Before the onset of dehydration, the treatment should aim at combating the loss of fluids and salts from the body. To allay thirst, the patient should sip water, soda water or green coconut water. Even these 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 a stay of every one minute means some absorption..;p
Ice may be given for sucking. This will reduce internal temperature and restrict the tendency to vomit. Once the patient is dehydrated, intravenous infusions of saline solution should be given to compensate for the loss of fluids and salts from the body. The patient may require two litres or more a day. Care should, however, be taken to avoid water logging. Potassium may be added to the fluids, if there are signs of loss of this mineral.
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 buttermilk. 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 are the best which he can ingest without endangering a reoccurrence of the disease. Lemon, onion, green chillies, vinegar and mint should be included in the daily diet during an epidemic of cholera.
Certain food remedies have been found beneficial in the treatment of cholera. The foremost among these is the use of lemon (bara nimbu). The juice of this fruit can kill cholera bacilli within a very 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 this fruit with meals daily also serves as an effective preventive against cholera.
The root bark of guava (amrud) is another valuable remedy. It is rich in tannins and can be successfully used in the form of concentrated decoction in cholera. About 30 grams of the root bark should be used in 500 ml. of water to make the decoction. The water should be boiled till it is reduced by one-third. It can be taken twice daily. It will arrest vomiting and symptoms of diarrhoea.
Another effective remedy for cholera is the use of 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 this disease. Half a teaspoon of fresh leaf-juice, mixed with equal quantity of honey and half a glass of tender coconut water, can be given two or three times as a medicine in the treatment of cholera.
Onion is very useful in cholera. About 15 grams of this vegetable and four 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 early stages of cholera. A teaspoon of this juice, mixed with equal quantity of white onion juice and half a teaspoon of lime juice, should be given.
Other Measures
The intense visceral congestion can be relieved by maintaining warmth and activity of the skin. This can be achieved by applying hot-blanket pack or by taking hot full-bath followed by vigorous cold rubbing with towel until surface is red. To check vomiting, ice-bag should be applied over stomach, throat and spine. Cold compresses can also be applied over the abdomen with beneficial results. They should be changed every 15 or 20 minutes.
Cholera can be controlled only by rigid purification of water supplies and proper disposal of human wastes. In cases of slightest doubt about contamination of 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 who handle food, and the elimination of all contacts with the disease.