SYMPTOMS OF CHOLERA. 361 



is, therefore, rather disheartening to find from this Eeport that 

 they produced no pernmnent benefit; and that the use of the 

 nitrite of amyl, from which one would have been inclined to 

 expect still more advantage than from that of oxygen, had to bo 

 abandoned, because it increased the distress of the patient by 

 impeding still more the already difficult respiration, and render- 

 ing more intense the tormenting thirst. It is, however, better 

 to know that they have been tried and found unsuccessful, than 

 to cherish a false hope in their efficacy, only to be undeceived 

 and disappointed when we come to try them ; and a careful 

 consideration of the cause of their failure may possibly help 

 tow^ards a more successful plan of treatment. In order to under- 

 stand why the oxygen and amyl did not fulfil the expectations 

 which had been formed regarding them, it will be necessary to 

 take a glance at the conditions which are found in the collapse 

 of cholera, their probable causes, and the mode of action of the 

 remedies employed. 



The most striking symptoms in the collapse of cholera are 

 generally the excessive purging; the peculiar nature of the 

 stools, which are liquid and colourless, resembling rice-water in 

 appearance ; and the large amount of fiuid which is evacuated 

 from the bowels. The extreme thirst of the patient, and his 

 urgent calls for w^ater ; the shrivelled and pinched look of the 

 surface, and its bluish colour and coldness ; the cramps in the 

 muscles ; the husky voice ; and occasionally the difficult respira- 

 tion, also attract immediate attention. A closer examination 

 shows that the pulse is small, or even imperceptible ; and that 

 the proportion of carbonic acid excreted by the lungs is not 

 more than a third of that given off in health.* 



In attempting to trace each of these symptoms back to its 

 origin, we do not deal with certainties, but only with probabilities 

 more or less strong. We cannot say with any approach to cer- 

 tainty what the cholera-poison is, by which all these symptoms 

 are occasioned ; but we may assign a proximate cause to each 

 one of them — to some w'ilh a probability almost amounting to 

 certainty ; to others, only with hesitancy and doubt. 



The rice-water stools, which form so prominent and charac- 



* Davy, quoted by Bayer, Gazette Medicule, 1S32, p. 27S. 



