The variations in the pressure and composition of the blood in cholera; and their bearing on the success of hypertonic saline transfusion in its treatment
During the quarter of a century which has elapsed since the discovery by Prof. Koch of the comma bacillus of cholera, research work has benn almost confined to the bacteriology of the subject. Unfortunately, with the exception of M. Haffkine’s prophylactic inoculations, which are now very little used even in india, this line of work has done little or nothing to help the practitioner who is confronted with the treatment of this terrible disease. No powerful antitoxic serum of practical value has been produced, and even if such should still be obtained, many patients value has been produced, even if such should still be obtained, many patients come under treatment in such a state of collapse that no medicine can be absorbed, even if retained. The old controversy between the evacuant conserative methods of treatment has long since ended in the practically universal adoption of the latter, although as late as 1866 Dr. George Johnson advocated castor oil, denying that there was any relationship between the amount of fluid lost from the body and the mortality, while he strenuously opposed the use of intravenous saline injections to replace it. There is still much difference of opinion about the latter treatment, for although all who have used transfusion testify to the remarkable immediate improvement in the pulse and general condition, yet this is commonly of such brief duration that many think it only severs to needlessly prolong the agony of the patient, so that of recent years it has been only exceptionally resorted to in India.