370 Analyses of Books. [May, 



and anxiety would arise ; the vomiting, oppression, and insensibility return, and 

 in a few hours terminate in death. 



When the disorder ran its full course, the following appearances presented them* 

 selves : What may be termed the cold stage, or the state of collapse, usually lasted 

 from 24 to 48 hours, and was seldom of more than three complete days' duration. 

 Throughout the first 24 hours, nearly all the symptoms of deadly oppression, the 

 cold skin, feeble pulse, vomiting and purging, cramps, thirst and anguish, conti- 

 nued undiminished. When the system showed symptoms of revival, the vital powers 

 began to rally, the circulatian and heat to be restored, and the spasmi and sickness 

 to be considerably diminished. The warmth gradually returned, the pulse rose in 

 strength and fulness, and then became sharp and sometimes hard. The tongue 

 grew more deeply furred, the thirst continued, with less nausea. The stools were 

 no longer like water, they became first brown and watery, then dark, black, and 

 pitchy; and the bowels, during many days, continued to discharge immense loads 

 of vitiated bile, until, with returning health, the secretions of the liver and other 

 viscera gradually put on a natural appearance. The fever, which invariably 

 attended this second stage of the disease, may be considered to have been rather 

 the result of nature's eft'ort to recover herself from the rude shock which she had 

 sustained, than as forming any integrant and neces'ary part of the disorder itself. 

 It partook much of the nature of the common bilious attacks prevalent in these 

 latitudes. There was the hot dry skin ; foul, deeply furred, dry, tongue ; parched 

 mouth ; sick stomach ; depraved secretions ; and quick variable pulse ; sometimes 

 with stupor, delirium, and other marked atfeciions of the brain. When the disorder 

 proved fatal after reaching this stage, the tongue, from beingcreamcoloured, grew 

 brown, and sometimes dark; hard, and mure deeply furred; the teeth and lips 

 were covered with sordes ; the state of the skin varied; chills alternating with 

 flushes of heat ; the pulse became weak and tremulous; catching of the breath ; 

 great restlessness and deep moaning succeeded ; and the patient soon sunk insen- 

 sible under the debilitating effects of frequent dark, pitchy, alvine, discharges. 



Among the Europeans, as might be expected, the disease 

 assumed a character somewhat different from the above. Ac- 

 cording to Mr. Crow, it was in them more nearly aUied to 

 tetanus than to cholera. This distinction was of great use as 

 indicating the mode of cure. The following extract is from Mr. 

 Crow's report : 



In these corps the disease makes its appearance sometimes by the same aflection 

 of the stomach and bowels as in the natives, frequently with spasm in the feet, legs, 

 abdominal muscles or arms ; but in all, the spasmodic affection is the pre-eminent 

 one, head-ache, pain in the eyes, excruciatiug pain at the scrobiculus cordis (a 

 pathognomic symptom of tetanus) qnick, full, hard pulse (but labouring and 

 oppressed according to the violence of the spasms), retention or difficulty oi^ void- 

 ing the urine, strong and violent spasm drawing up the legs, rigidly contracting 

 the arras and fingers, bending the body forwards, or backwanls, or laterally, the 

 patient at the same time exerting such physical strenglli as requires half a dozen of 

 men to hold him on his cut. I have already said that the intestinal evacuations are 

 watery and clay-coloured: this must not be lost sisrht of, as indicating a want of 

 bile; the vomitings are somewhat of the same kind, attended with eructations, 

 while the bowels are distended with flatus. These combined with a very distress- 

 ■ ing tenesmus, not to be allayed by anodyne enemas, strongly point out that nature 

 retoiires relief by the bowels. After the second day that the disease made its 

 appearance in the 65th, Dr. Burrell commenced blood letting with the most 

 decided advantage. This has, therefore, become the first grand remedy amongst 

 the Europeans, and in which he has been followed by tlie practitioners in other 

 European corps, and with the same result. Bleeding quoad vires, tlie calomel 

 and opiate, the hot bath, warm clothing, and frictions spirituous, or anodyne, form 

 the chain of treatment in the European hospitals here; and these are repealed 

 again and again as the symptoms may seem to demand. Under this system, and 

 ear{yapplication for relief, I think the disease is not fatal in a. greater proportion 

 than 1 in 100 cases. 



A fact is recorded in this volume highly honourable to the 



