118 PRACTICE OF MEDICINE. 



muscles, sometimes extending to the legs and arms ; tongue dry ; 

 urine high coloured, scanty, or suppressed; thirst urgent; pulse 

 frequent, but soon becomes small and weak. As the disease con- 

 tinues, the spasms become more severe, the countenance anxious 

 and collapsed; the strength is much reduced, and fainting occurs. 



As cholera morbus depends on simple irritation of the mucous 

 lining of the alimentary canal, the morbid appearances after death 

 are not very remarkable, consisting in some injection or congestion 

 of the vessels. 



Treatment. — To allay the spasm and irritable state of the diges- 

 tive canal, calomel and opium should be administered in a full dose, 

 and then repeated injections of gruel or starch in large quantities, to 

 bring away the irritating matters ; — and opiates. Warm fomenta- 

 tions may be applied over the abdomen, or the turpentine or ammo- 

 niated liniments. When the surface of the body becomes extensively 

 cold, and symptoms of exhaustion appear, it will be necessary to 

 administer stimulants, as camphor, ammonia, small quantities of 

 brandy, &c., combined with aromatics. When the more urgent 

 symptoms have been relieved, the discharge of the different abdomi- 

 nal secretions should be promoted by gentle laxatives, by enemata, 

 &c. ; and light nourishment may be permitted during the conva- 

 lescence. 



CHOLERA INFANTUM. 



{Summer Complaint of Infants.) 



This disease seems to be peculiar to the United States. It pre- 

 vails most extensively in large cities, during the hot months ; and is 

 one of the most fatal affections to which childhood is subject. 



It occurs in children from four to twenty months of age, or during 

 the period of dentition ; the second summer of children is con- 

 sidered the period at which they are most liable to the disease. 



It comm^ences with a profuse diarrhoea, the stools being light- 

 coloured and thin ; this is succeeded by great irritability of the 

 stomach, so that by constant vomiting and purging the child becomes 

 languid and prostrate, often in a few hours. 



The pulse is quick, small, and often tense ; the tongue is white 

 and slimy ; the skin is dry and harsh ; the head and abdomen are 

 hot, whilst the extremities are natural in temperature, or even cold. 

 Towards evening there is fever, restlessness, and pain. Occasion- 

 ally delirium occurs, manifested by violent tossing of the head, 

 attempts to bite, the eyes becoming wild and injected. Death may 

 result in six hours ; but generally the case is more protracted. The 

 emaciation becomes extreme, the eyes languid and hollow, the coun- 

 tenance pale and shrunken, the nose sharp and pointed, the lips 

 thin, dry, and shrivelled ; the skin upon the forehead tight and 



