CHOLERA MORBUS. 117 



Tonics may also be given with advantage in the chronic stage, par- 

 ticularly when the disease assumes an asthenic form. Those gene- 

 rally administered are, cinchona and the infusion of serpentaria, 

 colomba, or simaruba barks. Great attention should at the same 

 time be paid to the condition of the liver ; the bowels must be kept 

 regular, and all errors of diet or exposure to damp, cold, &c., care- 

 fully avoided. 



DIARRH(EA. 



Diarrhoea consists in the copious and frequent discharge of alvine 

 evacuations, which are generally fluid, without tenesmus or fever. 



The symptoms are, frequent discharge of mucus or slimy stools, 

 containing feculent or ill-digested matters, with griping pains, nausea, 

 and foul tongue. The state of the skin is generally natural. 



Causes and Treatment. — The causes of diarrhoea are very various, 

 and so must be the treatment adapted for various cases. 



1st. Injiatnmatory diarrhcea. This arises Irom irritation, inflam- 

 mation, or ulceration of the intestines, and is a frequent attendant of 

 fever, phthisis, &c. It is characterized by pain, tenderness, thirst, 

 and slimy evacuations ; and is to be relieved by small doses of hyd. 

 c. creta, and pulv. ipec. c. ; injections of starch and laudanum ; rube- 

 facients or fomentations to the abdomen ; chalk mixture, &c. 



2d. Diarrhoea from wnu-holesome food, or irritativg substances, 

 or foul accumulations in the intestines. This is a very common 

 ' form, being often produced by unripe fruit, and it is in fact what is 

 caused by a common dose of physic. This form of diarrhoea tends 

 to work its own cure, v/hich is best accelerated by a dose of rhubarb 

 and magnesia or castor oil, followed by chalk mixture. 



3d. Uiarrhoca from debility and relaarUiori . — This form is apt to 

 follow any of the others, and is to be recognised by the kind of con- 

 stitution to which it happens, and by the freedom from active symp- 

 toms. The various vegetable and mineral astringents with opium 

 are the remedies. 



4th. Diarrhoea in yoimg children often arises from the irritation 

 of weaning, or from an unnatural quality of the milk, or from attempts 

 to bring up children by hand. A very small dose of hydr. c. creta 

 with rhubarb, followed by chalk mixture with five or ten minims of 

 paregoric, are the remedies. Baked flour or biscuit powder may be 

 tried as food. 



In all cases of diarrhoea it is important to attend to the skin, and 

 to keep it warm. 



CHOLERA MORBUS. 



Causes. — Costiveness ; exposure to change of temperature ; indi- 

 gestible food ; putrid miasmata ; certain seasons. 



Symptoms. — Violent griping pain, followed by frequent vomiting, 

 and purging of greenish bilious matter ; spasms of the abdominal 



