161 
PATHOLOGY. 
nervous irritation, and to give emetics to provoke, or 
elrervefcing medicines to reftrain, vomiting; and fo on. In 
ourcountry the cure of cholera may, in general, be effected 
by diaphoretics, as the pulv. Doveri. comp, finall and 
frequently-repeated dofes of colomel, the warm bath, 
cold drinks, and abftinence; after which, columbo and 
other Simulants of the 'ftomach may be ufed to perfeft 
the approaches to health. 
In the Cholera fpafmodica we have however a much 
moreterrible malady to contend with. In the Report we 
have juft quoted, we are told that “the centre-divifion 
of the army, under the commander-in-chief, exhibited 
an awful fpecimen of the fatality of the difeafe. It con- 
lifted of lefs- than 10,000 fighting men ; and the deaths, 
within twelve days, amounted, at the very loweft efti- 
mate, to 3600 ; according to others, to 5, and even 8000!” 
The dread of a mortality fo great will, no doubt, ftimu- 
late us to ufe the meafures commonly fuccefsful with the 
utmoft care and promptnefs; and,confidering the immenfe 
body of information which we have received from the lur- 
geons who witnefi’ed the ravages of the difeafe in the vaft 
populations of either Ind, we can have little helitation 
in eftablilhing therapeutical dogmas. 
A meafure which ftrikes at the fons and origo mali is 
bleeding. This Ihould be at once carried ad deliquium 
animi, and Ihould form the firft part of the treatment. 
The alleviation of pain, the reftoration of the biliary fe- 
cretion and of the perfpiration, rauft be attempted by 
large dofes of calomel, varying from a few grains to a 
fcruple, and combined with opium. Antimony being 
fcarcely ever retained on the ftomach, the ficknefs is to 
be moderated by clyfters compofed of aqueous folutions 
of opium, fince even the latter fubftance, in a folid form, 
is rejected when given by the mouth. Mr. J. Boyle 
(Treatife on the Epidemic Cholera of India, 1821.) is of 
opinion, however, that ficknefs Ihould by no means be 
checked. He lays, “ The conftant naufea and irritation 
of ftomach, which is oblervable in the early ftages of this 
complaint, without full or violent vomiting, fimply 
fpouting up, as it were, any thing fwallowed ; the ob- 
ftrudiion of the biliary dudts obferved in difledtion, and a 
general want of fuccefs in practice; induced me to em¬ 
brace ideas perfectly new on the fubjeft. The obftruc- 
tion of the biliary dudts I looked on as a fource of irri¬ 
tation to the nervous fyftem generally, and the naufea 
and ficknefs of ftomach as an effort of nature to free ner- 
felf of an unaccuftomed evil. In accounting for the 
caufes of this difeafe, it has been obferved, and with 
great juftice, that when, from the exertions to vomit, 
bile makes its appearance, a favourable prognofis may be 
formed. Now, if the appearance of bile be a falutary 
one, (and it certainly is,) why not favour the progrefs of 
its formation, inftead of obftrudling its paffage by the 
adminiftration of fedatives ? We know of nothing which 
will increafe the fecretion of bile fo quickly or fo effec¬ 
tually as the adt of vomiting; we alfo know the fympa- 
thy which fubfifts between the liver and ftomach, and 
that derangement of either organ will more or lefs af¬ 
fect both. It is evident, then, that the gaftric derange¬ 
ment peculiar to this difeafe, is not only indicative of 
the exiftence of lurking mifchief, but diredtly points to 
the treatment. Further, of all the cafes of which I have 
feen or heard, there was not one fatal termination after 
bile had, in any way, or by any means, made its appear¬ 
ance.” 
The diaphoretics which the Indian pradlitioners give 
are often of a highly-ftimulating nature; as arrack-punch, 
&c. but thefe fhould not be ufed till the plethora and 
confequent cerebral difturbance, which in fome cafes is 
dreadfully violent, is fubdued by venefedtion. In ufing 
the bath, we fhould be careful to employ it hot ; for it 
is eftablifhed on good authority, that, till the temperature 
is railed to an unplealant height, no good is derived 
from it. 
The convalefcents of cholera fhould be fubjedted to the 
influence of the nitric-acid bath ; and the acid internally 
adminiftered likewife forms a cooling palatable drink, 
which tends to reftore the tone.of the alimentary canal, 
and improves the fecretion of the liver. 
With regard to the contagious nature of this com¬ 
plaint, the reader is referred to Pyrectica, 
Genus XI. Enterolithus, [from zirepov, bowel, and 7 u 0 of, 
ftone.] Stony concretions in the ftomach and bowels. 
For the information under this head we are wholly 
indebted to Dr. Mafon Good ; as no other fyftem con¬ 
tains a fimilar genus. We have therefore no fynonymes 
to put down. Dr.Good very juftly obferves, that “almoft 
all animals are endued with a power of feparating or fe- 
creting lime and other earths from the blood for particu¬ 
lar purpofes; as that of forming a (hell covering in infefts 
and worms, and of giving hardnefs to the bones in all 
other animals. Under a morbid adtion of Angle organs, 
or of the fyftem generally, this is often fecreted in an un¬ 
due quantity, and poured forth into cavities where its 
accumulation and cryftallization muft be attended with 
mifchief. Such, at times, is the cafe in refpeft to the 
ftomach and inteftines. But, independently of concre¬ 
tions derived from this fource, we often meet with others 
produced by an agglutination or cryftallization of the 
juices which are contained in the aliment, and which, not 
unfrequently, give immediate proof of their origin by 
the aromatic tafte, fmell, or other qualities, which fuch 
concretions exhibit. There is alfo a third kind of con¬ 
cretion occafionally to be traced in the inteftinal canal, 
of a fofter ftrudfure, and cetaceous or faponaceous feel, 
which appears to be produced by a peculiar combination 
of the materials of the feces, and conftitute proper fey bala, 
although this term has not unfrequently been employed 
to fignify portions of common feces or ftercoraceous 
matter in an indurated ftate.” Thus, then, we have three 
fpecies. 
1. Enterolithus bezoardus, the inteftinal bezoar : in 
concentric layers clofely agglutinated or cryftallized ; ca¬ 
pable of a fine polilh ; frequently with a metallic luftre 
on the furface of each layer; and an accidental nucleus 
in the centre: of a fpheroidal figure ; chiefly confiding 
of vegetable matter. It is faid, (though not proved) to 
be found in the human ftomach ; but more commonly in 
that of the fmaller ruminating quadrupeds, as the goat 
and antelope, particularly the beautiful and elegant fpe¬ 
cies of antelope denominated gazhul by the Arabians and 
Perfians, and tj'eb'i by the Hebrew poets; the ahu of the 
Turks; the Antilope gazella of Linnieus. It was for¬ 
merly employed as a febrifuge and alexipharmic in me¬ 
dicine; and worn as an amulet by the fuperftitious, who 
have fometimes purchafed a Angle one at fix thoufand li- 
vres when very fine, and hired them in Holland and Por¬ 
tugal on particular occafions at a ducat a-day. See the 
article Bezoar, vol. iii. 
2. Enterolithus calculus,inteftinal calculus: radiating 
from a common centre, or formed in concentric layers ; 
moftly with an accidental nucleus; more or lefs porous; 
fpheroidal or oblong ; admitting an imperfedt polifh ; 
compofed chiefly of earths and animal matter. This fpe¬ 
cies, Dr. Good fays, is by no means unfrequently found 
in the human ftomach and inteftines; but far oftener in 
the digeftive channel of other animals, and particularly in 
the larger ruminating quadrupeds, or thofe with a long 
complicated digeftive organ, where the food, as in the 
formation of bezoars, is flowly carried forward ; and in 
tardy draught-horfes, particularly thofe of millers, which 
are fed largely on bran, which feems to yield a ready 
balls for thefe concretions. See Phil. Tranf. xxiv. 1705. 
xliv. 1746. xlviii. 1754. In the laft cafe, the difeafe had 
exifted for years: the animal died aged twenty-two, 
nearly foaling; but gave no fign of pain or inconvenience 
till three months before her death. The calculus weighed 
15 lb. 12 oz. average diameter 8| inches by 8 inches. 
When chemically analyzed, they are chiefly found to 
con fill 
