Miscellaneous Notices Respecting Cholera. 177 



Some of the prominent circumstances brought forward by Doct. 

 Payne, though not considered by him as peculiar to the epidemic in' 

 New York, are, 



1st, The mildness of the train of symptoms immediately preceding 

 the dangerous state of collapse. These symptoms were principally 

 such as " denote some impaired function of the digestive organs, and 

 usually consist of diarrhoea, frequently connected with nausea and 

 vomiting." This state of impaired function, during the prevalence of 

 the epidemic influence, is excited by the slightest application of the 

 ordinary exciting causes of disease in the digestive organs. Still, in 

 the opinion of Doct. Payne, this state of the bowels is not cholera ; 

 nor does he believe the disease when fully formed, to be seated in 

 the mucous membrane of the intestinal canal, or in the adjacent 

 glands. As the name which he has selected indicates, he considers 

 the disease to be a general one, the distinguishing symptom of which 

 is seated in the blood vessels, " a fever, of which the collapse is the 

 first stage, and reaction the second." 



2d, The suddenness of the attack of the disease, or of the col- 

 lapse, and the disproportion between its violence and the exciting 

 causes. These may be merely a slight excess in the quantity of 

 food or drink, or the indulgence in articles of diet at other times per- 

 fectly harmless, yet the effects such as to prove fatal in a few hours. 



3d, The necessity, resulting from the fact just stated, of great cau- 

 tion in many of the common articles of food, and of restricting the 

 diet to a small number of the least irritating substances. 



4th, The great apathy, after the attack of the disease, both of body 

 and mind, to all ordinary impressions. The mind, although conscious 

 of the presence of danger, remained unmoved; and the body, al- 

 though sensible to the impression -of remedial agents, afforded no re- 

 action. Sensibility remained, while irritability was destroyed. 



5th, The great diversity of remedial measures which were resort- 

 ed to. Here, as elsewhere, every plan of treatment which ingenuity 

 could devise, or credulity confide in, was adopted. How far this 

 diversity arose from the want of success of all ; and how far from a 

 sort of undefined expectation on the part of medical men, of hitting 

 upon some specific, for what appeared to be beyond the reach of or- 

 dinary remedies, is uncertain. If physicians, instead of looking out 

 for extraordinary or specific modes of treatment, had confined them- 

 selves to those general principles which wisdom has discovered, and 

 experience sanctioned in other diseases, making all due allowance for 



Vol. XXV.— No. I. 23 



