1820.] Reports on the Epidemic Cholera in India. 369 



seethings of oatmeal. The action of the heart and arteries now nearly ceased ; the 

 pulse either became altogether imperceptible at the wrists and temples; or so 

 weak as to give to the finger only an indistinct feeling of fluttering. The respira- 

 tion was laborious and hurried ; sometimes with long and frequently broken inspi- 

 rations. The skin grew cold, clammy, covered with large drops of sweat, dank 

 and disagreeable to the feel, and discoloured of a bluish, purple, or livid hue. 

 There was great and sudden ])rostration of strength, anguish, and agitation. The 

 counte'nance became collapsed, the eyes suffused, fixed, and glassy, or heavy and 

 dull, sunk in their sockets, aud surrounded by dark circles, the cheeks and lips 

 livid and bloodless, and the whole surface of the body nearly devoid of feeling. In 

 feeble habits, where the attack was exceedingly violent, and unresisted by medi- 

 cine, the scene was soon closed. The circulation and animal heat never returned ; 

 the vomiting aud purging continued, with thirst and restlessness; the patient 

 became delirious or insensible, with his eyes fixed in a vacant stare, and sunk down 

 in the bed ; the spasms increased generally within four or five hours. 



The disease sometimes at once, and as if it were momentarily, seized persons in 

 perfect health ; at other times those who had been debilitated by previous bodily 

 ailment; and individuals in the latter predicament generally sunk under the attack. 

 Sometimes the stomach and bowels were disordered for some days before the attack, 

 which would (hen in a moment come on in full force, and speedily reduce the 

 patients to extremities. 



Such was the general appearance of the disease where it cut off the patient in its 

 earlier stages. The primary symptoms, however, in many cases, admitted of con- 

 siderable variety. Sometimes the sickness and looseners were preceded by spasms^ 

 Sometimes the patient sunk at once after passing off a small quantity of colourless 

 fluid by vomiting and stool. The matter vomited in the early stages was in most 

 cases colourless or milky ; sometimes it was green. In like manner, the dejections 

 were usually watery and muddy ; sometimes red and bloody ; and in a few cases 

 they consisted of a greenish pulp, like half digested vegetables. In no instance 

 was feculent matter passed in the commencement of the disease. The cramps 

 usually began in the extremities ; and thence gradually crept to the trunk ; some- 

 times they were simultaneous in both ; and sometimes the order of succession wa» 

 reversed ; the abdomen being first affected, and then the hands and feet. These 

 spasms hardly amounted to general convulsion. They seemed rather affections of 

 individual muscles, and of particular sets of fibres of those muscles : causing thril- 

 ling and quivering in the affected i)arts like the flesh of crimped salmon ; aud 

 firmly stiffening and contorting the toes and fingers. The patient always com- 

 plained of pain across the belly; which was generally painful to the touch, and 

 sometimes hard and drawn back towards the spine. The burning sensation in the 

 stomach and bowels was always present ; and at times extended along the cardia 

 and oesophagus to the throat. The powers of voluntary motion were in every 

 instance impaired, and the mind obscured. The patient staggered like a drunken 

 man, or fell dow n like a helpless cliild. Headach over one or both eyes sometimes, 

 but rarely, occurred. The pulse, when to be felt, was generally regular, and 

 extremely feeble, sometimes soft, not very quick, usually ranging from 80 to 100. 

 In a few instances, it rose to 140 or 150, shortly before deatli. Then it was dis- 

 tinct, smr-ill, feeble, and irregular; sometimes very rapid ; then slow for one or 

 two beats. The mouth was hot .ind dry ; the tonjjue jiarched and deeply furred^ 

 wliite, yellow, red, or brown. The urine at first generally limpid, and freely 

 passed ; sometimes scanty, with such difiicully as almost to amount to strangury } 

 and sometimes hardly secreted in any quantity; as if the kidneys hail ceased to 

 perform their office. In a few cases the hands were tremulous. In others the 

 patient declared himself free from pain and uneasiness; when u ant of pulse, cold 

 ikin, aud anxiety of features, portended speedy death. The cramp was invariably 

 increased upon moving. 



Where the strength of the patient'.-, constitution, or of the curative means admi- 

 nistered, were, altliough inadequate wholly to subdue the disease, sufficient to resist 

 the violence of its onset ; nature made various efforts to rally, and held out strong 

 but fallacious promises of returning health. In such cases, the heat was sometime 

 whollv, at others partially, restored; the chest and abdomen in the latter case 

 liecoming warm, whilst the limbs kept deadly cold. The pulse woulil return, grow 

 moderate and full, the vomiting and cramps disappear, the nati£eu diminish, and 

 the stools become green, pitchy, and even feculent; and with all these favourable 

 appearances, the patient would suddenly relapse; chills, hiccup, want uf vleep, 



Vox. XV. N° V. 2 A 



