SPASMODIC CHOLERA. 275 



fatigue of travelling and hard labour in the open air were 

 found the most powerful ; and thus troops on a march, and 

 people whose occupations exposed them to the weather, as 

 boatmen, fishermen, husbandmen, gardeners, grass-cutters, 

 washermen, palanquin-bearers, were extremely subject to 

 the disease. All derangements of the stomach and bowels, 

 as vomiting or purging, whether occurring naturally or 

 produced by purgative medicines, more particularly by 

 Epsom salts, had a tendency to bring on the disease. It 

 was found that a person who had completely recovered 

 from cholera was rarely seized a second time,* although a 

 few relapses were occasionally recorded. 



When the disease first makes its appearance in a town 

 or camp, a few solitary cases occur; these gradually in- 

 crease in ntimber for the first week or ten days, till at last 

 the malady spreads in every direction. For a fortnight or 

 three weeks it rages to a frightfial extent, and then as rapidly 

 declines, shifting its seat to some other district, where it 

 conimits similar devastation. In this manner it spread over 

 India ; and, in a way strictly analogous, it has pursued its 

 deadly progress over the continent of Europe. 



In the treatment of a malady which makes such rapid 

 inroads on the vital powers, prompt and decisive means are 

 especially requisite. The most approved practice, and that 

 which seems to have been generally followed by the medi- 

 cal men in various parts of Indiat with the greatest success, 

 is as follows : — In the first stage of the disease, before ex- 

 treme debility and exhaustion came on, blood-letting was 

 occasionally had recourse to.j This was followed by large 

 ■doses of calomel and opium, or laudanum mixed with brandy 

 ^nd spices, or oil of peppermint. The hot bath, of a high 

 temperature, was also used, together with friction of the 

 whole body, sinapisms, blisters, &c. If the disease had 

 proceeded to the second stage, termed collapse, blood-letting 

 was of no avail, and, indeed, from the feeble or almost ex- 

 tinct circulation, was impracticable. Stimulating cordials, 

 dry heat applied to the body by means of hot air-baths, hot 

 bran, or sand, hot bottles of water, and frictions unremit- 

 tingly employed, are the means recommended. Harts- 



* Mr. Jameson, Bengal Reports. 



t Bombay, Madras, and Bengal Reports. 



J Mr Scott's e.\oeUent Remarks prefixed to Madraa RopoMB. 



