204 



CHOLERA. 



;. v. inu-iinal flux); diarrhoea cholerica ! felliflua pat- 

 sio ; a genus of disease arranged by Cullen in the 

 class neuroses and order spasmi. It is a purging and 

 vomiting of bile, attended with anxiety, painful grip- 

 ings, spasms of the abdominal muscles, and those of 

 the calves of the legs. There are two species of this 

 genus: 1. Cholera spontanea, winch happens, in hot 

 seasons, without any manifest cause. 2, Cholera ac- 

 cidentalis, which occurs after the use of food tliat di- 

 gests slowly and irritates. In warm climates, it is 

 met with at all seasons of the year, and its occurrence 

 is very frequent ; but ui England, and other cold cli- 

 mates, it is most prevalent in the middle of summer, 

 particularly in the month of August; and the vio- 

 lence of the disease has usually been greater in pro- 

 portion to i lie intenseness of the heat. It usually 

 comes on with soreness, pain, distension, and flatu- 

 lency in the stomach and intestines, succeeded quickly 

 by a severe and frequent vomiting, and purging of 

 bilious matter, heat, thirst, a hurried respiration, and 

 frequent but weak and fluttering pulse. When the 

 disease is not violent, these symptoms, after continu- 

 ing for a day or two, cease gradually, leaving the 

 patient in a debilitated and exhausted state ; but 

 where the disease proceeds with much violence, great 

 depression of strength ensues, with cold, clammy 

 sweats, considerable anxiety, a hurried and short re- 

 spiration, and hiccoughs, with a sinking and irregu- 

 larity of the pulse, which quickly terminate in death 

 - -an event that not unfrequently happens within the 

 space of twenty-four hours. The appearances gene- 

 rally observed on dissection are, a quantity of bilious 

 matter in the primes vice ; the ducts of the liver re- 

 laxed and distended. Several of the viscera have 

 been found, in some cases, displaced, probably by the 

 violent vomiting. In the early period of the disease, 

 when the strength is not much exhausted, the object 

 is, to lessen the irritation, and facilitate the discharge 

 of the bile, by tepid demulcent liquids, frequently ad- 

 ministered. It will likewise be useful to procure a 

 determination to the surface, by fomentations of the 

 abdomen, by the foot bath or even the warm bath. 

 But where the symptoms are urgent, and the patient 

 appears rapidly sulking from the continued vomiting, 

 violent pain, &c., it is necessary to give opium freely, 

 but in a small bulk, from one to three grains, or even 

 more, in a table spoonful of linseed infusion, or with 

 an effervescing saline draught, which must be repeat- 

 ed at short intervals, perhaps every hour, till relief 

 be obtained. Sometimes, where the stomach could 

 not be got to retain the opium, it has answered in the 

 form or clyster ; or a liniment containing it may be 

 rubbed into the abdomen ; or a blister, applied over 

 the stomach, may lessen the irritability of that organ. 

 Afterwards the bile may be allowed to evacuate it- 

 self downwards ; or mild aperients, or clysters, given, 

 if necessary, to promote its discharge. When the 

 urgent symptoms are relieved, the strength must be 

 restored by gentle tonics, as the aromatic bitters, 

 calumba, and the like, with a light, nutritious diet : 

 strong toast and water is the best drink, or a little 

 burnt brandy may be added, if there is much lan- 

 guor. Exposure to cold must be carefully avoided. 

 The abdomen and the feet, particularly, must be kept 

 warm, and great attention is necessary to regulate 

 the bowels, and procure a regular discharge of bile, 

 lest a relapse should happen. It will also be proper 

 to examine the state of the abdomen, whether pres- 

 sure give pain at any part, because inflammation hi 

 the primce VUE is very liable to supervene, often in an 

 insidious manner. Should that be the case, leeches, 

 blistering the part, and other suitable means, must 

 be promptly resorted to. 



CHOLERA MORBUS, CHOLERA ASPHYXIA, 

 CHOLERA MALIG.NA, CHOLERA EPIDEMICA, EPIDEMIC 



CHOLERA FEVER. All these names have been ap- 

 plied to a formidable disease, which is now, for the 

 first time, known to be extensively epidemic in the 

 world, and whose origin and ravages will be reckon- 

 ed among the most distinguishing events of the pre- 

 sent century. This disease is in its principal symp- 

 toms altogether very different from English Cholera 

 (see the previous article), yet many persons liave 

 confounded them. In Hindostan, spasmodic cholera 

 has probably always existed as a comparatively mild 

 climatic disease, affecting at certain seasons of the 

 year a small number of individuals in various parts 

 of the country. There is no evidence to show that 

 the Indian cholera ever bore the epidemic character, 

 or was entitled to rank with pestilential scourges of 

 the worst description till the beginning of August, 

 1817, when it suddenly broke out with unprece- 

 dented malignity. 



Commencing among the inhabitants of Jessore, a 

 town one hundred miles N. E. of Calcutta, in le- 

 than a month it travelled along th course of the river 

 to that city, having desolated the intervening villages. 

 Before the expiration of August, the native popula 

 tiou of Calcutta were attacked, and early in Septem- 

 ber the disease was also manifested among the Euro- 

 peans. From January to May, 1818, the pestilence 

 raged with extreme violence, extending its destruc- 

 tive influence across Bengal, from Selhet to Cuttack ; 

 and towards the interior, from the mouth of the Gan- 

 ges to its confluence with the Jumna, a space includ- 

 ing four hundred and fifty square miles. 



Leaving Bengal, the disease retired for some time 

 to the western bank of the Ganges and Jumna. In 

 its most malignant form it appeared at Benares, where 

 in two months fifteen thousand persons perished. At 

 Allahabad forty or fifty died daily. To other locali- 

 ties situated on either bank the disease soon spread, 

 and the mortality was equally great. In the district 

 of Gorrakpore, thirty thousand were carried off in a 

 month. Then suffered in succession Lucknow, Cawn- 

 pore, Delhi, Agra, Muttra, Meerat, and Bareilly. 



Between the 6th and 7th of November, the epide- 

 mic had reached the grand army, which on the ap- 

 proach of the Pindarree-war, had been concentrat- 

 ed at Jubbulpore, Mundellah, and Sauger, under the 

 command of the marquis of Hastings. It consisted 

 of ten thousand troops, and eighty thousand follow- 

 ers. To the different divisions of this force the 

 cholera proved more fatally effective than could 

 the shot of the enemy in a well contested field. In 

 twelve days nearly nine thousand men had fallen 

 to rise no more. At this time the thermometer 

 ranged from 90 to 100 Farenheit. The heat was 

 moist and suffocating, and the atmosphere a dead 

 calm. The progress of the cholera in the centre di- 

 vision of the army, was as follows: After creeping 

 insidiously for a few days among the lower classes of 

 the camp followers, it seemed instantaneously to gain 

 fresh vigour, breaking out with irresistible force in 

 every direction. Previous to the 14th, it had 

 overspread the camp, sparing neither age nor sex in 

 the indiscriniinating violence of its attack. The old 

 and the young, the European and the native, fighting 

 men and camp followers were alike selected, and all 

 equally sank witliin its death-grasp. From the 14th 

 to the 20th, the mortality had become so extensive 

 that the stoutest hearts were yielding to despair. 

 The camp wore the aspect of a general hospital. The 

 medical officers, night and day at their posts, were no 

 longer able to administer to the numerous sick who 

 continued to pour in from every quarter. At this 

 time the scene was strikingly contrasted to what it 

 had been a few days before. The noise and bustle 

 almost inseparable from the presence of a multitude 

 of human beings, had nearly subsided into stillness. 



