454 



NEW ENGLAND FARINIER. 



Oct. 



the spasms of (he muscles of the abdomen, 

 feet and legs are very distressing. Hiccup is 

 an occasional symptom. The pulse is more or 

 less accelerated, small and feeble. The skin 

 is cool or cold, and is sometimes covered with 

 clammy sweat. The voice is feeble, and 

 sometimes lost, and there is anxiety, restless- 

 ness, and a sense of exhaustion proportionate 

 to the violence and duration of the attack. 

 This disease runs a rapid course, the patient 

 generally recovering. Occasionally, however, 

 a state of collapse comes on, and death takes 

 place within a few hours from the date of the 

 attack. 



The causes of sporadic cholera are various. 

 An elevated temperature, doubtless, has some 

 agency in causing it, for it occurs much more 

 frequently in hot weather than in cold, and 

 prevails most in warm climates. Children, 

 youth and middle-aged persons are more liable 

 to this affection than are those in advanced 

 life, and males are more often attacked than 

 females. Unripe fruits and vegetables, un- 

 cooked or improperly cooked food, and an 

 immoderate indulgence in the use of cold 

 drinks of any kind, are the most common 

 exciting causes ; but it is probable that in some 

 cases a special cause is involved, the nature 

 and source of which are not known. The 

 treatment of this aifection should vary some- 

 what, according to the particular circumstan- 

 ces of each case. If there is reason to sup- 

 pose that the stomach contains undigested 

 food, the vomiting may be encouraged by ad- 

 ministering large draughts of warm water or 

 a moderate dose of ipecacuanha, or some other 

 mild emetic. Usually, however, the con- 

 tents of the stomach are expelled by the first 

 acts of vomiting, and an emetic is not called 

 for. The object now is to arrest the vomiting 

 and purging, and also the pain ; and the most 

 effecti/e remedy for this purpose is opium, or 

 some one of its preparations. One-fourth of 

 a grain of opium, or ten to twenty drops of 

 laudanum may be given and repeated every 

 half hour, until relief be obtained ; or, what 

 is better, half a grain of sulphate of morphia 

 may be placed dry upon the tongue, immedi- 

 ately after vomiting. If this be quickly re- 

 jected, a second dose should be given without 

 delay ; and if a second and third dose be re- 

 jected, the administration by the mouth should 

 be abandoned, and a teat^poonful of laudanum, 

 mixed with a little starch, thrown into the rec- 

 tum, to be repeated every half hour until the 

 vomiting and purging ceases. The injection 

 of a solution of morphia under the skin is at 

 present, a popular practice among physicians, 

 and a very successful one too. 



A highly important part of the treatment of 

 this disease consists in witholding from the 

 patient all liquids, with the exception of a ta- 

 blespoonful of ice water occasionally, or, what 

 is better, a small piece of ice. If spasms or 

 cramps occur, brisk frictions with hot dry flan- 



nels should be resorted to. Great care, as 

 regards diet, will, in most cases, be required 

 for some time after the disease has been ar- 

 rested. The food should consist of the light- 

 est and most easily digested articles. 



2. Epidemic, or Asiatic Chlera. 



This disease seems to have originated in In- 

 dia, and to have prevailed there for a long 

 period. It commenced its march from Ben- 

 gal in 1817, and during the lifteen years fol- 

 lowing, it traver.-ed nearly the whole of the 

 known world. It visited the American con- 

 tinent first in 1832, and again in 1834. In 

 1847, it began its march a second time from 

 India, and again travelled over the greater 

 portion of the world, visiting the United States 

 in 1849, '50, '51, and '52. Since then it has 

 occasionally prevailed to a very limited extent. 



The development of epidemic cholera is, in 

 most cases, preceded by diarrhoea, more or 

 less severe ; but this is not always so. The 

 disease is characterized by vomiting a watery 

 liquid, free from any admixture of bile ; by 

 copious evacuations from the bowels of a thin 

 liquid, resembling lice- water, and by violent 

 and painful muscular contractions or craups 

 of the abdominal walls, feet, legs, and some- 

 times of the arms, hands and face. If relief 

 be not obtained speedily, a state of collapse 

 comes on, in which the pulse at the wrist be- 

 comes extinct, and the blood stagnates in the 

 veins, giving a purple hue to the fingers, lips, 

 face and surface of the body generally. 



This variety of cholera is exceedingly fatal ; 

 but few of those who suffer from collapse 

 recover, death taking place, usually, within 

 a few hours from the advent of the disease. A 

 special cause is, doubtless, essential to th'^ 

 production of Asiatic cholera ; but this special 

 cause, whether it be a contagious or an infec- 

 tious material, does not, in most cases, pro- 

 duce it independently cf other agencies. In- 

 temperance, improper food, want of sleep, 

 over-exertion, depressing emotions, filthy 

 apartments, an obstructed perspiration, &c., 

 are powerful exciting causes in a large ma- 

 jority of cases. 



The treatment of this affection is divided 

 into that which is proper during the premoni- 

 tory diarrhoea, and that which s^hould be 

 adopted after the occurrence of the attack. 

 To check the diarrhoea, opium, laudanum, and 

 morphia, as recommended for choiera mor- 

 bus, with the addition, perhaps, of tannin, 

 kino, or some other astringent, are the best 

 remedies. Jf the diarrbcea be not arrested, 

 and the disease becomes fully developed, the 

 same remedies should be continued, wirh the 

 addition of stimulants, such as comphor, am- 

 monia, brandy, &c. ; and if collapse comes on, 

 external warmth, by means of hot blankets, 

 or bottles of hot water placed near the body, 

 and the application of mustard to the chest 

 and abdomen, should be resorted to as aux- 

 iliaries to the treatment above recommended. 



