SPASMODIC CHOLERA. 277 



In many cases the attack is so sudden, and the progress 

 to a fatal termination so rapid, as to baffle all attempts at 

 afibrding relief. 



From this brief account of the disease, the precautions 

 necessary to be observed, in order as much as possible to 

 guard against its attacks, will at once suggest themselves. 

 Thus every circumstance which debilitates the system is to 

 be carefully avoided : such as excessive exertioli, exposure 

 to night-dews or vicissitudes of temperature, unwholesome 

 food, — as bad rice, bad water, &c. ; irregularity of living, — 

 especially intemperance ; all damp and unhealthy situations, 

 or crowded places of abode, particularly sleeping apart- 

 ments. A generous nourishing diet, with a moderate allow- 

 ance of wine to those who are habituated to this mode of 

 Jiving, are recommended ; while, on the contrary, as Mr. 

 Kennedy justly remarks, the person who has uniformly 

 rived on a spare diet, and found it the best suited to his con- 

 stitution, ought to beware of suddenly changing his ab- 

 stemious system. Every extreme and every species of ex- 

 cess should be carefully guarded against. 



The prevalence of spasmodic cholera on the continent of 

 Europe, and lately to an alarming extent in Great Britain, 

 has enabled practitioners who have witnessed the disease 

 both here and in India to identify it as the true Asiatic 

 cholera. The leading features of the disease, as common 

 to both hemispheres, are exactly the same. Some pecu- 

 liarities, however, of the symptoms as they have manifested 

 themselves in Russia and in Britain, it may not be uninter- 

 esting to mention. 



The first or premonitory symptoms, consisting of slight 

 bowel complaints, giddiness, and nervous palpitations about 

 the heart, prevailing from one to three or more days pre- 

 vious to the second stage of the disease, are found to occur 

 in a much larger proportion of cases in the English than in 

 the Indian disease. 



The febrile symptoms, or reaction after the state of col- 

 lapse, accompanied by determination to the head, bowels, 

 &c., are also more universal and more protracted in the 



" The patient, il" thirsty, is to be frequently supplied with acid drink : 

 a -wine-glassful of tepid water, acidulated with lime-juKe or citric acid, 

 Or With nitric or sulphuric acid, may be given as often as the patient re- 

 quires it." 



VcL. III.— A a 



