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6 
symptoms referable to the cord or membranes, depend how recent or 
remote the attack has been. If quite recent, and there is slightly 
increased capillary circulation of the part, there is increased function of 
the nerves, that is transmitted to the muscles they serve, and as a 
consequence they are affected, perhaps, first by tremors or dome 
spasm, which may become tonic in character until the increase m blood 
of the membranes produces pressure, and paralysis is the result. In 
some cases that are fatal after an average duration, say about three 
days, we have appearances of exudation, similatmg inflammatory 
products; while in the f ulminating or explosive form, where death oc¬ 
curs in from five to ten hours, we have no local lesions, perhaps ecchy- 
mosis of serous membranes as in other blood diseases; death being 
produced in these short cases by the immediate effect of the poison m 
the blood, the system being completely overwhelmed with it. 
The idea of this disease, in its ordinary form and of average du¬ 
ration being paralysis of the sympathetic system is new to most, and 
is scouted by some to whom I have given my ideas in the last five 
years; but others high in authority in the medical profession think 
there is reason in what I advance, particularly in connection with the 
success of treatment, both as a curative and preventive agent, that T 
have directed towards the supposed pathological condition; for I am 
more and more convinced, after an experience of seventeen years with 
this disease, that an endemic can be cut short, cases prevented, 01 if 
not, rendered mild, so they will yield to treatment, if cases still un¬ 
affected be placed under treatment. 
Much has still to be learned about the diseases of the sympathetic 
to clear up many at present unknown pathological conditions, i have 
thought for some time, and within the last year or two, I have 
seen°one or two articles published with the same idea, by others, that 
epidemic cholera was a disease of the blood, affecting the capillary 
circulation by its effect on the sympathetic, but in the opposite con¬ 
dition to what we find in Cerebro-Spinal-Meningitis. In the latter 
vaso-motor paresis from paralysis of the ganglionic system, in cholera 
the system is so stimulated by the poison and the small vessels so con¬ 
tracted that circulation is difficult; effusions take place; hence the dis¬ 
charges, cold surface, collapsed and cyanotic condition. 
My reasons for not considering the disease either inflammatory or 
febrile are the pulse and temperature. The first (pulse) is but little, 
if any, increased in frequency and compressible in character. The 
second (temperature) is but slightly increased until towards a fatal 
termination, when it may reach 102f4 to 3 F, but T have seen the re¬ 
verse condition, in a former endemic, six or seven years ago, an ex¬ 
plosive case (duration only five hours). The temperature was only 
