THE
CHOLERA GAZETTE.
VOL. I. _WEDNESDAY, AUGUST 1st, 1832._ No. 4.
_Injection of Saline Solutions into the Veins._
The following documents relative to the treatment of cholera by the
copious injection of a saline solution into the veins, communicated to
the Central Board of Health of Great Britain, are of so interesting
a character that we hasten to lay them before our readers; though we
are far from participating in the sanguine estimate of the curative
powers of the remedy, entertained by Drs. Lewins, Latta and others. The
measure has been resorted to in New York, and on the whole, with but
slender success, and the results of trials of it, in this city, so far
as we have been able to obtain authentic information, have not been
very encouraging. Some of the symptoms have been relieved, but we know
as yet of no cure effected by it.
No. 1.
SIR,--I conceive it to be my duty to let you know, for the
information of the Central Board of Health, that the great
desideratum of restoring the natural current in the veins
and arteries, of improving the colour of the blood, and
recovering the functions of the lungs, in cholera asphyxia,
may be accomplished by injecting a weak saline solution into
the veins of the patient. To Dr. Thomas Latta, of this place,
is due the merit of first having recourse to this practice.
He has tried it in six cases, three of which I have seen, and
assisted to treat. The most wonderful and satisfactory effect
is the immediate consequence of the injection. To produce the
effect referred to, a large quantity must be injected--from
_five to ten pounds_ in an adult--and repeated at longer
or shorter intervals, as the state of the pulse, and other
symptoms, may indicate. Whenever the pulse fails, more fluid
ought to be thrown in, to produce an effect upon it, without
regard to quantity. In one of the cases I have referred to, 120
_ounces_ were injected at once, and repeated to the amount of
330 ounces in twelve hours. In another, 376 ounces were thrown
into the veins between Sunday, at 11 o’clock, A. M., and this
day (Tuesday) at 4 P. M.; that is, in the course of 53 hours,
upwards of 31 pounds!
The solution that was used consisted of two drachms of muriate,
and two scruples of carbonate, of soda, to sixty ounces of
water. It was at the temperature of 108 or 110 degrees.
The apparatus employed in injecting was merely one of Reid’s
common syringes, (the fluid being put into a vessel rather deep
and narrow,) with a small pipe fitted, that it might easily be
introduced into an incision in the veins of the usual size that
is made in bleeding. It may, however, be well to keep in mind,
that, in the event of the operation being frequently repeated,
it may be adviseable to inject by different veins.
I forbear at present to enter further into the particulars;
nor have we had sufficient experience to speak decisively on
the subject. I may, however, mention, that the idea of having
recourse to this remedy in cholera, occurred to Dr. Latta,
from being convinced, (which I am also,) that the evacuations
upwards and downwards are in reality the serum of the blood;
that it is the duty of the physician to replace it, as speedily
as possible, by injecting a fluid, as similar to the serum as
can be formed artificially, directly into the veins, which
has been done here with wonderful, and, so far as we can yet
judge, excellent effect. An immediate return of the pulse, an
improvement in the respiration and in the voice, an evolution
of heat, an improvement in the appearance of the patient, with
a feeling of comfort, are the immediate effects. The quantity
necessary to be injected will probably be found to depend upon
the quantity of serum lost--the object of the practice being
to place the patient in nearly his ordinary state, as to the
quantity of blood circulating in the vessels.--I have, &c.
(Signed)
ROBERT LEWINS, M. D.
TO W. MACLEAN, Esq.
_Secretary to the Central Board of Health._
No. 2.
SIR,--I did myself the honour to address a letter to you
lately, on the effects of injecting a saline solution into
the veins of a patient labouring under cholera. We have not
frequent opportunities of trying this, which I denominate,
admirable remedy, as the disease is decidedly less frequent
here; but I have seen it employed in two other cases, in the
course of the last two days, with the same excellent effect.
Sixty ounces are generally thrown in at once, and repeated
at the end of three or four hours. In a case to-day, where
I saw fifty-eight ounces injected, (being the third time
of performing the operation,) the patient’s pulse, at the
commencement, was 180, very small, and very feeble. She was
excessively restless, with a feeling of great weakness and
tormenting thirst. Before twelve ounces were injected, the
pulse began to improve; it became fuller and slower, and it
continued to improve until, after 58 ounces had been injected,
it was down to 110. Before I left the patient, (a woman,)
her condition was altogether amazingly amended. There was a
fine glow and a slight perspiration on her face; the veins
on the back of her head were well filled; the restlessness
was removed, the feeling of excessive weakness gone, and the
thirst ceased. The pulse was under 100, free, full, and soft!
Verily, sir, this is an astonishing method of medication, and I
predict will lead to wonderful changes and improvements in the
practice of medicine! I have addressed you upon the subject, as
the organ, from your high official station, of disseminating
a knowledge of the extraordinary facts referred to. It will,
of course, give me great pleasure to enter further into
particulars upon any particular point on which you may require
information, in reference to the cases that have come under my
observation.--I have, &c.
(Signed)