504 Observations on the medical effects 



dies. This is frequently the case in cholera; such patients 

 are immediately relieved by the use of the tourniquets. Fre- 

 quent examples of this disease occur in the Insane Asylum 

 of this city, and I have had opportunity of employing the 

 powerful stimulus, of throwing more blood into the internal 

 organs, with the happiest effects. In these unfortunate 

 individuals, the excitement of feelings and agitation of mind 

 conjoined often with want of rest and sleep, are not unfre- 

 quently followed by great exhaustion ; particularly at the 

 commencement of the cold season. These weak and debi- 

 litated patients first lose their appetite, and this is followed 

 by diarrhoea, coldness of the surface, and a rapid prostration 

 of strength. In such cases the circulation is so languid, that 

 the pulse cannot be felt at the wrist. After repeated trials, I 

 found that artificial heat applied to the surface, and different 

 kinds of internal stimuli, were of little use. In some of these 

 patients the weakness was so great, that when placed in bed 

 they were not able to move, so as to place their limbs in a 

 more comfortable position. The eyes become often affected 

 with indolent ulcers, which not unfrequently terminated in 

 sloughing of the cornea. In other cases the eyes are languid, 

 the vision indistinct, and hearing obtuse. The skin remains 

 cold, and is often covered with a cold clammy perspiration. 

 The average of seven of these cases shewed the animal tem- 

 perature to be 94°. There was generally a looseness, and the 

 dejections were often evacuated involuntarily ; but it did not 

 appear to be the cause of the debilitating symptoms. It 

 seemed rather one of the consequences, as it was sometimes 

 not present. In such cases I found the tourniquets afforded 

 the only remedy, and to obtain the full effect one required 

 to be put on each extremity. The result of my experience 

 is very favourable to this agent. The stimulus of the ad- 



