498 Observations on the medical effects 



of the physician. Among these are the remarkable changes 

 in the blood from the escape of the serous parts into the ali- 

 mentary canal, and the extreme thickness of what remains in 

 the veins ; which renders its circulation extremely difficult, 

 and produces that congestion in the heart, as well as in the 

 head and portal system, which forms such a remarkable fea- 

 ture in that disease. 



If the unusual determination of blood to the alimentary 

 canal can be checked or modified, it will probably strike at 

 the root of the disease, and this can best be done by the 

 application of the ligatures to the extremities, by which more 

 blood is sent into the interior. The morbid congestions are 

 thus removed, and the painful cramps of the extremities be- 

 ing stopped, there is an accession of heat in the trunk which 

 modifies the disease, and allows time for medicines to act. 

 This theoretical notion I had soon an opportunity of testing, 

 and the result was highly satisfactory. This is best seen by 

 examples, of which the following are a few. 



Case X. — Hunoman, aged 25, was brought into the city 

 hospital on the 15th July, after several evacuations, which 

 had reduced him very much. No pulse at the wrist, and 

 severe cramps in the legs. A cholera pill, with some of the 

 mixture, was immediately administered ; hot bricks applied 

 to the feet, and oil rubbed over the body. The tourniquet 

 was applied for ten minutes, which immediately stopped the 

 cramps, and improved the pulse. Pain of the abdomen at 

 times severe with restlessness. This pain appeared not to be 

 affected by the ligatures ; the pulse however improved, and 

 the cramps of the legs were completely and permanently re- 

 moved. 



18^.— Well : left the hospital. 



Case XI. — Noor Mahomed was brought to the hospital 

 labouring under cholera ; purging and vomiting ; skin cold, 



