_Leith, May 27th._
No. 5.
_Details of Two Cases of Malignant Cholera treated by Venous Injection,
by Dr. Craigie, of Leith._
_No. 1. Case successful. 15lbs. injected at intervals in nine
hours._--Martha Smith, aged thirty-eight, a noted drunkard,
thin and debilitated, in sixth month of pregnancy, admitted
into the hospital at 8 P. M. May 16th, 1832.
It appears she had had vomiting and purging since Sunday
morning, 12th inst. Cramps came on about four hours ago in both
legs; great evacuations both upwards and downwards like dirty
water. The countenance is now collapsed; eyes sunk; tongue
cold; pulse imperceptible at wrists; very small in brachial
artery; 124.
℞. Muriat sodæ, ℨiij; Carbon sodæ, ℨi; Aq. calid. ℔vj. solve.
Ft. Enema statim injiciend. Sinapisms to spine and epigastrium;
let her be placed on heated tin mattress.
Nine A. M. Has a good deal of vomiting; is getting warmer;
pulse now perceptible in right wrist; tongue warmer; she
allows the enema to come away without giving notice to nurse.
Saline enema as above, with the addition of white of eggs, to
be repeated every half hour.
Ten. Vomiting and purging of watery fluid, with slimy matter in
it.
Half-past ten. Cramps have returned severe in left leg; pulse
again imperceptible; urgent thirst, and constant vomiting.
_Rep. enema et pulveres effervescentes._
Half-past eleven. Breathing becoming much affected; extreme
restlessness; cramps severe in legs, and every symptom of
sinking. Let the following saline solution be injected into one
of the veins of the arm.
℞. Muriat sodæ, ℨi; Carbon sodæ, gr. x; Aq. calid. ℔iij, solve
temp. 105° Fahr.
Noon. When about ℔i. had been thrown in, the pulse was
perceived to flutter at the wrist, and gradually strengthened
as the injection was proceeded with. By the same ℔iiiss.
had been injected, the countenance, which was before quite
death-like, now beamed with the appearance of health, and she
began to converse freely. Pulse 96, moderate. To have ℥i. gin
in warm water with sugar.
Half-past one. The gin was immediately rejected. Pulse has
again gradually become imperceptible, and respiration quick and
laborious.
Two. Let the venous injection be repeated to ℔vij.
The effect of the injection, as formerly, was very striking.
To see an individual who seemed _in articulo mortis_ brought
back, as it were, in so short a space of time to an apparently
tolerable state of health, could not but astonish the beholder.
Before the injection was finished the pulse had returned to a
healthy fulness and firmness. Expresses herself much relieved;
no purging, but vomits much serous matter.
℞. Muriat sodæ, ℨij; Carbon sodæ, ℨi; Alcohol. dilut. ℥i; Aq.
calid. ℔iij. M. ft. enema statim injiciend.
Four. Enema retained about an hour and a half; surface of body
now comfortably warm; she has not passed more fluid by stool
than was thrown into the rectum.
Six. Has slept softly for an hour; the first sleep she has had
for many days.
℞. Subm. hydrarg. gr. v; Pulv. opii, gr. ss. M. sumat stat. et
rep. 3tia quaque hora.
Nine. Complains much of vomiting and sense of weakness;
countenance rather collapsed; breathing rather difficult.
Let ℥lxxx. be injected into the veins again gradually.
After the first few ounces were thrown in she complained of an
acute pain at the epigastrium, and faintness, probably arising
from the fluid being thrown in too fast upon the heart, or
from the passing of a bubble or two of air, which may have got
in from the inaccuracy of the injecting apparatus used. Be
that as it may, the circulating system was so much affected,
that the pulse, from being distinct though feeble, became
quite imperceptible, but on stopping the injection for a few
minutes the pulse gradually returned, and the pain abated. She
expresses herself as always getting relief from the operation.
Eleven. Vomiting continues urgent.
App. emp. cantharid. epigast. Effervescing draughts
occasionally.
May 17th. Has passed about ℔j. of urine, of natural appearance;
this is the first she has made since she was brought in.
From this time she went on gradually to improve, but stomach
continued very irritable, and the matter vomited was bilious.
21st. Labour pains came on, and she was delivered of a
still-born female child.
22d. Symptoms of phlebitis in right arm came on, proceeding
from the wound upwards, but this yielded to the ordinary
treatment, and she may now be considered out of all danger,
though she is not yet reported cured.