16 JOURNAL OF THE [January, 



turbance of the nerve centres. Diarrhoeal discharges have 

 been frequently claimed to have a purely neurotic origin. 



It means an excessive activity in the spinal cord, and in the 

 sympathetic nervous centres, combined with a superabundance 

 of blood in these organs. Dr. Auzont, a French physician, 

 says " Cholera is to the great sympathetic (nerve) what 

 Epilepsy is to the brain. From pursuing the symptoms of differ- 

 ent cases any unbiased observer must admit, that Cholera is to 

 a large extent a disorder of the nervous system, notably the 

 sympathetic." 



Dr. Chapman's treatment consists of the spinal ice-bag. At 

 the last meeting I mentioned another treatment, which reports 

 enthusiastic success, and whose author is Dr. Peacan, of Buenos 

 Ayres, S. A. He bases his treatment on the Neurotic Theory, 

 and applies actual cautery to the condyle of the lower jaw, 

 behind the right ear, with a view of stimulating; the pneumo- 

 gastric nerve, and thus paralyzing the action of the sympathetic on 

 the abdomen. 



Reconciliation of Theories of Cholera. — This Neurotic 

 Theory is not adduced here merely to add something to the 

 innumerable theories, all of which have a more microscopical 

 origin and demonstration, while the Sympathetic Nerve Theory 

 has only clinical results to show ; but for the sake of reconciling 

 the vehement opposition and contradiction of the two 

 schools — the German and the English schools — notably those 

 of Koch and Klein. 



To this end I propose the following compromise: Every 

 one, who has lived in an epidemic, like Cholera, Typhus, Yellow 

 Fever, or even Smallpox, has seen cases of a simulating character, 

 caused by nervous shock. They may appear, or begin as imagin- 

 ary at first, yet they become real — real in a symptomatic sense, 

 real as a true nervous shock, real even in fatal result. I was 

 in Paris in '67, during an endemic of Puerperal Fever in the 

 lying-in ward of the Hotel Dieu. One morning, when we came 

 in inquiring about a certain number in a ward, which were sick 

 a few days before, we met the nurses in the court-yard of 

 the Hospital in a frantic condition. '' They are all dying," was 

 their frightened report. Even those who were not sick a day 

 before, and had no contact by nurses or otherwise with distant 

 wards, had through nervous shocks been severely attacked with 



