This is a disease characterized by sudden onset of incessant vomiting and purging (both resembling rice-water in character), which, if not checked in time, bring on much thirst, suppression of urine, cramps in calves’ legs etc. and ultimately collapse i.e. thready or imperceptible pulse at the wrist, cold clammy sweat, cold body surface, difficulty in breathing, etc.)
Cause—The disease is due to the ingestion of the causative germ (called cholera virus or comma bacillus), with food or drink. The germ occurs plentifully in the excreta of sufferers from cholera. If the dejecta of a sufferer get access to any food or drink, then that food or drink can import the disease. The three-principal means whereby the dejecta of cholera patients are mixed with food and drink are—
- by the help of flies,
- by the illiterate folk washing soiled articles in or near a tank, well or stagnant river;
- by attendants of cholera patients not taking proper care in disposing of the dejecta of the patient.
The reader should remember very carefully that there cannot be cholera unless its germs are present in food or drink, just as there cannot be burning of any part of our body unless a fire is present. But almost every disease has two kinds of causes—direct and predisposing.
The direct cause of cholera is the access of the comma or cholera germs into our alimentary passages.
The predisposing causes are those that render the system weak and all the more vulnerable to the inroads of the direct cause. For a person to be attacked with cholera, they are fasting, night-keeping, drinking, excessive venery, mental depression or fright or eating rich dishes or unsound food, late and heavy dinners, abuse of purgatives, exposure to cold and wet and other indiscretions. The animal food (like meat, fish, milk, cream, ice-cream, egg), if stale, are the most offending articles of diet. Wherever a large number of miscellaneous people congregate (as in fairs or pilgrimages), suddenly upsetting all sanitary arrangements, there too cholera breaks out.
Types or Varieties—Three types of this disease are known. They are:
- Cholerine or simple cholera,
- Asiatic or Virulent Cholera
- Dry Cholera (or Cholera Sicca).
Below we show the distinguishing points between:
|Cause||Dietetic indiscretion||Germs of cholera-in one who may have dietetic indiscretion.|
|Stools||At first bilious-green then rice-water-like.||Rice-water-like from the beginning.|
|Cramps||Commences in abdomen and do not affect the upper parts of the body.||Commences in fingers & toes and then passes on to both limbs.|
|Temperature||Falls gradually but seldom with much prostration.||Falls rapidly and leads to rapid and marked prostration.|
|Suppression of urine||Rare||Common|
|Facial aspects||Light pallor||Cyanosis or blueness of the skin.|
In Dry Cholera, but a phase of Asiatic Cholera, the patient feels suddenly intensely thirsty, with restlessness and a burning sensation all over the body. Without any vomiting or purging occurring, the patient suddenly collapses and gets comatose and dies. The chief remedies are: Camphor 6, Ars. 6, Acid Hydro. 6, Tabacum 6.
Types—Of Cholera itself there are several clinical varieties—making them out for separate treatment on homoeopathic lines. Thus, some cases have been known to have these prominent symptoms:
- Purging or Diarrhoeic Type—in which the downward evacuations are as frequent as they are large.
- Vomiting or Gastric Type—in which nausea, retching and vomiting predominate.
- Gastro-intestinal Type— in which vomiting and purging equally prevail. Medicines Ricinus 3, Veratrum 6.
- Haemorrhagic Type—in which bloody vomit or stools occur. Medicines: Acon. 1x, Iris 3x, Carbo. Veg. 6, Merc. Cor. 6, Phosphorus 3.
- PyreticType—in which fever co-exists with vomiting and purging. Medicines Acon 1x, Bell. 6, Byro. 3, Baptisia 6, Rhus Tox. 6, Ricinus 3x.
- Crampy or Spasmodic Type—in which cramps and convulsion are the most distressing symptoms. Medicines: Cuprum 6, Secale 6, Camphor Ө.
- Algid Type—in which from the start, the patient is cold, cyanotic and pulseless; he is more or less comatose, with difficulty in breathing and oppressive sensation chest. in Medicines Verat. Alb. 6, Veratrum 3x (trit), Ars. Alb. 6, Nicotine 3.
Symptom and Stages
- Incipient Stage—Duration, 1 hour to 3 or 4 days. The patient feels out-of-sorts; appetite is dulled, distaste for food appears; nausea, thirst, a sensation of dead weight at the pit of the stomach, dizziness, sensation of noise in the ears and weakness mark this stage.
- Developed Stage—Duration, about 3 to 24 hours. Profuse vomiting and purging of rice-water-like fluid, intense thirst; gripes and rumbling inside the abdomen; sunken features, pallor of the body, cold clammy sweat, suppression of urine, collapse, cramps in the limbs and restlessness mark this stage. In some cases, instead of actual vomiting, retching is marked. After 8 to 12 hours, the patient passes into the stage either of convalescence or of collapse.
- Collapse Stage—Duration 12 to 36 hours. This is the worst of the five stages. In it, thirst is agonising and drink is invariably followed by exhausting retching. The pulse becomes so feeble as to be hardly felt at the wrist and oftentimes is felt at the middle of the arm. The surface of the body is bluish and cold, lips are bluish; eyes are sunken in the sockets and are lustreless or, often injected; pupils are dilated; voice is husky; breathing is laboured, tips of fingers and toes wrinkled like those of a dhobi and urine is suppressed. There is intense burning sensation in the body and cold clammy sweat comes out. Prostration is intense and oftentimes the patient retains his senses throughout. During this stage, the vomiting and purging may suddenly cease and bring on coma or death, a short while later; or vomiting and purging gradually abate and patient is put on the way to recovery.
- Reaction Stage—Duration uncertain. This often ushers in convalescence. The stools and vomit, instead of ceasing all atonce, come on at long intervals, are more consistent and bile-tinged. The bony-surface becomes warm; urine is passed naturally and the patient recovers.
- Complication Stage—Instead of normal reaction, the reaction may be unduly excessive, resulting in congestion of such important organs as lungs, brain, kidneys etc. The temperature may go up substantially; there may be flatulent distention of abdomen, hiccough, retching and coma.
Prognosis: The following symptoms are considered:
Favourable symtoms are If the vomiting or purging are less severe, if the general aspects are not very bad, if the temperature of the body is not much reduced, if there is no difficulty in breathing and no restlessness; if he is not pulseless; if the reaction stage comes on early; if the cramps are not very painful; and if thirst is not intense.
Unfavourable symptoms are sudden and early in the morning onset, followed rapidly by prostration and collapse, unconscious evacuation, sleeplessness, coma, very high or low temperature of the body, rapid pulse or pulselessness, laboured breathing, violent gripes, bloody evacuations, prolonged suppression of urine, delirium, difficulty in swallowing etc. If unconscious patient lies on his back, in a cross-legged decubitus, that also is an unfavourable sign. If the patient is pregnant, drunkard or an opium-eater, very young or very old or weak, or a sufferer from malaria— the prognosis is grave. Cholera invariably causes abortion in pregnant women.
- Do not depress your system—By fright, over-work, worry, night-keeping, purgative or exposure.
- Keep clean—Take regular baths and use the soap freely to wash your hands and feet. Keep the nails cut short and their undersurface clean. Keep clothes etc. clean. Live in clean, well-ventilated rooms and places.
- Keep out flies and dust—Kill them. Never keep any food or drink uncovered. If a fly sits on any food or drink, or dust settles on them, reject the same without hesitation. Do not purchase food from shops where food is exposed to flies and dust.
- Avoid unwholesome food—Food that it stale or cooked badly or unripe or over-ripe, or rich. Do not overeat late dinners.
- Drink only boiled water—If a well or tank water is suspicious, it is best always to boil it. Simple filtration affords no safety. Treat it with potassium permanganate or copper sulphate at first and then always thoroughly and repeatedly boil it before use. If possible, have the source of water-supply properly guarded by police.
- If one has to attend a case of Cholera—He must not go there with an empty stomach, nor must he eat or drink anything while on duty there. Duty done, he is to thoroughly rinse the hands upto the elbows, repeatedly in hot water and soap and thereafter in some antiseptic lotion (like carbolic, bin-iodide of mercury lysol, etc.) He is to boil his clothes and bathe. Thereafter he can take his meals.
- Regarding the rejecta (stools, vomits)—They must be atonce mixed with sawdust or rags and burnt; or if that is not possible atonce, they must be covered over with lime and burried deeply—away from all habitations and sources of drinking water. No fly should be allowed to settle on them and all soiled clothes should be atonce treated with strong phenyle-solution or carbolic lotion and boiled as soon thereafter as possible.
- Other measures—A nursing mother attacked with cholera should not give suck to her baby. Take regularly everyday Cuprum 30 or Sulphur 30, as preventive.
Hygienic and Accessory Methods of Treatment
Keep the patient in a clean, dry, well-ventilated room. Keep out flies and sprinkle scents (not very strong) on his bed or burn incense occasionally in the room. Remove all dejecta as soon as passed and never keep any edibles in the room. The patient is to pass his evacuations lying down or else exhaustion will too rapidly set in. All foods should be strictly avoided, and all water given to the patient to drink must be repeatedly well boiled and kept covered. Water must be freely given whenever called for. When the cramps set in apply hot water bottles or flannels or rub spirit over the parts. Keep the room warm in winter. If the patient sleeps (but not comatose) do not wake him up any account. Bits of ice may be given to suck, if desired; but it is better to give water freely.
Diet—Anything in the way of food is strictly forbidden, unless the patient is well convalescent, and reaction is fully established. After the stools become bile- tinged and secretion of urine is well established, food can be thought of. To give any food before that, is to court death. This first diet should be coconut or very thin pearl- barley-gruel, flavoured with lime and seasoned with salt. Of this, only teaspoonfuls can be given at the start, at interval of 2 or 3 hours. If these do not give rise to acidity or flatulence or do not increase the frequency of motions, then a more liberal quantity can be given and that always gradually. When barley can be well tolerated then try ghole (skimmed curd, diluted with water) or milk-whey, and thereafter, milk and barley. Last of all, try soft rice with (Paederia Foetida) soup or with fresh fish-soup. In short, proceed cautiously.
Treatment— [As a general rule, use lower potencies (3—6) and medicines may be given after each evacuation, if required].
General Indications: For a beginner or a very busy man, following hints are given, though it is desirable that none should undertake the treatment of a case of cholera, without very careful consideration of all the material points.
TREATMENT IN BRIEF
- Repeated and large watery motions, sometimes faintly greenish in colour; greenish bilious vomits; much gripes or burning pain is felt in the anus after each evacuation. —Iris
- Rice-water like vomit and stool, passed—without gripes; shreads float on liquid motions; cramps and prostration marked. —Ricinus
- Onset sudden and severe; greenish watery motions, with shreddy deposits: vomiting, hiccough and gripes; severe thirst for cold drinks; clammy sweat on forehead; body cold and bluish; cramp and prostration and dhoby’s finger present—Veratrum Alb.
- If cramps are very severe (especially in the arms and legs)—Cuprum
- Intense thirst following vomiting and purging; a desire to cover up the body inspite of burning sensation all over; body cold; prostration and restlessness—Arsenic
- (f) Vomiting and purging; burning sensation at the pit of the stomach; gripes; thirst; fear of impending death; restlessness—Aconite Radix
- (g) Frequent retching, not relieved by vomiting-Ipecac 6; if relieved by vomiting—Antim Tart 6:
- (h) Body cold, but burning sensation inside the body and patient wants to be constantly fanned and throws off clothes; unconscious evacuations, with relaxed arms; cramps especially of fingers and toes-these being forcibly bent backwards-Secale 3.
- Urine suppresed; abdomen distended with wind; breathing laboured. —Opium 3.
- Dry cholera, with painful cramps from the beginning; breathing difficult; eyes sunk in the sockets; body bluish and cold but not perspiring, severe prostration-Rubini’s Camphor 5 to 7 drops in sugar, by mouth, every ½ hour and to rub the same over the body; this failing, try Acid Hydro 3-30, Arsenic 200, Carbo Veg.
If reaction occurs and yet there is no urine—try Cantharis 6. In the last stage (face deadly pale, body icy cold, no pulse, hard breathing)-Cobra or Naja 3.
- In the case of children–
- Hot evacuations; with or without thirst associated with teething-time—Podophyllum
- Stools liquid; frequent evacuations; lumpy vomits followed by sleep or exhaustion; sleep is followed by appetite—Ethusa
- Profound exhaustion; body cold and bluish; no pulse at the wrist; convulsion—Kali Brom.
TREATMENT IN DETAIL OF EACH STATE OF THE ATTACK
During Incipient or Invasion Stage
Camphor (Robini’s spirit of camphor) 0 —Its indications are-
- Buring sensation inside the abdomen; purging with gripes; convulsion and chill follow evacuations (Robini).
- Useful so long as stools are frequent. Sudden exhaustion, husky voice; face pale, eyes sunk in sockets; body cold; burning sensation at the pit of stomach (Hahnemann).
- Vomitings are more than the purgings; body cold; voice husky (Farrington). [Note—We, however, are inclined to think that camphor should not be given where vomitings are more than the purgings and when the body becomes rapidly cold. In such circumstances give instead-Ars.]
If diarrhoea following an exposure to cold merges into cholera, Camphor is useful. It is also of use in the initial stages of cholera marked by chill, exhaustion, burning sensation at the pit of stomach; dizziness and laboured breathing. In dry Cholera, Camphor is the best medicine. Where there is much nervous prostration and the body is blue or is icy cold (with or without clammy sweat), the eyes are fixed in a stare, pulse is weak, extremities are benumbed, Camphor is of value. Where reaction is due, but is not coming on after cessation of vomiting and purging Camphor is given with benefit. Where after the use of Carbo Veg. or Phosphorus, the large intestines, heart and muscles are not regaining their tone. Camphor is indicated. In the paralytic type of cholera too, Camphor is useful. Camphor must be used at the commencement of Homoeopathic treatment following Allopathic or Kaviraji or Hakimi treatments. It is important to remember that Camphor is useless in non- convulsive types of cholera as well as in the developed stage of convulsive cholera.
Our experience is that indications for the use of Camphor are: (a) Frothy vomit and stools at the start, chill and rapid exhaustion; and (b) cases of cholera in which the body becomes cold and blue from the start.
Dose: 5 to 10 drops (for adults) or 1 to 2 drops (for children) on a lump of sugar, every 5 or 10 minutes. If no effect follows from 8 or 10 doses, try other medicines. If repeated use of Camphor results in burning sensation in the rectum, mental uneasiness or other distressing symptoms, give one or 2 doses of Phosphorus 6.
Arsenic Alb. 6— Attack due to too free indulgence in fruits or ice; burning sensation inside stomach; intense thirst, easily satisfied by small sips; much restlessness, great prostration.
China 3—Attack follows eating too much of fruits. Motions liquid but yellow or contain undigested food matter; rumbling of bowels, flatulent distention of abdomen; weakness.
Aconite Nap. 1x—Motions bloody or like agitated water of melon; unbearable gripes; restlessness; thirst; chill; fear of impending death; slight rise of temperature. Useful also in cholera following exposure to heat or cold.
Acid Phos. 3, 6—Painless ashy motions; chronic diarrhoea merging into cholera; following upon excessive venery. Pain increases after food or while lying on right side.
Phosphorus 6—Painless, greenish, mucoid, or watery and hot evacuations with coldness, anus is open and faeces constantly oozing aggravation of symptoms after eating hot things or while lying on the left side; evacuations follow taking salt; vomits and motions are both hot.
Cabo veg. 6—Attack after eating butter, ice, icecream, salted or decomposed fish or stale vegetables; attacks of old or weak people or people who (like cooks, masons or blacksmiths) have to work exposed to the fire or to the sun; stools bloody or reddish, body cold.
Ricinus 6—Copious, painless vomiting and purging, without any convulsion.
Chamomilla 6—Attack after a fit of anger or distemper; motions hot, acrid, corroding or foetid smelling; during dentition of children, bilious, liquid, green motions with gripes; gripes subsiding after evacuations.
Ipecac 6—Nausea and hiccough from the very start; vomits exceed the stools; stools are greenish and frothy, with foul smell or mixed up with mucus and blood; gripes and tenesmus present dysentery.
Podophyllum 6—Evacuations are passed without pain, are hot and greenish white, frothy or bloody; are most in number towards the morning. The stools are profuse and gushing, each stool seeming to drain the patient dry. But nothing of the kind occurs.
Nux Vomica 6—Diarrhoea coming on after a drinking bout, night-keeping, irregularities of eating, ingestion of purgatives, or prolonged over-drugging or fatiguing exertions; flatulence; ineffectual efforts at evacuations which when passed are foul-smelling and bile tinged; motions follow eatings or are frequent early in the morning. Nux Vomica is the best adapted to persons given to too much brain-labour.
Pulsatilla 6—Diarrhoea follows eating fatty food; stools mucous, green, changeable; thirst absent; aggravation of symptoms at night, Pulsatilla suits best the woman easily given to weeping or men of gentle temperaments.
During the Fully Developed Stages
Kaliphosph 12x—If camphor is unavailing and rice- water-like stools set in, this drug failing try Veratrum and Arsenic.
Veratrum Album 6, 30, 200—Large rice-water like evacuations following gripes; pulse thready or not felt at the wrist; heart; feeble; suppressed urine; intense thirst not fully relieved by large rotations; cold sweat; tongue and breath cold ; body cold and bluish; pupils contracted; cramps in both extremities and in thighs and abdomen; face pinched and blue.
Veratrum—is useful where the prostration is less than what the amount of vomiting and purging would warrant; where the evacuations are passed without effort; where the thirst is severe and can be quenched only by large draughts; and where inspite of the prostration the mind is at ease.
Arsenic 6,30 200—Vomits and motions are not copious; insatiable thirst but drinks small quantities at a time and vomits immediately after each drink, suppression of urine; much restlessness and prostration; unconscious evacuations; burning sensation at the pit of stomach, often after vomiting; body cold and becomes suddenly pale; pulse feeble or imperceptible at the wrist; fingers and toes wrinkle like those of a washerman; breathing quick and laboured; tight sensation in the chest; heart’s action is quickened after evacuations; voice husky; cramps, twitching of muscles; tongue dry, rough and cold; gurgling sound on drinking [If, with all or most of the above indications, the evacuations are bilious or mixed with mucus, Arsenic can be given. Dr. Russel and many others think, that Arsenic should invariably follow Camphor; while more authorities think that Arsenic can and ought to be used in every stage of cholera. Dr. Hughes thinks that the indications for its use are: Restlessness, anxiety, prostration, intense thirst, death like pallor of appearance].
Arsenic—is indicated when the prostration is out of proportion to the loss of fluid; where the evacuations are scanty as compared with the urgings and efforts; where inspite of severe thirst the patient sips only small quantities of water and where restlessness mental and physical uneasiness are prominent.
Cuprum Metallicum 6,12, 30—It is a very valuable remedy in cramps, especially of hand, feet and toes and fingers. If this fails, use Secale, It is also used when spasms follow an attack of convulsions or when patient cannot retain food or medicine, owing to severe irritation of alimentary passages. Its indications are Body cold and bluish; cramps in both extremities; restlessness; pulse thready or imperceptible; eyes sunk in sockets or turned upwards; deficient hearing; gurgling noise is produced while drinking liquids; a desire for warm drinks; nausea checked by cold drinks; gripes; eyes water during vomitings; itching sensation around the anus; speech blurred; vomitings partly liquid and partly shreddy; ineffectual urging to urinate; breathing quick; delirium; gnashing of teeth; screams.
Secale Cornutum 3, 6, 30—Useful for checking cramps. It is valuable after Cuprum has failed to stop spasms and when the following indications are present Fear of impending death; eyes sunk in sockets; hearing deficient; face pinched, pale and melancholy or distorted, tongue clean or coated white and tremulous, thirst and appetite keen; nausea or vomiting; a burning sensation at the pit of stomach; suppression of urine; cramps in left side of chest and in fingers and toes; pulse barely perceptible at the wrist; extremities tremulous; tongue is bitten; unconscious evacuations; burning sensation all over the body, causing clothes to be cast off. Secale is also useful in the collapse stage when the patient gets his back arched (opisthotonos), his face is bluish, cramps attack his extremities and when he vomits either mucus or mucus mixed up with worms and feels relieved after vomits.
Aconite Rad. Ө, 1x—Body becomes blue and cold very soon after onset of vomiting and purging; much difficulty in breathing; breath is cold; severe gripes; stools are watery; vomitings are green, black or yellow; suppression of urine; vertigo; pulse hardly perceptible at the wrists; face swarthy in appearance. Prescribe Acon. Rad 1x when body is cold but heart’s action is regular though feeble; and where the patient is in fear of death and is anxious; also when during the collapse stage, the motions consist of sticky mucus. When during the terminal stage, fever sets in give Acon. Rad. 1x alternately with Belladonna 3.
Antim Tart. 6-30—When towards the end of the stage of full development, coma tends to set in—coma that is broken only by each act of vomiting give Ant. tart. Its other indications are Pain and burning sensation in the chest; lethargic stupor, frequent moannings; feeble pulse; watery, frothy or greenish evacuations, often passed involuntarily; painful retchings followed and relieved by slight vomiting; eyes sunk in sockets; vision hazy, inspiration deep but expiration is shallow. In cases of threatened heart failure during the collapse stage, use Antim Tart. The leading indications of Antim. Tart and Verat. are much alike; use Antim Tart. when there are muscular twitching or paresis, and where Verat. Alb. fails to relieve the weakness of heart or its paresis.
Iris versicolor 3x —Onset of disease early in the morning, pain around the navel and in the lower part of the abdomen; vomits are sour smelling or contain undigested food-matters; stools are sour smelling or whitish or yellow coloured; a burning sensation throughout the digestive tract, from mouth down to the anus. Burning sensation all over the body following vomits; burning sensation inside the mouth; sweating. Iris is of no avail if collapse is present.
Ricinus 6—Copious liquid evacuations; bilious vomit; cold sweat on the brow; cramps, burning sensation inside abdomen, but no gripes; suppression of urine.
IIaterium 3—Copious, painless, bilious or frothy vomiting and purgings; gripes or flatulence; chill and yawning.
Tabacum 6—Retching or vomiting after stools have ceased; movements aggravate the nausea; cold sweat, body cold; cramps in legs or chest, palpitation. [It is a valuable remedy in the cholera of infants].
Cuprum Ars. 6 (trit.)—Cramps or convulsions following upon severe gripe. [Valuable in infantile cholera].
Phosphorus 6—Evacuations passed with noise and following upon rumbling inside the abdomen. Vomits excited by drinks, specially cold drinks.
Ipecac 3x, 6—Much retching or vomiting and bloody stools (without mucus).
Mercurius Cor. 3—Where cholera follows diarrhoea or is characterized by bloody mucous stools.
Croton Tig. 3, 6—Liquid, yellow motions, passed with force; tenesmus or urging; vomiting immediately after liquid drinks; pain at the pit of stomach.
Jatropha 3, 6—Sticky mucous motion, instead of rice-water-like evacuations; vomits precede purgings; body cold, with cold sweats; spasms in muscles of hands and feet; rumbling noise inside abdomen.
Dose: —These medicines should be administered every ten, fifteen, twenty or thirty minutes, according to the severity of the symptoms.
During Collapse Stage
If homoeopathic treatment is started at this stage and particularly if allopathy has been tried and too much of homoeopathic medication has been done, start with two or three doses of Camphor. Cases of cholera in which collapse sets in early, also require a few preliminary doses of Camphor. Then try successively, Ars., Verat. Cuprum, Secale Cor. and Aconite, according to indications. But, if any of these has been already used in vain, it is better not to use them again in the collapse stage.
Arsenic 6—Rapid onset of collapse; burning sensation all over (especially inside the abdomen), restlessness, difficulty in breathing, suppression of urine.
Cobra or Naja 6—Difficulty of breathing, not relieved by Arsenic; inability to swallow; thready pulse; patient lying down.
Nicotine 6, 30—Used where every other medicine fails to relieve difficulty of breathing; cold sweat on forehead; suppressed urine; frequent vomiting and purging.
Carbo Veg. 6, 12, 30—Flatulence, with offensive evacuations, is the characteristic of Carbo Veg. Very valuable in collapse stage, with much distention of abdomen and passage of foetid stools. Body is very cold and bluish; tongue is cold and bluish; pulse imperceptible at the wrist; eyes sunk in sockets; beads of perspiration on forehead and neck; voice husky; much difficulty in breathing; distention of abdomen, consequent upon stoppage of evacuations; burning sensation all over the body.
Acid Hydro. 3, 6—Face blue; body limp and cold; inability to swallow; shallow breathing; cold sweats; pulseless wrist; tongue cold; ‘coma vigil’; dilated pupils; tips of fingers and toes blue and pinched; low moaning; unconsciousness; difficulty of breathing amounting almost to gasping. If no benefit follows the use of Camphor in cholera, use Acid Hydro.
Kali Cyanatum 3x (trit.)—Used in cases where there is no other sign of life than the mere movement of the chest in respiration.
Aconite Nap. 0 and 1x—Body cold and looks like that of one dead; heart acting feebly, that regularly; restlessness; fear of impending death. It is useful also in (a) cholera with bloody evacuations, and (b) cholera with watery or greenish motions, gripes much thirst, restlessness, cardiac weakness, rise of temperature. Abdomen; hiccough; cramps; convulsive aching of the back.
Lachesis 30—With the onset of symptoms, patient falls down senseless on the floor and unconsciously goes on vomiting and purging.
Agaricus 6 (Every 10, 15 or 20 minutes)—Body is icy cold; sensation of being pricked with needles of ice; suppression of urine; flatulent distention of abdomen; patient is inclined to run away from bed.
Accessory Treatment—In cases of threatened heart- failure, apply a mustard poultice to the region of the heart. The mustard found in our homes is useless for this purpose. Buy a 6″ x 6″ Mustard Plaster from some Allopathic store and specify ‘Dunham Mustard.’ To check profuse and cold sweat, heat a little arrowroot or any other starch on a plate, rub it gently all over the body.
During Reaction Stage
As this is nature’s own effort at cure, hardly any medicine is called for. It is not to be exposed, however, nor is it desirable either, that all purging should cease completely, with the onset of reaction. If, however, any of the untoward symptoms reappear, have recourse to the medicines already described—prescribing higher potencies at longer intervals. In cholera, the blood is drained off most of its salt and serum; hence, it is very necessary to allow water to a cholera patient liberally. Salt water (a teaspoonful of pure table salt to one pint of boiled cooled water), if it can be retained is preferable to plain boiled water; and it can and ought to be given freely at every stage and condition of cholera. When however, reaction has well set in, in addition to or in the place of salt water, unripe coconut water (dab) or very thin barley-gruel (heaped teaspoonfuls of ‘patient’ barley, boiled in one litre of water and slightly salted), may be given.
Treatment of Complications
- Relapse—If vomiting and purging begin again, give in higher potencies, the drugs enumerated under invasion and ‘fully developed’ stages. If relapse is due to worms, give Cina 3x-200.
- Fever and Delirium—If there is fever only, give Aconite If fever is accompanied with red eyes; prominent, throbbing blood-vessels on temples and excitement of mind, give Belladonna 6 or 30. If the patient is in delirium and picks up bed-clothes, or starts up from bed, Hyoscyamus 6. If patient gnashes his teeth, scratches the tip of his nose, turns upward the white of his eyes, and has waterbrash, Cina 3x-200. If patient is furious or maniacal, and attempts to bite those about him, Stramonium 6. If patient is comatose, and lies with half open eyes, Opium 6—30. If there is penumonia, Bryonia or Phosphorus 6. If there is inflammation of, or burning pain in stomach, Arsenic 6, Nux Vomica 30 or 200, Bryonia 30. If there is inflammation of the liver, Bryo 6, Nux Vomica 30, Merc. Sol. 30. If with fever there are frequent evacuations, Merc. Cor. 30, Nux Vomica 30 Ipecac 6, Carbo Veg. 30 or Acid Phos. 30. If there is suppression of urine with fever, Aconite 6—30 alternately with Cantharis 6 or Terebinthina 6. If with typhoid condition there are thirst, delirium and apathy, Rhus Tox. 6.
- Suppressed Urine and Drowsiness—If urine is not secreted or retained in bladder; abdomen is distended, delirium and convulsions present, Cantharis If patient is drowsy; no urine passed, Arsenic 6x. If Cantharis 6 in 2 or 3 doses is unavailing and pulse is weak, Terebinth 6. If urine is not voided; pulse is full, Kali Bichrom 6. If, inspite of all these, no urine is voided, try Belladonna, Strammonium, Hyoscyamus, Cicuta, Opium, Cannabis Indica in 6th or 30th potency. A rag soaked in cold water or water containing Nitre in solution may be applied over the lower abdomen. May also apply heat to the loins and the back.
- Hiccough—Try Alb 30 or Ars. 30. If hiccough is persistent and at times fairly strong; nausea; deafness during the intervals between hiccough. Belladonna 6. If patient is unconscious and there are occasional and loud hiccough, Cicuta 3. Pain and sensation of weight at the pit of the stomach; gripes; cramps of abdominal muscles; hiccough follows meals; rumbling noise inside abdomen and involuntary passage of water during the spasms of hiccough, Hyoscyamus 6. Hiccough on slight movements; depression; white of eyes rolled upwards during interval between hiccoughs, Carbo Veg. 6. Hiccough after meals or smoking. Pulsatilla 6. A sensation of weight at the pit of stomach and hiccough, Phosphorus 6. Hiccough after food or drink; gripes around the navel and pain in liver and stomach. Ignatia 6. Persistent hiccough with nausea but not thirst, Staphysagria 6. Other medicines suggested are Kreosote, Antim tart. Aconite, Arsenic, Cuprum, Secale cor, Acid phos.
- Nausea and Vomiting—Constant nausea but actually no vomiting of acid or bilious matter. 6. Nausea subsides as soon as actual vomiting occurs, Antim Tart. 6. Vomiting as soon as nausea appears, Nux Vomica 6. When Nux Vomica or Ipecac, used singly is unavailing, use them alternately for 2 or 3 doses, Even if then no benefit follows try Podophyllum 6. Vomiting immediately after fluid drinks, Eupatoreum Purp. 6. Dr. Nash found Phosphorous efficacious in cases with intense thirst for copious cold drinks and vomiting sometimes after the drinks.
- Diarrhoea—Occasionally mild evacuations are met with in the reaction stage. They disappear with good nursing and careful feeling. If however diarrhoea tends to be severe, use the indicated medicines mentioned under ‘the fully developed stage.’ These failing, the following remedies are suggested Urine is passed but there is much nervous depression, and diarrhoea is free, Acid Phosphorus 6—30. Liver is tender; stools are small, bilious and liquid, Podophyllum 3-30. Abdomen slightly distended; slightly yellow, foetid, liquid evacuations take place after rumbling noise inside abdomen China 6-30 or Ferrum 30 alternately with Stools are sticky, mucous or bloody; liver is painful; slight yellow discolouration of eyes; foul odour in mouth. Merc. Sol. 6. Blackish liquid motions, Rhus Tox 6 or Ricinus 6. Bloody stools, Carbo Veg. 6. Scarlet-red stools, Ipecac. 6.
- Flatulence—Distention of abdomen with gas and diarrhoea present, Carbo Veg. Flatulence distention with very hard mouths. Lycopodium 30, Opium 30 or Merc Sol. 6. Flatulence with diarrhoea or constipation, Nux Vomica 6.
- Prostration—China 30, Acid Phos. 30.
- Sleeplessness—Coffea 6.
- Abscesses or Parotitis—In any case of pus formation, Hepar Sulph. If pus goes on secreting and abscess has burst or been cut open, Silicea 30. In parotitis without pus formation, Belladonna 3x. If pus forms Lachesis 6 or Silicea 30; Bed-sores with presence of discharge, Lachesis 6, Ars. 6, Carbo Veg. 6 or Arnica 6. Sores in eyes, China 6, Pulsatilla 6. Ulcers in gum or inside mouth—Acid Nitric 6, Hepar Sulph. 6, Cargo Veg. 6. In gangrenous sores inside mouth, Aurum 6, Ars. 6, Sulphur 30, Silicea 30; Gangrene calls for Arsenic 6-200, Lachesis 6, Crotalus 6.
- Pneumonia—Aconite 3, Phosphorus 6.
(For treatment of infantile cholera vide the ‘infantile cholera’ under Chapter ‘Diseases of Infants and Children)’.
Saline Treatment of Cholera— Col. Sir Leonard Rogers, Kt. C.I.E., M.D., I.M.S., F.R.C.P. etc., late Director of the School of Tropical Medicine, Calcutta and Professor of Pathology, Calcutta Medical College, has introduced what is known as the intravenous medication by Hypertonic Saline Solution. This treatment seeks to replace the salt and water lost from blood; as much as five pints of such solution may have to be introduced through veins. The saline solution contains per pint 120 grains of salt (sodium chloride) and 4 grains of calcium chloride. Along with this, Sir Rogers advises to use Atropine Sulph. gr. 1/100 and, where necessary, ‘Pitutrin’ and to administer Calcium Permangnate in 2 gr. pills (salol coated) by mouth.
This injection of saline through veins is devoid of any risk to the patient; but subcutaneous or intracellular injection of it is not without its risks.
Pure Homoeopaths, however, prefer the Salt-water treatment (recommended under the fourth or reaction stage of cholera) to the Saline Treatment of Sir Leonard Rogers.