Frequent and violent discharges of bilious matter, both upwards and downwards, with painful gripings, constitute the disease called Cholera Morbus.

In warm climates it is met with at all seasons of the year, and its occurrences are very frequent; but in moderate and cold climates it is most prevalent in the fall of the year, when there is excessive heat, or sudden transitions from heat to cold; and the violence of the disease is generally in proportion to the intensity of the heat. In England, Cholera Morbus is .said to come in with the plums, the plum season being that in which the disease is most prevalent; but whether from too large a consumption of fruit, from the alternations of heat and cold at the season, or from both causes combined, is not certain; most probably the last. In this country, where plums are yet, comparatively, but little cultivated, the prevalence of the complaint is generally due to the changes of the weather.

The disease usually comes on suddenly, with nausea, soreness, griping pain in the bowels and stomach, with flatulency, succeeded after a time by severe and frequent vomiting and purging of bilious matter, thirst, a cold skin, hurried respiration, and a frequent but weak and fluttering pulse.

When the disease is not violent, these symptoms, after continuing for a day or two, cease gradually, leaving the patient in a debilitated and exhausted state; but where the disease proceeds with much violence there arises great depression of strength, with cold clammy sweats, considerable anxiety, a hurried and short respiration, cramps in the legs, coldness of the extremities, and hiccups, with a sinking and irregularity of the pulse, which quickly terminate in death.

Cholera Morbus is to be distinguished from Diarrhoea and Dysentery by the matter which is discharged by stool being purely of a bilious nature, unmixed with blood or mucus, and with scarcely any mixture of faeces. It may be distinguished from Dry Belly-ache by the evacuations, for in the latter, although there is sometimes a considerable quantity of bilious matter thrown off by vomiting, yet the bowels remain obstinately costive.

Treatment

From the very irritable state of the stomach on the first attack of the disease, almost everything taken is immediately vomited up again. Our first endeavour, therefore must be to quiet the stomach. With this object in view, the patient may drink plentifully of Oatmeal gruel or Barley water or thin Starch, till the stomach appears to be cleared out, and then commence taking the effervescing draughts as recommended under the head of Colic. These may be continued every ten or fifteen minutes till the vomiting ceases, and the stomach appears settled, when a pill of One grain of solid Opium may be taken. If this should be rejected by vomiting, one or two more of the effervescing draughts may be taken, and half an hour afterwards the Opium may be repeated. The patient should be wrapped up warm; the feet may be put in hot water; and flannels wrung out of hot water may be applied over the bowels, and changed frequently.

After the vomiting ceases, nothing seems to have such a soothing effect upon the stomach and bowels as plain Beef Tea, made without vegetables. A little pepper and salt may be added, and, if the patient is inclined, a little toasted bread may be soaked in it. The fat, if any, floating on the Beef Tea should be carefully skimmed off, as fatty substances are apt to disagree with an irritable stomach. The patient should be kept as quiet as possible.

The following liniment may be rubbed over the bowels with the hand for half an hour:-

Take Camphorated Spirit......................One Ounce.

Laudanum..........................................One Ounce.

Soap Liniment [Opodeldoc]..................One Ounce. - Mix.

If this is not conveniently obtainable, a large mustard poultice may be laid on the belly, and kept there till it produces a considerable amount of smarting.

When convalescent, the patient should, for some time, pay particular attention to his diet, avoiding indigestible food, and living principally on boiled mutton, light puddings, and things of that description. He should also be warmly clad, and, as much as possible, avoid exposure to extremes of heat and cold.

Spasmodic or Asiatic Cholera will be treated of in a future part of this work.