THE SALOL TREATMENT OF CHOLERA.

By Surgeon J. H. TULL WALSH, i.m.s. My attention was first called to Salol as a

remedy for cholera by Dr. Nicholson's article in the Indian Medical Gazette for September 1889. His results seemed so surprisingly good that it appeared as if we had at last found a

drug which, if not infallible^ was at least more useful in the treatment of cholera than any other which has been tried up to the present time. The arguments of Lowenthal were ex- tremely illogical and unsatisfactory, but the clinical results givinc eighteen cases without a

? 1 1 1 O O

smgle death were good. A supply of salol was obtained for use in the

Puri Cholera Hospital, and I give below in a

tabular form the results in fourteen cases treated with the drug. The salol was given in the

manner prescribed by Dr. Nicholson iu order that our experiments might tally with his. The mixture was given every three hours.

TABLE I, JANUARY 1st TO MARCH 1st, 1890.

Treatment, Rum and Salol Mixture.

No. Race

and Sox.

State on Admis- sion and General

Appearance.

Fairly nourished ; collapsed.

Well nourished; collapsed.

Well nourished; collapsed.

Fairly nourished; collapsed.

Starved; with diarrhoea of

Choleraic kind. Fairly nourished; collapsed.

Well nourished; collapsed.

Fairly nourished; collapsed.

Well nourished ; collapsed.

Starved; collaps- ed. [ed.

Starved ; collaps- Fairly nourished; collapsed.

Fairly nourished; collapsed.

Feeble; collapsed.

Result. Time under treatment. Remarks.

H. F.

H.M.

H.M.

II. F.

II. M.

H. M.

H. M.

H.M.

H. H.

H.M.

H.M. H.M.

H.M.

H. F.

GO

45

Cured.

Died.

Cured.

Died.

Died.

Died.

Died.

Died.

Died.

Died.

Cured. Died.

Died.

Died.

7 days.

15 hours.

3 days.

13 hours..

8 hours.

6 hours.

9 hours.

9 hours.

8 hours.

21 hours,

5 days. 2 days.

4 days.

Few hours.

Salol for 3 days only.

5 doses Salol.

Doubtful case afte r war d s t r e a t e d for

dysentery. Doubtful case

death pro- bably acce- lerated by starvation.

Counting day of admissiou and day o f death.

Dates not ac-

curately given.

Total number of case 14 Deaths 11 Death rate p. c. ... 78*5

July 1890.] WALSH ON THE SALOL TREATMENT OF CHOLERA. 203;

The results were not encouraging, and from careful observation of the above cases it could

not be shown that any extraordinary improvement appeared in the symptoms; neither the

vomiting nor the diarrhoea were markedly influenced by the salol. This drug was first recommended by Professor F. Hueppe, and subsequently by Professor

Lowenthal, and the most that cau be said in their favor is that they have added one moie to the

number of medicines that will not cure cholera. As I have by me a tabular statement of all the

cases of cholera treated in the Puri Cholera Hospital during 1889 it will be, I think, interesting to

compare two sets of 14 cases with the 14 treated by salol during the first two months o t us year.

TABLE II.

First fourteen cases treated in the Puri Cholera Hospital 1889.

No.

10

11 12

13

14

Race and Sex.

H. JVL

H. F.

H. M.

H. F.

H. F. H. M.

H. M. H. F.

H. F.

H. M.

H. M. H. F.

H. M.

H. M.

Age.

~54~

50

40

55

17 70

40 55

25

35

50 25

30

40

Condition on Admission.

Collapsed IT

Collapsed ...

Early stage of disease

Collapsed ...

Callapsed ...

Collapsed ...

Collapsed ...

Collapsed ...

Collapsed ...

Collapsed ...

Collapsed Collapsed

Collapsed

Collapsed

Resume of treatment.

StimuiantsTmustard plasters.

Stim., mustard, diuretics

creasote and sulph. acid drink.

Soda bicarb, sulph. acid

drink.

Stim., diuretic, chlorodyne chloroform, creasote.

As 4, except chloroform.

Stim., chlorodyne, ipecac- soda. [chloroform, soda.

Stim., diuretics, creasote, Stim., chlorodyne, iodide of mercury, ipecac, soda, sulph. acid drink, quinine.

No stimulant; simple astrin- gent mixture, sulph. acid

drink, iodoform for hiccup. -

Stim., iodide of mercury, ; Recovered

sulph. acid drink.

Result.

Died

Rec overed.

Recovered.

Recovered.

Died Died

Recovered. Recovered.

Recovered.

Died Died

2 days

1 day

-2 c3 cS o o

EHflfl

Stimulant only ...

Stim., iodide of mercury, sulph. acid drink.

Stim., iodide^ of mercury,] citric acid drink.

^ , As 13 ... ?

The next table will inr.lndft fmivtpen cases taken seriallv from the records foi Juue^ 1889. were treated in the

Time under treatment.

3 days

5 days

1 day

4 days

6 days 6 days

4 days 8 days

16 days

3 days

2 days 3 days

Remarks.

No drugs given. Mustard in all cases.

Symptoms chole- raic, but case doubtful.

o

l>Q T?t 1^

? &

o m m ?

The next table will include fourteen cases taken serially fiom June is generally a bad month for cholera in Puri, and 102 cases in a

hospital during that month. TABLE III.

First fourteen cases treated in the Puri Cholera Hospital in June 1889.

No.

4 5 6

7

8

9

10 11 12 13 14

Race and Sex.

H. M.

H. F.

H.M.

H.M. H. M. H.M.

H.M.

H. M.

H.M.

H. F. H. M. H.F. H.M. H.M.

Age.

40

40?

25

28 30 20

50

1

40

60 45 55 60 55

Condition on Admission.

Collapsed

Collapsed

Collapsed

Collapsed Collapsed Collapsed

Collapsed

Collapsed

Collapsed

Moribund Collapsed ...

Collapsed ...

Collapsed ???

,

Not quite collapsed, very weak.

Resume of treatment.

Stimulants only, mustard

plaster (all cases).

Stimulants, astringents, soda, sp. am. aromat tr. nux

vom.

Stimulants, astringents, an- tifebrin.

Stimulants only ...

Stimulants only ...

Stimulants, diuretics, blister to nape of neck.

Stimulants, sulph. acid drink.

Stimulants, astringent mix- ture.

Stimulants, blister to nape of neck.

Stimulants Stimulants ... ...

Stimulants ...

Stimulants, sulph. acid drink Stimulants, sulph. acid drink, quinnie. antifebrin.

Result.

Died

Recovered.

Recovered.

Died Died Died

Died

Recovered.

Died

Died Died Died Died Recovered,

Time under treat- ment.

3 days ...

7 days ...

2 days ...

2 days ...

1 day ...

4 days ...

2 days ...

3 days ...

4 days ...

1 day ...

1 day 2 hours ...

2 days ...

4 days ...

Remarks.

Day of ad- mission and day of death counted.

THO-Lj

?4-i c3 c3 O O O

EHAQ

Note.?In.Tables II and III " Time under Treatment" means actual time spent in the Cholera Hospital. Cases of Debility

' after recovery were treated in the Wards of the General Hospital.

204 ? THE INDIAN MEDICAL GAZETTE. [Jdly 1890.

Comparing Tables I, II, and III it seems clear that a miscellaneous treatment, with stimulants and astringents, gives better results than the salol treatment. There is, however, reason to

believe that the cholera was of a milder type in 1889 than during the early part of 1890 which would in some measure account for the difference in the percentage of deaths.

I will not attempt to discuss the general question of the treatment of cholera as I am of opinion that, after the algid stage is reached

recovery depends in some way on the vitality of the patient and is generally independent of drugs.

Sanitation universal and perfect should, I

think, be the only end and aim of those who desire to see the mortality from cholera lessened.