1833.] Analysis of Books. 599 
and the nails are blue. The patient appears almost quite indifferent to his situation, 
and speaks unwillingly. 
“*Scarcely have these appearances been observed than the scene changes. The half 
dead patient revives, the countenance assumes a painful expression, the legs are 
drawn to the belly, the feet and toes crook themselves downwards, hard moveable 
knobs are felt in the calves and thighs. These are the muscles drawn together by 
agonizing cramps. The arms are also often attacked by cramps, and the patient 
exhibits such strength that several persons are necessary to hold him. Oppressive 
sighing takes place ; the cramps at length cease, but another painful phenomenon 
makes its appearance ; the patient worn out by internal heat, cries out for cold water, 
swallows a quantity of it greedily, which scarcely gets to the stomach before it 
comes up again, generally followed by severe retchings ; and im proportion as the 
stomach empties itself above, so the bowels empty themselves below in rapid suc- 
cession of evacuations of a large quantity of thin rice-water liquid, which generally 
exhaust the patient, who now refuses to speak, except to cry for drink, or utter 
broken complaint of weakness, and groanings extorted by the spasms.” Page 7. 
The author then proceeds to a more minute and detailed account of the whole 
course of the disease, which he divides into three stages. The first, consisting of 
the preliminary symptoms till the appearance of vomiting ; the second, from that 
period till the commencement of the state of torpor and insensibility ; the third, 
from thence to death. In all this it will be seen that not the least notice is taken 
of the state of re-action previous to death on which the European Physicians dwell 
at such length ; nor indeed has it been noticed by any practitioner we believe in this 
country. Is this state peculiar to the Cholera of cold climates, and does it constitute 
a difference between the disease as it occurs there and in India? 
The reader must always remember that there is a certain degree of Poetry in 
Physic as in every thing else, and that a sick man constitutes in some respects a very 
picturesque object, particularly when dying of a horrible and incurable disease. Most 
Physicians (even the very soberest) are apt to indulge their poetical vein a little in 
describing the circumstances of such patients, and to make a striking picture out 
of the collection of their symptoms. Hence in reading accounts of Cholera, or 
indeed of any other fatal ailment, we must always substract a certain proportion of 
the terrible, and endeavour to judge of what the description would be, if written in 
plain prose. 
Dr. Muuuer then goes on to an account of the post-mortem appearances, which 
are detailed with great minuteness ; he divides them into sections, the external 
appearances, the cranium, the thorax, the heart, the lungs, the abdomen, the 
stomach, the duodenum and jejunum, the ileum, the mesentery, the colon, the 
liver, the gall-bladder, the spleen, the kidneys, the bladder, the abdominal gan- 
glia: of these last the aathor observes, that ‘‘ they have been frequently examined 
without exhibiting any thing unusual except an increase of redness, arising from 
the plethora of their blood vessels, the ganglions themselves seemed unaltered.” 
Pas9. 
He then proceeds to the diagnosis, which we pass over, concluding that it can 
present little difficulty. The symptoms of Cholera are too formidable to be easily 
or frequently mistaken. 
Then follow the causes of Cholera, in which however he merely confines himself 
to that disposition of body which renders an individual susceptible of the disease, 
and this in general he considers to be debility, or, to use his own words, 
