Page 37 - PERSIAN 4 1899_1905

RESIDENCY AND MASKAT POLITICAL AGENCY FOR THE YEAR
1899*1000. 20

nCJ8 the bultan and h«iofflci.1. at their request for the purpose of sending them into the
interior when cholera broke out there. This w.. not, however, the course adopted in the
case of tho attacked persons for whom regular relief was sought. There being no epecifio
remedy or plan of treatment for cholera, we thought it beat to be guided by the symptoms
though in order to assure success this mode of treatment involved great trouble, it being
necessary at first to report the symptoms almost hourly or every two hours. The plan most
generally followed was to administer a dose of ealol (gr. x) with or without sp. chloroform
after the application of a large sinapism over the pit of the stomach; this was followed iu
about half an hour by a cholera pill containing the following ingredients, being the formula
of the cholera pills 6old by McKesson & Robbins, of New York;__
Pulv. Cap6ici,
Assafoetida,
Pulv. Pip. Niger,
Camphora a a 4 parts, and
Pulv. opii—1 part.
In many instances this first dose of 6elol and cholera pill were found enough to check the
vomiting and purging, aud it was necessary in only a few cases to repeatIhe dose of salol
or cholera pill or both according to symptoms; a third dose had very rarely to be given.
Salol in my opinion had a highly beneficial effect in not only checking vomiting, but also in
relieving in n charming manner the restlessness and burning sensation when present in a later
stage of the disease, lu the stage of collapse diffusible stimulants such as brandy, ammonia,
and ether were principally administered hourly or every two hours or at longer intervals
according to the urgency ot the e.iee, and the strychnia was administered hypodermically in
S'une few cases, and bv the mouth in a few others with marked benefit. External application
of heat to the surface by moans of warm water bottles, heated stones or warmed pieces of cloth
was also had recourse »o for restoring the normal heat of the body. For relieving the
suppression of urine calomel in 2-grain doses with or without the extract of Cannabis Iodica
was found highly beneficial, and that uith dry cupping to the loins and hot water fomentations
to the abdomen and loins rarely failed to restore the function of the kidneys. The febrile
stage wa? Heated on general principles. It may be here noted that whenever a friend of
an attacked person called for mediciue, he was given in addition to the necessary medicines a
bottle containing carbolic acid solution ( 5 per cent.) for disinfecting the dejecta and clothes of
the patient with instruction foi its use and as to the manner in which the clothes and bedding
were to be disposed of on recovery or death.
It is true that in the treatment of cholera no particular line of treatment can be always
depended upon for giving the same favourable
Result cf treatment. result, nor can any given epidemic be taken as
the standard of the utility of our therapeutic measures for striving with the disease;
still it cannot but be admitted that a certain percentage of cases in a given epidemic
when treated on rational principles may recover in addition to the usually accepted average
of 50 per cent, of natural recoveries. This is fairly illustrated by the result of our treatment
in Maskat aud Mat rail. The total cumber of persons who more or less received medical
relief from us was 243, out of whom 70 died, giving a ratio of 23*8 percent, of deaths to treated,
whilst among the remaining 1,098 who did not receive our treatment the rate of mortality
was 59 S percent, being a little raoie than double of the former. This great diflereroe between
the rate cf mortality among the treated and that among the non-treated becomes still more
accentuated if we separate the figures for Maskat where evidently the disease was of a more
virulent type as judged from the general rate of mortality, from those for Matrmh.
In Maskat out of a total of 162 persons treated only 39 died, giving a ratio of only *4
per cent, of deaths to treated, whilst among the remaining 287 persons who were not treated
there were 235 deaths, or thj alarming rate of Hl*9 per cent. Although the dispari:y between
the two rates seems to be very great, in faot almost incredible, it must be remembered that
many of the persons for whom medical relief was sought had probably by the time the
relief could reach them passed through the critical stage of the disease. Under other
circumstance* perhaps, 1 should have felt inclined to doubt the accuracy of these figures,
tat considering that they hare been furnished by an assistant in whom I have perfect
reliance for truthfulness aud ca.efuluess and who himself treated all the cases in Maskat, I see
no reason to discredit them, though the result 1 personally obtained in Matrah is not nearly
a* favourable a* this.
In Matrah out of SI persons treated 31 died giving a ratio per cent, of 88*3 to treated*
whilst among the remaining 809 who were not treated by me the rate of mortality was 52 per
cent., or nearly the same as the general rate of mortality. But m order to find a correct esti­
mate of the value of our treatment we must take the figures only for the Khojas and Hindu.