Observations on spasmodic cholera : its origin, nature, and treatment : with remarks on epidemic diseases generally / by Henry M'Cormac.

Date:
1832
Catalogue details

Licence: Public Domain Mark

Credit: Observations on spasmodic cholera : its origin, nature, and treatment : with remarks on epidemic diseases generally / by Henry M'Cormac. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    26/28 (page 26)
    J6 Now, I shall say a word on the mode of action of the remedies which I have enlarged on so panegyrically. First, as to heat, every one knows, that, without a certain degree of heat, we must surely die; the absence of this alone, then, would prove the certain cause of death in Cholera. No other reason need be urged for employing it. The blood-letting acts as an indirect, but powerful stimulus. If asked how, I answer, by lessening the burthen of the heart’s action, and di- minishing the internal congestion, thereby permitting a freer circula- tion, and consequently, a better discharge of the functions of life, al- ready much impeded ; for the blood, turned away from the surface, crushes, as it were, as the sufferers rightly express it, the heart and internal viscera, and adds to the actual loss of nervous power, along with the clamminess of the blood, in preventing the heart from exe- cuting its functious. When drawn, I have sometimes seen the blood exhibit more the consistence of porridge than that which naturally belonged to it. Without the due circulation of the blood, life must cease ; for the functions which constitute it cannot be discharged : by restoring the circulation, these functions are resumed, and should not the agent which performs this be called a stimulus ? False or con- tracted views of the physiology of our frame, would assert, that the operation of blood-letting is always a debilitating one ; but this is not true ; for in Cholera it is directly the reverse. In many states of the animal economy, indeed, it is a process highly productive of debility ; but Cholera is one of the diseases in which it is not only not so, but in which it proves a most powerful stimulant. Patients will be brought in with a heavy labouring pulse, great uneasiness in the head, chest, but especially in the heart, which they sum up in the one word, crushing. They throw off the clothes; they toss their arms from side to side; they sigh deeply and gasp for breath, and sometimes say their breast feels as if bound with cords. Bleed them largely, and all these distressing symptoms flow away with the blood. The crushing is gone—they breathe freely, and. the eye loses its heaviness—in a word, blood-letting proves an admirable remedy, in addition to our other means of treating Cholera in the early stages. Plethoric patients, having felt the relief arising from blood-letting, have intreated that it should be repeated, as the crushing was not quite gone. By blood- letting, the consecutive fever is almost wholly averted—so much so, as to be a mere incidental feature of the complaint; it hinders con- gestion in any of the viscera, which would lay the foundations for after complaints, and prevents the effusion of blood on the brain and spinal marrow, which is the cause of death in many who would otherwise have recovered from collapse. A powerful man, a sailor, was brought to the hospital a few days since ; he was taken ill at sea ; the master gave him pepper and brandy, which prolonged his life long enough to permit eflnsion of blood upon the spinal marrow, under the effects of which he laboured when brought in. Upon opening the spine after death, to see if my conclusion was correct, I found the sheath of the spinal marrow absolutely gorged with blood during its whole course, precluding all chance of the poor man’s recovery. This instance illustrates one of the grounds upon which I urge the utility of blood-letting. 1 here was no reason in the nature of things, why this man should have died, save in the absence of proper care. Nature, indeed, is good and bountiful; ehe furnishes us with abundance of means, but leaves them under our own controul.