502 Observations on the medical effects 



chance of eventually removing the painful state of anxiety 

 and restlessness. They were disappointed that it did not, as 

 they expected^ immediately alleviate the more distressing 

 symptoms. When the obstruction was allowed to continue 

 for a short time, the tourniquet was no longer complained of ; 

 and I have seen European patients request that the tourni- 

 quet might be applied ; so great was the relief which they had 

 obtained from previous applications. 



These favourable effects of the tourniquet in the cholera 

 may be classed under the following heads : 



1st. — Stopping immediately the most distressing cramps of 

 the extremities. 



2nd. — By increasing the circulating fluid in the trunk, it 

 removes morbid congestions, prevents the morbid secretions, 

 increases animal heat, produces new effects, and most power- 

 fully tends to restore the patient to health. 



3rd. — By sustaining, and in a measure restoring, the vigour 

 of the constitution, so that medicines act more powerfully, 

 and in a more salutary manner, in removing the remains of 

 the morbid action. 



4th. — When reaction takes place, by loosening one or more 

 of the tourniquets, the local determinations to the head or 

 heart are prevented ; the quantity of blood sent to particular 

 parts, is thus diminished. In such cases the patient must be 

 carefully watched, and the tourniquets immediately tightened, 

 when there is any tendency to a relapse, or any symptoms of 

 sinking appear. I have seen the happiest effects produced 

 which have been ultimately blasted by removing the tourni- 

 quets too early, and allowing the symptoms of cholera to 

 form anew when its fatal course could not be arrested. 



5th. — On this account, I have often been under the neces- 

 sity of continuing the application of the tourniquets for days 



