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XXVIII] Diarrhœa occurring during cholera epidemics should be promptly and vigorously treated.

Treatment.— During cholera epidemics it is customary to establish depôts where sedative and astringent remedies for the treatment of diarrhœa are dispensed gratuitously. Experience seems to encourage the belief that by such means incipient cholera may be aborted during the stage of premonitory diarrhœa. Of the various drugs used with this view, chlorodyne, or chlorodyne with brandy, is the most popular. Lead and opium pill; chalk, catechu, and opium mixture; compound kino powder; aromatic powder of chalk and opium; a pill of opium, asafœtida, and black pepper; dilute sulphuric acid and laudanum, are among the drugs more commonly employed for this purpose. Whether true cholera can be cut short in this way or not, it is certainly in the highest degree advisable at such a time to neglect no case of diarrhœa, but to insist on rest, warmth, and the greatest prudence in feeding in all cases of intestinal catarrh or irritation.

Many plans of treatment, based on theoretical considerations, have been advocated from time to time. The eliminative treatment advocated by Dr. George Johnson; the spinal ice-bag recommended by Chapman; various antiseptic methods directed to the destruction of the vibrio in the intestinal canal; drugs designed to counteract the physiological effects of the cholera toxins, as chloroform, atropine, nitrite of amyl, and nitro-glycerine, may be mentioned as belonging to this category of remedies. Until recently, the only treatment of proved value in cholera was the purely symptomatic and expectant one. If our efforts have failed to counteract the premonitory diarrhœa, attention should be given to maintaining the patient in as favourable a condition as possible to struggle against the poison of the disease. He should be kept strictly in the horizontal position, in a warm bed, and in a well-ventilated but not too cold room. His thirst should be treated by sips of iced water or of soda-water, or champagne, or brandy and water. Copious draughts,