ITS THE TREATMENT OF DISEASES. 



contagiousness, so that it is quite evident that it can't be very catching. The doctors, 

 nurses, and others engaged in attending to the sick do not suffer from it more than 

 other people. It would seem as if the poison affected places rather than individuals. 

 The following may be quoted as an example : A regiment proceeding by water 

 down the country had the disease badly. It met a corps coming up the country, 

 with which it exchanged boats : the disease stuck to the boats, left the corps it first 

 affected, and attacked the new regiment, which had a clean bill of health. By many 

 it is supposed that the disease is communicated only by the stools or vomited matter 

 of the patient. Practically what it comes to is this : that if you want to nurse any 

 one suffering from the disease you need not be deterred from so doing by fear of 

 catching it. There is a little risk, but very little. 



One attack affords no protection from another. 



The disease often, sets in with purging and vomiting, but in many cases the 

 bowels are relaxed for some hours or days before the real attack begins. The bowels 

 are opened three or four times in the twenty-four hours, perhaps with a little griping, 

 and the motions are watery or semi-fluid. There may, in addition, be a little feeling 

 of exhaustion. 



We have no intention of describing an attack of cholera in full, but shall content 

 ourselves with little more than an enumeration of the leading symptoms. The attack 

 begins with violent purging, usually painless, but sometimes attended with griping. 

 At first the motions consist of the contents of the bowel, mixed with much fluid, 

 but subsequently they assume the appearance of water in which rice has been boiled. 

 They are shot out with considerable force, often in a full stream, and the quantity 

 may be so great as to fill an ordinary-sized stool-pan in two or three hours. The 

 evacuations are frequently repeated, the patient becomes exhausted, and is glad to 

 remain in bed. With purging is generally combined vomiting, the fluid, which is 

 clear and watery, being ejected with considerable force, often in quantities of a pint 

 or more. Cramps in the limbs set in, the face becomes shrunken, the pulse feeble, 

 and the patient passes into a state of collapse. In this condition there is the utmost 

 depression possible Avith a capability of recovery. The surface is deadly cold, the 

 tongue icy to the touch, the very breath a cold air stream, and the temperature in 

 the mouth often as low as 80. The patient may die in a few hours, or he may 

 remain in this condition for a clay, or even two days, and then recover. When 

 reaction sets in recovery is generally very rapid. It is said that a woman has been 

 standing at her door on Wednesday, who on Monday was in perfect collapse. 



The mortality in cholera is high. In some epidemics it is from 20 to 30 per 

 cent., in others from 70 to 80. It is usually higher at the beginning of an epidemic 

 than towards its termination. 



There is usually no difficulty in recognising a case of cholera. The purging, 

 vomiting, anxious countenance, cramps, and the quick advent of collapse, indicate only 

 too surely the nature of the complaint. The only other disease with which it is at 

 all likely to be confounded is choleraic diarrhoea, or as it is sometimes called 

 ' : cholerine." Should there be any doubt as to whether it is true cholera or only 

 choleraic diarrhrea, act on the supposition that it is the more serious disease. 



How are we to avoid cholera ? This is a question which one naturally asks 



