CHAPTER LXXVIl 



THE CHOLERAS 



Cholera — Synonyms — Definition — -History, Geography, and Epidemiology — 

 etiology — Pathology — Symptomatology — Diagnosis — Prognosis — 

 Treatment — Prophylaxis — Paracholzra — Pseudocholera — References. 



CHOLERA. 



Synonyms. — Cholera Asia tica. Hindustani: Haiza. TamzV ; Enerum Vandee. 

 Chinese : Ho -lousin. Arabic: Duba, 



Dafinition. — Cholera is an acute specific endemic or epidemic 

 disease caused by Vibrio cholem Koch, 1883, and characterized by 

 violent purging, vomiting, muscular cramps, suppression of urine, 

 and collapse. 



Remarks. — There is little doubt that in the past the term ' cholera ' 

 — in analogy to other diseases — has been used to cover a group of 

 clinically similar affections caused by closely allied germs. See 

 remarks on paracholera, p. 1819. 



History, Geography, and Epidemiology.— Cholera appears to have 

 been known in India from the most ancient times, for Charaka 

 and Susruta describe symptoms which most probably refer to this 

 disease. The name is of Greek origin, being perhaps derived from 

 XoXepa, a spout, which may have been applied with the idea that 

 the violent purging resembled the water rushing out of a spout. 

 Apart from the two authors mentioned above, the earliest record of 

 the disease is found in 1438, when Ahmed Shah's army is said to 

 have been decimated by it. After this date there are several refer- 

 ences, for it is mentioned by Vasco da Gama in 1490; an account 

 is given of an outbreak in Goa in 1543, another in Pondicherry in 

 1768, and another in Calcutta in 1781-82, the last of which appears 

 to have spread to Madras, Ceylon, and Burma in 1782-83. Out- 

 breaks occurred in Travancore in 1792, and in the Mahratta country 

 in 1794. But these are only a few of the recorded outbreaks, for, 

 according to Macnamara, no less than sixty-six separate observers 

 mention the disease between the years 1438 and 1817. 



With regard to Europe, cholera was recorded at Nismes in 1564, but it and 

 the sporadic outbursts in the seventeenth century may not have been true 

 cholera. It also appears to have been endemic in Java as far back as 1629, 

 and occurs yearly in Southern China and the Philippine Islands. 



In 1817 began an epidemic which may have originated in Cal- 

 cutta or in Jessore, and which lasted till 1823. During this time 



1801 



