SEPTEMBER 7TH, 1866: Outbreaks of cholera were common in Dublin in the 19th century due to poverty, overcrowding and, especially, the lack of sanitation. A brief editorial in today's newspaper in 1866 noted that a meeting of Dublin Corporation to set up a public health committee with newly extended statutory powers had to be abandoned because not enough councillors turned up to form a quorum: it contrasted their lack of interest with the intense interest there would have been had there been a political motion on the agenda. In the same paper, this letter from a doctor also warned against a common but ineffectual remedy against cholera:
Sir, - Will you allow me, through the medium of your influential journal, to caution the public against trusting to the use of camphorated spirits as a remedy for the prevention or cure of the cholera epidemic, now, unhappily, prevalent amongst us.
In my opinion it is, as a remedy, not only worthless, but dangerous; it is worthless in not possessing any controlling power whatever over the premonitory diarrhoea, and it is dangerous as by placing any trust in its supposed efficacy, persons are lulled into a false security, valuable time is allowed to pass away, the invidious stage of collapse creeps on, and all hopes of recovery soon vanish.
I am induced to offer these remarks in consequence of witnessing all the sad results above stated within the last 24 hours. In two cases, to which I was called, I found the camphorated spirits on the dressing table; its use was persistently persevered in during the whole period of the premonitory diarrhoea, and it was only when cramps seized on the legs that the attendants became aware that danger was at hand, and then only was medical assistance sought for; but it was too late; the continued drain from the system, during so many hours, had done its work, and the result might be easily anticipated.
Here two valuable lives were lost, by delay, which, in all probability, would have been saved if timely and judicious treatment was adopted.
In the name of common sense, if people will make use of domestic remedies for the prevention or cure of cholera, why not follow the advice so well and judiciously laid down for their guidance by the College of Physicians of Dublin and London, or the still more simple instructions lately given by the Poor Law Commissioners on the subject, and not trust their lives to the supposed efficacy of a nostrum, the modus operandi of which is unknown, and whose vaunted utility cannot be explained on any pathological principle whatever.
The commonly received theory of the action of the cholera poison, on the human system, may be, according to Dr McPherson, summed up as follows: - The first step in the process is the transudation of the liquor sanguinis from the blood into the intestinal canal; the blood thus deprived of its watery part recirculates badly, and ends by stagnating, not only in the capillaries, but by degrees in the large vascular trunks – thence blueness of the skin.
To repair the loss of fluids by the blood, there is a general imbibition from all the tissues and structures . . . The absence of blood from the lungs, and the imperfect aeration, accounts for the want of heat and the feeling of suffocation in the more advanced stages, and the feebleness of the voice is probably caused by the weakness of the respiratory organs, which are not able to pass into the larynx a column of air strong enough to produce the natural voice.
If this theory be true, and it is generally believed to be so, the increased discharge from the gastro intestinal mucous membrane is, therefore, the most important result of the above series of morbid changes, the arrest of which is the object aimed at by every plan of treatment.
That camphorated spirits of wine is totally inadequate to effect this much-to-be-desired object must at once be apparent to every intelligent understanding. - I am, your most obedient,
John Ryan, MD,
Francis Street, September 6th
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