Case of Cholera Treated by Saline Injections

J. GREELY STEVENSON
1832 Boston Medical and Surgical Journal  
16. G. It., aged 22, a shoemaker, of temperate habits and feeble health, has suffered mental distress from family events these two days. He had no alvine evacuation yesterday, ate beeT and bread at dinner, toast and tea at supper, and was at work in his ordinary state of health. He is habitually costive. At 5, A. M., to-day, he had a copious dejection ; seven smaller discharges occurred in the course of two hours. At 11, A. M., he was visited by a physician ; he had just come in from the privy
more » ... in from the privy with cold skin, feeble pulse, anxious look, and nausea following profuse vomiting. A small dose of rhubarb with camphor was administered, and hot applications were made to the surface. 1, P. M. Lies in bed, making no complaint but of cramps, which are almost entirely confined to the left gastrocnemius ; they are rare and slight in the right. No abdominal soreness. Countenance haggard, purplish ; dark areola? round sunken eyes ; skin deadly cold ; hands of a dirty blue color ; skin of the fingers corrugated. The mind is tranquil, or indifferent ; the senses perfect ; no ringing in the ears. The voice is husky. Respiration is quick, somewhat laborious. Pulse 120, imperceptible in the left wrist, very feeble in the right, not tumultuous in tho carotids. Tongue yellowish on surface, doited red at tip and edges, . dry, rough, cold. Thirst not very urgent. Vomiting of a thin fluid of the color of rhubarb. No dejections since 11 o'clock ; their color is not known. No urine since 6, A. M. R. Hydr. Submur. gr. i. Tinct. Opii gtt. ii. to iv. To be repeated every ten minutes. If the vomiting ceases, continue tho calomel and omit the laudanum. Give drinks sparingly. Apply hot sand to the epigastrium, and hot fomentations to the legs. 3, P. M. Has had one dejection of a half pint of clear, colorless liquid, containing three or four flakes, and looking like pure water into which one may have spit a little phlegm. Has vomited a little yellowish, turbid fluid. Says that he feels quite well, were it not for the cramps. The skin is warm and wet ; the lace darker ; eyes more sunk ; fingers more blue and wrinkled ; the voice more huskv. Buzzing in the ears.
doi:10.1056/nejm183210310071201 fatcat:5jv6iojfxra7finvxfmipk5yzi