CHOLERA MORBUS. 501 



When the injuries that excite the acute gastric catarrh are more 

 intense, or the patient more sensitive, there is greater nausea, which 

 finally increases to retching and vomiting. By the latter the contents 

 of the stomach are evacuated, more or less changed, with a very acid 

 smell and taste, and usually mixed with quantities of mucus. The 

 vomiting may be repeated at varying intervals ; the longer it lasts, the 

 more the matter vomited is mixed with bile, which gives it a bitter 

 taste and green color. These severe forms of the status gastricus are 

 almost always accompanied by great irritation of the intestinal mucous 

 membrane. Then there is severe diarrhoea, by which green masses are 

 passed, with or without pain. After the vomiting and purging, the 

 patient is almost always relieved, and, although perhaps a little feeble, 

 is usually well otherwise in a couple of days. In other cases, the 

 vomiting and diarrhoea are very bad, and present the symptoms of 

 cholera morbus. 



By cholera morbw we mean that form of acute gastric catarrh 

 which extends to the intestinal mucous membrane, and is characterized 

 by profuse transudation of a fluid, containing little albumen, into the 

 stomach and intestines. These watery transudations occur so fre- 

 quently in the first stage of acute catarrhs of other mucous membrane, 

 especially of the nasal, that we cannot hesitate to designate as a ca- 

 tarrh the gastric and intestinal affection, on which depend the symp- 

 toms of cholera morbus, and mostly, also, those of Asiatic cholera, 

 which will be hereafter described, and which only leads to symptoms 

 that other catarrhs do not have, on account of its extent. 



The disease prevails most during the hot weather of summer, and 

 then often attacks a number of persons simultaneously; it is more 

 rarely excited, at other times, by errors of diet. The cholera attacks 

 arp rarely preceded by premonitory symptoms ; on the contrary, the 

 patient is usually attacked suddenly, often during the night, with a 

 disagreeable feeling of pressure at the pit of the stomach, which is 

 soon followed by nausea and vomiting. At first the food last eaten is 

 vomited, little changed, but the vomiting is soon repeated, and quan- 

 tities of a pale-yellow or greenish bitter fluid are thrown up. After 

 this, or, in some cases, even previously, there are borbyrigmi, followed 

 by pulpy stools, which soon become thin and liquid. In a short time 

 enormous quantities of fluid are evacuated ; the greater the amount, 

 the less color it has, as the bile, even if of normal amount, no longer 

 suffices to color all the transudation. The loss of water from the blood 

 excites intense thirst, which is only temporarily quenched by large 

 quantities of drink. The fluid taken into the stomach is rapidly evacu- 

 ated, upward or downward, being voided every quarter of an hour, or 

 oftener, as long as the diarrhoea and vomiting continue. The blood 



