CHOLERA ASIATICA. 099 



therefore do well to confine its exhibition to cases which commence 

 with well-marked gastric disturbance. Its administration, however, 

 at the beginning of a sudor anglicus, during which the bowels are 

 generally confined throughout, is not so hazardous a step as it would 

 be at the commencement of a typhoid fever, when an emetic might 

 seriously aggravate the diarrhoea which always sets in. 



The various drugs which have been deemed specifics in certain 

 epidemics have invariably failed in others, and quinine alone seems to 

 have maintained its reputation as an antipyretic. It may be given in 

 doses of twelve or fifteen grains daily, not only when the type of the 

 malady is decidedly remittent or intermittent, but even when the type 

 is continued and the temperature exceeds a certain height. The fact 

 that the danger of the sweating-fever is greatly dependent upon the 

 height of the temperature has already forced itself upon the attention 

 of the best observers, even without the use of the thermometer. 

 When there is no occasion to use quinine, it is best to prescribe acids, 

 especially muriatic or phosphoric acids properly diluted. 



An important step in the treatment of sudor anglicus dates from 

 the time when the practice ceased of keeping the patients immod- 

 erately warm, for fear that the sickness should " strike in." If my 

 opinion be correct, namely, that the production of heat is intensely 

 active, but that the danger of an overheating of the body is averted 

 by evaporation of the sweat, then it is plain that it would be danger- 

 ous to envelop the patient in thick blankets, beneath which the air is 

 so saturated with moisture as to impede further evaporation. Light 

 clothing and free ventilation are imperatively indicated. At the same 

 time the patient must not be set in a draught, lest he take cold, the 

 danger from which is greater in sudor anglicus than in kindred affec- 

 tions, owing to the profuseness of the perspiration. 



CHAPTER XV. 



CHOLERA ASIATICA. 



ETIOLOGY. It is possible, and even probable that, where cholera 

 is endemic, it results from miasm. Whether this miasm, the cholera 

 germ, develop in India, on diseased rice or not, and whether or not 

 the disease rage in India, more especially in years when circum- 

 stances particularly favor the increase of these vegetable germs, among 

 us, it is not indigenous ; but all the cholera epidemics occurring among 

 us are due to the exotic parasite being brought to us by cholera pa- 

 tients, and finding for a time a suitable soil and favorable circum- 



