■278 SPASMODIC CHOLERA. 



British cases than those of India ; and, consequently, in 

 the favourable cases the recoveries are much slower. A 

 deeper and more general discoloration of the skin, resem- 

 felino- a leaden hue, is also more common in the former than 

 in the latter. It is found, too, that the majority of the cases 

 in Britain consist of females, being in general as two or 

 three to one male, and in some as high as six to one. A 

 greater proportion of children likewise appear to become 

 victims to the disease in Britain than in India.* 



In the treatment hitherto pursued in Britain, great im- 

 portance is attached to checking the first or premonitory 

 symptoms; for this purpose pills, containing one or two 

 grains of calomel, with a quarter or one-half grain of opiuin, 

 are given every hour or two hours ; at the end of five or six 

 hours to be followed by a gentle dose of castor-oil or mag- 

 nesia and rhubarb, in peppermint-water. The operation 

 of this to be followed by another moderate opiate, combined 

 with chalk-mixture ; bleeding from the arm is also advised, 

 especially in those patients where the pulse is full, and 

 where there is much pain across the region of the stomach. 



In the state of collapse, or when it is apprehended to be 

 coming on, an emetic of a table-spoonful of common salt 

 in a glass of tepid water, t or two tea-spoonfuls of powder 

 of mustard-seed, in the same quantity of water, have been 

 used with apparent advantage.} External heat by means 

 of heated plates, hot bags of sand, hot bricks, and even the 

 application of cloths dipped in boiling water, is to be unre- 

 mittincrly employed. The steam of water or spirits of tur- 

 pentine, raised to a high temperature, and diffused over the 

 whole surface of the body by means of a steam apparatus, 

 has been found very efficacious. An enema of two or three 

 pounds of very hot water, to which may be added five or six 

 ounces of common spirits, is meanwhile to be administered, 

 and hot brandy and water, hot beef-tea, or other stimulants, 

 are to be given at short intervals. The febrile symptoms 

 occurring after this stage are to be treated with local bleed- 

 ings, gentle purgatives, and cool regimen. 



* Essay on Cholera by J. A. Lawrie, M.D., Glasgow, 

 t Mr. Searle on Russian Cholera. 



i Suggestions on Malignant Cholera, by Dr. J. Atnbercrombie, Edllt- 

 bBrgh, Dn. Burton and Loriraer, Mr. Greenhow, &c. 



