24 THE PAkM DOCTOR. 



A mild emetic (antimonial wine), or a slight laxative (castor 

 oil), may be followed by tonics (gentian, quinia), febrifuges 

 (saltpetre), and expectorants (ipecacuanha), with perhaps an 

 anodyne (belladonna). As fever subsides, tonics must be given 

 freely (wine, quinia, sulphate of iron, Fowler's solution). In 

 all the various complications treat as for the different diseases, 

 but avoid weakening remedies, and keep up tonics, stimulants, 

 and a rich diet 



MALIGNANT CHOLERA. ASIATIC CHOLERA. 



This attacks the domestic quadrupeds and birds simulta- 

 neously with man, and has been produced experimentally by 

 feeding the dried bowel discharges. These were found to 

 increase in virulence from the first to the third day, and to 

 decrease to the fifth day, after which they were harmless 

 (Sanderson). 



Symptoms. — Muscular cramps, gi-eat prostration, partial loss 

 of motor power and excitability, great lowering of the body 

 temperature (80° F.), deathly-cold bloodless extremities, viscid 

 tardily-flowing blood, and lastly, violent abdominal pains and 

 fluid bowel dejections, often having the specific rice-tvater 

 appearance. 



Treatment. — The disease is mainly important as propagating 

 a poison so fatal to the human being, hence the most perfect 

 disinfection of all bowel dejections is imperative, together with 

 the seclusion and burial of the sick and dead. As an example 

 of current treatment may be named, aromatics (oil of anise, oil 

 of cajeput, oil of juniper, tincture of cinnamon), stimulants 

 (ether), and acids (sulphuric acid), mixed and given every 

 quarter of an hour. In the early stages add opium to check 

 diarrhoea. To overcome surface coldness and collapse, use hot 

 fomentations, rubbing, inhalation of nitrate of amyle ; to sheath 

 the intestines, demulcent drinks (linseed tea, mallow, slippery 



