Cholera is one of the most severe diseases of the intestines. It is a serious affliction, involving
the lower part of the small bowel. It is a waterborne disease and is common during the
monsoons. The mortality rate for this disease has been quite high.
The disease strikes suddenly and fills the intestinal canal with bacilli which die rapidly and leave
the person quickly , alive or dead. It comes as a fell
epidemic and creates havoc but subsides
quickly in the locality. Those who are
susceptible to it are carried away and those who are left
alive are immuned to it. Thus after an
epidemic in a non-epidemic area, there is no re-visitation
in the locality for two or three years.
The original home of
cholera is Bengal in India. It spread from this country during the 19th
century in a series of epidemics along the trade routes. It reached Japan and also Astrakhan, in
Russian, in 1817. The disease spread to Moscow in 1826, Berlin in 1831 and London and Paris
in 1832. Subsequently, it spread to Canada and several countries in Europe. However, by 1895,
cholera had disappeared from Europe.
Symptoms
Cholera appears in three stages. In the first stage, the patient suffers from mild
diarrhoea and
vomiting, which worsens rapidly. The motions become watery, containing no feacal matter. The
patient feels severe cramps in the muscles of the abdomen and limbs, resulting from lack of
salts. The temperature rises but the skin is generally cold and blue and the pulse is weak.
Taking water to quench thirst dilutes the body salt still further, and makes the cramps worse.
In the second stage of collapse, the body becomes colder, the skin dry, wrinkled and purple.
Voice becomes weak and husky while the urine looks dark and formation is less, or altogether
absent. It is in this `algid' stage that the patient may die, as early as 24 hours after the onset of
the
symptoms.
In the third stage,recovery follows in favourable cases. All the changes seem to reverse
themselves, the fluid loss decreases and there is improvment in the general condition. Even at
this stage, a relapse may occur or the patient may sink into a condition resembling typhoid fever.
The condition may deteriorate over a period of two or three weeks. During this stage of reaction,
the temperature may rise and the patient may be in danger from penumonia.
Causes
Cholera is caused by a short, curved, rod-shaped germ known as vibrio
cholera. This germ
produces a powerful poison or
endotoxin. It is spread by flies and water contaminated by the
germs. The real cause of disease , however, is the toxic and devitalized condition of the system
brought about by incorrect feeding habits and faulty style of living. This condition facilitates
invasion of
cholera germs.
Treatment
The treatment should in the beginning aim at combating the loss of fluids and salts from the
body. To allay thirst, water, soda water or green coconut water should be given for sipping
although this may be thrown out by vomiting. Therefore, only small quantities of water should be
given repeatedly, as these may remain for sometime within the stomach and stay of every one
minutes means some absorption. Ice may be given for sucking. This will reduce internal
temperature and restrict the tendency to vomit.
Intravenous infusions ofsaline solution should be
given to compensate for the loss of fluids and salts from the body. The patient may require five
litres or more a day. Care should, however, be taken to avoid waterlogging the patient.
Potassium may be added to the infused fluid. Rectal saline may sometimes prove useful for
adults. Normally, half a litre of saline , with 30 grams of glucose, should be given per rectum
every four hours until urine is passed freely.
After the acute stage of
cholera is over, the patient may be given green coconut water and
barley water in very thin form. When the stools begin to form, he should be given butter-milk. As
he progresses towards recovery, rice softened to semi-solid form mixed with curd, may be given.
The patient should not be given solid food till he has fully recovered. Liquid and bland foods,
which the patient can ingest without endangering a reoccurrence of the malady, are best.
Lemon, onion, green chillies, vinegar and mint should be included in the daily diet during an
epidemic of
cholera.
Home Remedies
Certain home remedies have been found beneficial in the treatment ofcholera. The foremost
among these is the use of lemon ( bara nimbu). The juice ofthis fruit can kill
cholera bacilli within
a short time. It is also a very effective and reliable preventive food item against
cholera during
the
epidemic. It can be taken in the form of sweetened or salted beverages for this purpose.
Taking of lemon with food as daily routine can also prevent
cholera.
The root bark of guava (amrud) is another valuable remedy. It is rich in tannis and can be
successfully employed in the form of concentrated decoction in
cholera. It will arrest vomiting
and
symptoms of
diarrhoea.
According to Culpepper, an eminent nutritionist for children and young people, nothing is better
to purge
cholera than the leaves and flowers of peach (arhu). They should be taken in the form
of syrup or conserve. The leaves of drumstick (sanjana) tree are also useful in treatment of this
disease. A teaspoon of fresh leaf-juice, mixed with honey and a glass of tender coconut water,
can be given two or three times as a herbal medicine in the treatment of
cholera.
Onion is very useful in
cholera. About 30 grams of this vegetable and seven black peppers
should be finely pounded in a pestle and given to the patient. It allays thirst and restlessness and
the patient feels better. The fresh juice of bitter gourd (karela) is another effective medicine in
the early stages of
cholera.
Two teaspoons of this juice, mixed with an equal quantity of white onion juice and a teaspoon of
lime juice, should be given
Cholera can be controlled only by rigid purification of water supplies
and proper disposal of human wastes. In case of the slightest doubt about the contamination of
the water, it must be boiled before use, for drinking and cooking purposes. All foodstuffs must be
kept covered and vegetables and fruits washed with a solution of potassium permanganate
before consumption. Other precautions against this disease include avoiding all uncooked
vegetables, thorough washing of hands by all those who handle food, and elimination of all
contacts with the disease.