine which is seceted at this period is » •" «l'«"e1 This could not be obtained at the moment, ht wa* -J- 
 
 ;irUh considerable force ''^^^'ir^yifhe bUdder by owed a part of a .alt herring, which h. ate w.tt» - 
 
 ;;«n on the last drops "f the acrid flmd v^;«J^^^ eri which go far f.ward confirming the oi/'"">n« "I 
 
 pelled, is probably the chief cau e why this organ ^ .;;\,hich I have already advanced in this work • 
 
 ;o firm and contracted after death. '^^^^ j^e present volume has already «"««'*• 
 
 We have seen that animal heat is genemeciana e uui, « » y or ginally intended, the ob* 
 
 Toivcd in the extreme texture all over th^^^^^^^ ervaTon.wSl intend to^.ake on thi. .ub,e«l 
 
 ^A^:^:^:^^^^^^^^ ^rZJ wiU prota^y be published .a a ...araf fonu. 
 
 ierom 55 
 
 Cnuiaiacntuai ••*'* 
 
 100 
 Cholem Blood. 
 t«ram "msm 
 
tb« body, of 
 in the loalig* 
 all other di«- 
 lequa'-tity of 
 I potviule. 
 I had gentrtl* 
 imarkably th« 
 state of com* 
 louM. When 
 that hr road* 
 nnaekarcl. A« 
 mt, he wa« •%!• 
 t ate witb ft* 
 
 tionRon ChoU 
 e opinion! on 
 in thi« work* 
 dy attained a 
 tended, the ob« 
 a thie tubjetl 
 leforro. 
 
 Or. 
 
I