This was rather a long digression from the main subject under consideration–the treatment of the premonitory diarrhoea during a cholera epidemic. And yet, the subject is by no means exhausted. There remains still to be mentioned.
Iris Versic. Diarrhoea coming at 2 or 3 in the morning. Stools copious, sour belching, vomiting. Anus burns during passage of stool afterwards.
Podoph. Stools coming regularly in the morning, stop with the advance of the day, and may or may not appear again in the night. These stools are generally profuse in the morning with a mealy sediment, cramps in the calves and toes. Podoph. represents a picture of cholerine, and is in such cases most useful. In cholera proper it has not been found of any use, as far as I know. But in the precursory diarrhoea occurring in cholera seasons it is a remedy not to be neglected, often even an indispensable remedy. In the tenth volume of Allen’s Materia Medica, P. 636, we find a record of a policeman who took two ounces of Sulph. and Molasses at one dose. Within an hour he vomited, throwing the most of it out. Within five hours a diarrhoea commenced, slight nausea, painful griping and rumbling in the bowels, (I purpose to give the gastric symptoms only). These symptoms continued till the morning of the third day, when the diarrhoea became painless and almost involuntary. The stool was light colored, watery and lienteric. This condition continued till the middle of the seventh day when the discharges of the bowels stopped, and were followed by symptoms in the lungs and head. Hahnemann records moreover: Diarrhoea like water every half hour always preceded by rumbling in the abdomen, without pain. Kali Sulphuricum (see Allen V and X volumes) has even more claim upon our attention in the case of cholera than Sulph; it has actually produced all the symptoms of cholera. It should certainly be tried. Considering moreover that Kali Sulph. has (like Sulph.) produced diarrhoeic stools every morning between 3 and 4, preference should be given whenever such a diarrhoea pathologically, occurs, to Kali Sulph. as the same combines the two elements, each of which is characteristic of early morning diarrhoeic stools.
There remain only a few words for me to say with regard to-
Veratrum Album. Stools watery, greenish with flakes; vomiting; coldness and blueness of face and hands; colic before every stool; desire for large quantities of cold water; for acids; prostration after every stool, with cold sweat on the forehead, during the stool. Prevalence of either diarrhoeic or paralytic cholera. The indications of Veratrum show, that it is best suited to cholerine, or to a diarrhoea which appears on the point to assume a graver form of disorder. Under similar circumstances, during prevalence of cholera, simultaneous with, or preceded by an outbreak of variola, I would recommend Tartar Emetic. Particular indications for the use of this drug, both in the stage of diarrhoea occurring during cholera seasons, and for the diarrhoeic stage of cholera itself, are the following: Profuse sweats with thirstlessness or desire to drink often but little at a time. (Tart. Em. is classed by Grauvogl amongst the Hydrogenoid Remedies that show aggravation from dampness and aversion to water, which in fact being in excess in the system in an unassimilated state, does all the mischief). Pustular eruptions in the face or on any other part of the body is another strong, I might almost say, urgent indication for our drug. The Tart. Em. patient is phlegmatic, indolent, given to sleepiness (although, most likely as a reaction very irritable when not somnolent, as is often seen in children); he would fall asleep after every fit of vomiting or purging. The nausea is more persistent in Tart. Em. patient than in any other; there is a constant strain or attempt towards vomiting. The Veratrum patient vomits after drinking vomiting. The Veratrum patient vomits after drinking large quantities of water, and there is an end of it, soon he drinks again and vomits again, of course, by no means merely the water he drinks (Phosphorus). The Arsenic patient vomits because there is gastric irritation; in the Tartar Emetic patient, there is simply gastric uneasiness, coupled with a feeling of faintness. The vomiting is cerebral originating in the medulla oblongata. Of course, when once set up it may by its very action establish gastric irritation, and in this way the vomiting may continue after the Tartar Emetic action has exhausted itself. In such a state of things Arsenic may finally establish order on homoeopathic principles. To distinguish further, we may say : Arsenic aggravations are caused by cold; Veratrum aggravation by heat; and Tart. Emetic aggravation by dampness. There is again the least reactionary power in the Tartar Emetic patient; he gives passively way to his disorders without hardly any struggle; he rather faints under the weight of exhaustive discharges, then tries to keep up in order to make a stand against the threatening extinction. And in this passive state, near the brink of death the Tart. Emet. would remain for a considerably long time without getting either better or worse.
Of such drugs as Nux Vomica, Pulsatilla, Chamomilla, etc., we shall only then find occasion to make use, when some infringements against the usual dietetical rules has, to all appearance, given rise to the bowel disorder. Thus :
Chamomilla after anger.
Nux Vomica after intemperate drinking, or eating; acidity of the stomach; ineffectual urging to stool; stools with tenesmus.
Pulsatilla, after indulgence in greasy food; diarrhoea especially at night; greenish watery; mucus; tongue coated white; feels chilly, yet likes fresh air; finds the room uncomfortable.
I could go on in this way, giving you ten or twenty remedies more, all suitable in certain casualties. The above will, however, be found sufficient for the usual run of diarrhoeic cases preceding cholera.
Properly speaking, no cholera case should be considered as treated homoeopathically, that has been tampered with at its stage of premonitory diarrhoea by some other medication of massive dosage. Only then could we have an exact idea of what the mortality of cholera under homoeopathic treatment really is. I am afraid half of our patients have been poisoned by opium, chlorodine, etc., before they come under our treatment. These are no more cholera patients, but poisoned cholera patients; and yet all failures are put to the debit of our account, increasing thereby the rate of cholera mortality under homoeopathic treatment. Now, this is not as it ought to be. Of course the world at large, will always be ready to throw stones at us; but we, for ourselves, should know better. No homoeopath should consider a cholera case as being, or having been homoeopathically treated, unless the case has from the very beginning been under his care. The world may throw stones at us; this is no reason why we should pick them up and pass them on amongst ourselves as current coins. Let it, once for all, be established amongst ourselves, that no case shall be admitted as having been treated by our system of medicine, unless we had the opportunity of treating it from the very outset-and our statistics will be, I am sure, by far more favourable than they are now.
