Miscellaneous Notices Respecting Cholera. 175 



" 1. The disease essentially consists in this stage, in a determina- 

 tion of fluids to the inner surface of the small intestines, diverting 

 the respiratory, perspiratory and urinous discharges, with their neu- 

 tral salts, from their usual channels ; and discharging them through 

 the intestinal exhalents, rapidly emptying the blood vessels of their 

 contents, and changing the relative proportions of the remnant of cir- 

 culating fluids. 



"2. That the failure of the functions of the heart, lungs, capillary 

 circulation, and various secretions, results from direct depletion, de- 

 priving those organs of their accustomed stimulus. 



" 3. The absorbent system is rapidly taking up the adipose and 

 waste parts of the body, to supply the failing resources of the heart, 

 and thus results the rapid emaciation. 



"4. The spasms of the voluntary muscles, and those drawn into, 

 contractions in the act of vomiting, by compressing the intestinal ex- 

 halents, tend to arrest the discharges ; and by aiding the return of 

 the venous circulation, stimulate the heart to redoubled exertion, 

 giving a centrifugal direction to the circulation, thereby making a 

 metastasis of the exhalation from the inner surface of the bowels to 

 the skin. 



" 5. ■ That a striking analogy exists between this disease and he- 

 morrhage, differing only in its effects upon the constitution, from the 

 circumstance of its changing the relative proportions of the ingredi- 

 ents of the blood." 



From this summary it will be seen that Dr. Spencer considers the 

 exhalent tissue of the intestinal canal to be the proximate seat of the 

 disease, and to the restoration of this tissue to the healthy perform- 

 ance of its functions, his remedies are directed. The indications 

 which he lays down for the treatment of the second stage of the dis- 

 ease, will convey a just view of the remedial measures which he re- 

 commends. 



These indications are, 



" 1. To arrest the intestinal discharge. 



"2. To make a transfer of the serous discharges from the exhalents 

 of the bowels to those of the external surface. 



"3. To restore the lost balance and healthy performance of the va- 

 rious excretory and secretory functions. 



" 4. To support the powers of the system, and combat incidental 

 symptoms." 



