THESE days most travelers visiting developing countries tend to carry with them a
copy of "Travelers' Health. How to Stay Healthy Abroad" or "When there
is no doctor", which they consult whenever illness strikes. These "health
bibles" for travelers describe the symptoms of various common diseases and the
treatments used. Depending how the information is interpreted, it can assist a person
to deal with their illness or lead them to believe they have some life-threatening
disorder and throw them into a complete panic leading to further psychosomatic disorders.
Overall, though these books can be useful.
But what did the daring and intrepid explorers of last century, the Garniers, Pavies,
Delaportes, and Lecleres, who trekked into the jungles of Indochina, consult when
they were struck down by illness? For example if they contracted something resembling
cholera, which during the 19th Century was a devastating illness, did they pull out
their copy of "En l'absence d'un médecin"? Had they such a book
it may have contained instructions for the treatment of cholera, similar to those
instructions issued by Doctor Chastang, Chief Physician of the French Navy, in a
pamphlet distributed to Europeans living in Cambodia in 1884.
In those heady days of medical science there were two treatments for cholera -
internal and external. The treatments as described in the pamphlet were:
- Treatment for the outside: First cover the sick with linen sheets, give him "wrap-around"
to the limbs, add hot water bottles under the covers. Vigorously massage with pure
schnapps or spirits with added camphor, especially when the patient suffers cramps;
- Treatment for the inside: Provide large quantities of tea-punch, to which a considerable
quantity of rum or spirits has been added (60-80 grams per liter). If these drinks
tend to increase the number of times that the patient vomits, one can then from time
to time administer some "Seltzer water", together with (more!?) schnapps,
spirits or rum. Warm wine or champagne, if on hand, can be used towards that same
goal, which consists of encouraging blood circulation and preventing the body from
becoming to cool (and one would think lead to further ferocious vomiting!).
You might think that this would be enough to put anyone out of their misery, but
no, there is a potion that had to be taken in conjunction with this treatment. This
apparently well known formula consists of the following ingredients which could be
administered together or separately:
Chloroform
1 gram
Saudanum (Sodium?)
1 gram
Alcohol or spirits
8 grams
Ammoniac acid
10-12 grams
Sugar
20 grams
Water
120 grams
This treatment had to be continued regularly until body warmth returned or until
the patient "reached a state of complete agony" (probably the more likely
outcome).
Compare this 19th Century treatment with the treatment used today. Oral antibiotics
and abundant quantities of oral rehydration solution is considered the simplest and
most effective measure. Cholera can produce dramatic fluid loss within hours of infection,
with 5-10 liters of fluid replacement needing to be administered quickly. Using Doctor
Chastang's remedy the patient was probably more likely to die from alcohol poisoning
before he/she recovered from the illness!
Equally interesting to the treatment was the precautions to be taken against the
further spread of the disease. Some precautions, amongst others, were:
- Get rid as soon as possible the materials "thrown out" by the sick
(vomit and excrement) and bury them in a pit at least half a meter underground;
- Burn all the clothes and bedsheets that were used by the sick during the illness
(there is a slight allusion to burning down the building the sick person was staying
in);
- Burn sulfur in the apartment for several days and have bowls filled with chlorine
and hot water exposed to the air.
So if you have the following symptoms:
- Vomiting and excrement of thin watery texture;
- Absence of urine, partly or totally;
- Fast and weak pulse, then absence of pulse (too late);
- A face that becomes longer...
then according to Dr. Chastang you have cholera. Perhaps, next time you pack your
traveler's medical kit it might be worth stowing a bottle or two of schnapps into
the backpack.
- Information for this article was taken from National Archives of Cambodia, file
No.12029 (former number) Envoi d'une brochure de Docteur Chastang, médecin
en Chef de la Marine, Relative aux soins à donner aux cholériques,
1884. The National Archives, located behind the National Library alongside the Hotel
Royal, is open Monday-Friday, 8-11am and 2-4pm.
