Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    182/974 (page 164)
    as Cholera. The mortality is not great, however, of such as remain classified as diarrhoea. The deaths from diarrhoea in the Cholera season of 1854 appeared to vary from 6 to 18 per 1,000. The great success in the treatment of these shows how desirable it is to check all cases of Choleraic Diarrhoea; by so doing, there is little doubt that many cases of Cholera are arrested. Cholera Fever.—It has been frequently noticed that at certain periods of the Cholera epidemic, towards its decline, the Choleraic Diarrhoeas pass into a sort of low fever. In speaking of the Kurrachee epidemic, Mr. Thom says, as Cholera closed its career it gradually changed its type to that of fever; while one out of four or five cases ran into Spasmodic Cholera, the others would terminate in fever, and were registered as such, showing all the characters of a low remittent. Sir Eanald Martin speaks of Cholera Fever occurring in Calcutta in 1834, and at other times during the Cholera season, which was remarkable for diarrhoea, and for the tendency which this had to run into Cholera, especially under doses of saline and drastic purgatives, and when these were administered over night. It is not so easy to say what is the connexion between these fevers and Cholera. In Calcutta one frequently meets with fevers which begin with diarrhoea. I have elsewhere, mentioned this as frequently ushering in the red fever, sometimes prevailing there, and it is not unusual for some of the common fevers of children to begin in this way. It is probable that some of these happening to prevail during Cholera times, are influenced by the epidemic constitution of the atmosphere. It is not likely that the fever is a variety of Cholera. We should learn from them the practical lesson of not giving much purgative medicine, even in fever, during Cholera seasons, and especially to avoid salines and hydragogue purgatives, and the administration of any at bedtime and likely to operate in the course of the night or morning. In classifying cases of Cholera, we may, excluding Choleraic Diarrhoeas and fevers with Choleraic Diarrhoea, arrange them as follows :— 1. Those in which collapse is not perfect. 2. Those which after vomiting and purging pass into well-marked and complete collapse. S. Those in which collapse comes on with little or no apparent evacuation. 4. The sthenic cases. The cases most frequently met with are of the second class. Duration.—This may, including sequelae, vary from two to three hours in the worst form, to several weeks in those protracted by secondary disease. The time which elapses from the first symptoms of choleraic evacuations to the period of reaction is-more limited. In the Eeport of the Board of Health for the epidemic of 1853-54, the duration of 1,744 fatal cases from the first symptoms is stated to have been an average of not less than 64 hours ; the duration of 1,856 cases