520 
CHLOROFORM IN ASIATIC CHOLERA. 
On my arrival I found the patient presenting all the symptoms 
of malignant Asiatic cholera in an advanced stage : the features 
collapsed and ghastly ; extremities and tongue cold; burning sen- 
sation in the stomach and oesophagus; pulse rapid and scarcely 
perceptible ; voice diminished to a whisper ; stomach exceedingly 
irritable, and the dejections from the bowels presenting the cha- 
racteristic rice-water appearance ; and all the voluntary muscles 
of the body affected by spasm, so that the patient actually writhed 
in agony. I immediately administered a large tea-spoonful of the 
chloroform mixture (containing about six minims of chloroform 
and forty of turpentine) in a wine-glass of dilute brandy, and 
applied sinapisms to the calves of the legs and abdominal and 
thoracic surface. Thirst was relieved by drinking plentifully of 
water nearly cold. Notwithstanding the irritable state of the 
stomach, I had the satisfaction to find that the chloroform draught 
was retained, as well as the fluid drunk after it, and was followed 
by no dejection. I now (half an hour after the draught) gave two 
of the following pills: — R. Calomelanos, 9ss; fellis bov. inspis., 
3j. M. et divide in pilulas quatuor. 
Tn an hour after the administration of the chloroform, vomiting 
ensued of a portion of the fluid drunk, slightly tinged with the 
gall : this soon subsided ; the diarrhoea had apparently ceased, and 
the cramp diminished in frequency and severity. I now adminis- 
tered a second dose of the chloroform mixture, and soon after re- 
peated the pills. The stomach retained both ; she soon felt decided 
relief : the pulse rose in power and became slower, the spasms less 
frequent; and in an hour after the second dose she was bathed from 
head to foot in a warm perspiration, and expressed herself com- 
paratively free from all uneasy sensations. The attack had been 
completely subdued, leaving behind a good deal of pyrexia and 
debility, from which she is now rapidly recovering. 
Remarks . — I believe it is the prevailing opinion that malignant 
cholera is, primarily, an affection of the mucous membrane of the 
alimentary canal ; and in this view, its accompanying spasm, as 
well as the disturbance or arrest of function in the secerning organs, 
would be regarded as the reflex effect of irritation of the peripheral 
extremities of the spinal and sympathetic nerves supplying the 
coats of the canal. 
This view of the disease, however, appears liable to many objec- 
tions : — 
First. On examination of the canal after death from cholera, its 
coats seldom present any remarkable appearance ; that most fre- 
quent being thickening or corrugation of the lining. membrane, 
which is, no doubt, the physical result of deprivation of its water, 
