722 



ACUTE INFECTIOUS DISEASES. 



is the proper treatment, and the return of the evacuations is the best 

 evidence of its success. Frictions of the skin with tincture of mustard 

 often relieve the painful cramps in the muscles ; but I would warn 

 against the very common application of mustard-plasters. For, even 

 if they be left on a long while, the patients rarely complain of their 

 burning, and the attendants are so excited by the fearful appearance 

 of the patient that they lose their presence of mind, and forget the 

 sinapisms, and I have seen them left on half a day, and during conva- 

 lescence the patient has been troubled by obstinate and painful inflam- 

 mations of the skin induced by the mustard. Of course, nourishment 

 cannot be given to cholera patients during the actual attack ; but, even 

 after the attack is over and reaction has begun, we should be very 

 careful about the food, and in order to protect the diseased intestine 

 from injury, we should give nothing more irritating than diluted milk, 

 meat-broth, and biscuit. Nutritious and solid food should not be 

 allowed till pulpy and consistent stools appear. Infringement of this 

 rule is generally severely punished. 



No general rules can be given for the treatment of the stage of re- 

 action, and still less for the sequelae of cholera comprised under the 

 name of cholera typhoid, for the treatment must be based on a careful 

 analysis of the symptoms in each case. The former custom of bleed- 

 ing for violent reaction should be discontinued. If there be evidences 

 of great fluxion to the brain, we should apply ice compresses to the 

 head and leeches behind the ears. But we must take care not to mis- 

 take the hydrocephaloid that often occurs in children after an attack 

 of cholera with hyperaemia and cedema of the brain. If the severe 

 symptoms of cholera typhoid depend on uraemic intoxication, we may 

 employ the treatment already laid down, little as is the prospect of 

 success. If the attack be followed by an asthenic fever with typhoid 

 symptoms, and the belly be puffed up and painful, and thin but colored 

 and badly-smelling evacuations are passed from time to time, we maj> 

 cover the abdomen with cataplasms, and order small doses of calomel 

 and opium. In the same way, when treating inflammations of the 

 different organs occurring after cholera, we must bear in mind the ex- 

 haustion of the patient. 



CHAPTER XVI. 



BLOODY FLUX DYSENTERY. 



ETIOLOGY. Dysentery is an infectious disease (when treating of 

 diseases of the intestinal canal, in the first volume, we spoke of " ca- 

 tarrhal dysentery," which does not depend on infection) ; but it differs 

 from typhus, and other infectious diseases, in that the infection with 

 dysenteric poison induces perceptible pathological changes in the in- 



