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XXVIII] College Hospital has been greatly reduced; and others, who have practised his methods, have in most instances had equally good results. The principle of the treatment is based on the fact that not only is the water content of the blood reduced by one-third to two thirds, according to the severity of the case, but in addition there is a loss of the saline constituents. Hence the necessity for supplying the latter. His hypertonic solution is composed as follows: Sodium chloride, 120 gr.; potassium chloride, 6 gr.; calcium chloride, 4 gr.; sterilized water, 1 pint. This he introduces by means of a special stop-cocked cannula and transfusion bulb at the rate of not more than 4 oz. a minute, the flow being slowed down to 1 oz. if distress or headache supervene. At the same time he gives permanganate of potassium in solution or in pill by mouth up to 50 gr. a day 2 gr. every quarter of an hour for two hours, then every half -hour till the stools are coloured green. In suppression of urine, if the blood pressure is normal, isotonic solution should be used. As the injections may have to be repeated several times, the cannula, suitably secured and protected, should be left in the vein till symptoms indicate that the acute stage is subsiding.

With the intravenous saline Rogers combines hypodermic injections of atropine.

Rogers considers that the occurrence of uræmia in cholera is the result of the development of an acidosis. In such cases he recommends the injection subcutaneously or per rectum of a 2- to 3-per-cent. solution of sodium bicarbonate if the specific gravity of the blood is low; if the specific gravity of the blood is high or normal, it should be given intravenously at first, and subsequently by rectum. Other Indian practitioners claim to have got better results in suppression of urine from permanganate in adrenalin solution, the dose of the latter being 10 minims of a l-in-10,000 solution every three hours.

During the stage of reaction, should purging persist, large doses of salicylate of bismuth with a little opium may prove of service. In these circum-