The Arkansas Advocate

LETTER FROM DR. DRAKE,

To a physician in Louisville, Ky.

CINCINNATI, Oct. 18, 1832.

Dear Sir—A considerable degree of indisposition, compels me to answer your letter briefly. But all that I could say, that would be useful to you, may indeed be said in a few words.

Epidemic Cholera commenced here on the 30th ultimo. I was called to the first case, and till yesterday have been constantly witnessing it in every stage. I am enabled to say, absolutely, that it is not contagious, but dependent upon a general distemperance of the atmosphere or the waters. When the patient has sunk into collapse, he has almost invariably perished under every mode of treatment. That stage, therefore, must be prevented. To accomplish this, let the minds of medical men, and the whole people be directed solely to the first indisposition. This is generally a diarrhea or lax, but sometimes the bowels are costive and the stomach is affected with nausea and vomiting. In other cases, the disease makes its onset, as a fever. Any form of indisposition, is apt, indeed, to terminate in cholera. A fact of which every physician should be aware. But to the remedies:

The very first is to require the patient to 'take to his bed, and remain there till all symptoms have ceased.' This is a sine qua non, and medical men in reference to it, must be absolutely imperative. Being in bed, he should cover up warm, and be enjoined to be still. If his pulse be active he should lose blood, in some cases liberally. The first and almost only medicine, should be calomel with opium, or Dover's powder, or Sulphate of Morphia, which must be repeated according to the judgment of the physician. As a sweating drink I have found an infusion of Boneset, or Thorough wort (Eupatorium perfoliatum.) to be the best and almost invariably successful in exciting the skin. In some cases it vomits, an effect, which must not be confounded with vomiting attendant on the disease. Other infusions, as those of sassafras, sage, catnip, and pennyroyal, or even hot water, may be used as an auxiliary. Camphor dissolved in water, by the aid of magnesia, as proposed by Dr. Parish of Philadelphia, I have found beneficial when but little inflammatory action existed. I began this practice as far back as Wednesday the 10th instant, and am enabled to say, that it has not yet failed to arrest the disease in a single instance in which it was fairly tried. Since that day, I have refused to prescribe for those who would not go to bed. I ought to have said, that where there is pain in the stomach or bowels, I have directed fomentations with hot water, or bags of hot mush or bitter herbs with great advantage, and think them preferable, in this stage of the disease, to sand or mustard.

I am happy to be able to state that this practice is almost universal in the city and that the very best results are flowing from it. It proceeds, as you will perceive, on the idea of maintaining the secretions of the liver, kidneys and skin. As long as those are kept up, the patient is safe, but this cannot be accomplished unless he lie in bed, in a warm room.

In one case I observed decided tenderness on pressure on each side of the spine at the junction of the last rib and consequently over the semi-lunar ganglions, to relieve which, I resorted to cupping, with subsequent application of a tartar emetic plaster, a practice which I strongly recommend.

Throughout the whole stage of the disease, the diet of the patient should be liquid and of the mildest kind, such as gruel, broth and arrowroot.

Respectfully, your obedient servant,

DANIEL DRAKE.

P. S. One of our medical friends who has just heard this letter read, informs me that he has found blistering along the spine in the early stage of the disease, of much apparent advantage.

Pitch plasters as a preventive of the disease, I have reason to believe, may be useful to those who are predisposed to coldness of the skin.