SIMPLE

See also:

• CHOLERA (from the Gr. Xo)du, tile, and Map, to flow)

CHOLERA (synonyms, Cholera Europaea,

See also:

• BRITISH

British Cholera, Summer or Autumnal Cholera)  is the cholera of ancient medical writers, as is apparent from the accurate description of the disease given by Hippocrates, Celsus and Aretaeus . Its occurrence in an epidemic form was noticed by various physicians in the 16th century, and an admirable account of the disease was subsequently given by Thomas Sydenham in 1669-167z . This disease is sometimes called Cholera Nostras, the word nostras, which is good Latin and used by Cicero, meaning " be-longing to our country." The relations between it and Asiatic cholera (see below) are obscure . Clinically they may exactly resemble each other, and bacteriology has not been able to draw an absolute line between them . The real difference is epidemiological, cholera nostras having no epidemic significance . The chief symptoms in well-marked cases are vomiting and purging occurring either together or alternately . The seizure is usually sudden and violent . The contents of the stomach are first ejected, and this is followed by severe retching and vomiting of thin fluid of bilious appearance and bitter taste . The diarrhoea which accompanies or succeeds the vomiting, and is likewise of bilious character, is attended with severe griping abdominal pain, while cramps affecting the legs or arms greatly intensify the suffering . The effect upon the system is rapid and alarming, a few hours of such an attack sufficing to reduce the strongest person to a state of extreme prostration . The surface of the body becomes cold, the pulse weak, the voice husky, and the whole symptoms may resemble in a striking manner those of malignant cholera, to be subsequently described . In unfavourable cases, particularly where the disorder is epidemic, death may result within forty-eight hours .

Generally, however, the attack is arrested and recovery soon follows, although there may remain for a considerable

time a degree of irritability of the alimentary canal, rendering necessary the utmost care in regard to diet . Attacks of this kind are of frequent occurrence in summer and autumn in almost all countries . They appear specially liable to occur when cold and damp alternate with heat . Occasionally the disorder prevails so extensively as to constitute an epidemic . The exciting causes of an attack are in many cases errors in diet, particularly the use of unripe fruit and new vegetables, and the excessive drinking of cold liquids during perspiration . Out-breaks of this disorder in a household or community can some-times be traced to the use of impure water, or to noxious emanations from the sewers . In the treatment, vomiting should be encouraged so long as it shows the presence of undigested food, after which opiates ought to be administered . Small opium pills, or Dover's powder, or the aromatic powder of chalk with opium, are likely to be retained in the stomach, and will generally succeed in allaying the pain and diarrhoea, while ice and effervescing drinks serve to quench the thirst and subdue the sickness . In aggravated cases where medicines are rejected, enemata of starch and laudanum, or the hypodermic injection of morphia, ought to be resorted to . Counter-irritation by mustard or turpentine over the abdomen is always of use, as is also friction with the hands where cramps are present . When sinking threatens, brandy and ammonia will be called for . During convalescence the food should be in the form of milk and farinaceous diet, or light soups, and all indigestible articles must be carefully avoided .

In the treatment of this disease as it affects

young children (Cholera Infantum), most reliance is to be placed on the administration of chalk and the use of starch enemata . In their case opium in any form cannot be safely employed .