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.
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.
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.
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 of saline 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 water logging 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 re-occurrence of the malady, are best.
Lemon, onion, green chillies, vinegar and mint should be included in the daily diet during an epidemic of cholera.
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.