OF THE CHOLERA MORBUS, AND OTHER EXCESSIVE DISCHARGES FROM THE STOMACH AND BOWELS.
THE cholera morbus is a violent purging and vomiting, attended with gripes, sickness, and a constant desire to go to stool. It comes on suddenly, and is most common in autumn. There is hardly any disease that kills more quickly than this, when proper means are not used for removing it.
CAUSES.—It is occasioned by a redundancy and putrid acrimony of the bile, cold, food that easily turns rancid or sour on the stomach, as butter, bacon, sweetmeats, cucumbers, melons, cherries, and other cold fruits. It is sometimes the effect of strong acrid purges or vomits, or of poisonous substances taken into the stomach. It may likewise proceed from violent passions or affections of the mind, as fear, anger, &c.
SYMPTOMS.—It is generally preceded by a cardialgia, or heart-burn, sour belching, and flatulencies, with pain of the stomach and intestines. To these succeed excessive vomiting, and purging of green, yellow, or blackish coloured bile, with a distension of the stomach, and violent griping pains. There is likewise a great thirst, with a very quick, unequal pulse, and often a fixed acute pain about the region of the navel. As the disease advances, the pulse often sinks so low as to become quite imperceptible, the extremities grow cold or cramped, and are often covered with a clammy sweat, the urine is obstructed, and there is a palpitation of the heart. Violent hiccuping, fainting, and convulsions, are the signs of approaching death.
MEDICINE.—At the beginning of this disease, the efforts of Nature to expel the offending cause should be assisted, by promoting the purging and vomiting. For this purpose, the patient must drink freely of diluting liquors, as whey, butter-milk, warm water, thin water-gruel, small posset, or, what is perhaps preferable to any of them. very weak chicken-broth. This should not only be drank plentifully to promote the vomiting, but a clyster of it given every hour in order to promote the purging.
After these evacuations have been continued for some time, a decoction of toasted oat-bread may be drank to stop the vomiting; the bread should be toasted till it is of a brown colour, and afterwards boiled in spring-water. If oat-bread cannot be had, wheat-bread, or oatmeal well toasted, may be used in its stead. If this does not put a stop to the vomiting, two table-spoonsful of the saline julep, with ten drops of laudanum, may be taken every hour till it ceases.
The vomiting and purging, however, ought never to be stopped too soon; as long as these discharges do not weaken the patient, they are salutary, and may be allowed to go on, or rather ought to be promoted. But when the patient is weakened by the evacuations, which may be known from the sinking of his pulse, &c. recourse must immediately be had to opiates, as recommended above; to which may be added strong wines, with spirituous cinnamon-waters, and other generous cordials. Weak negus, or strong wine-whey, will likewise be necessary to support the patient’s spirits, and promote the perspiration. His legs should be bathed in warm water, and afterwards rubbed with flannel-cloths, or wrapped in warm blankets, and warm bricks applied to the soles of his feet. Flannels wrung out of warm spirituous fomentations should likewise be applied to the regions of the stomach.
When the violence of the disease is over, to prevent a relapse, it will be necessary for some time to continue the use of some small doses of laudanum. Ten or twelve drops may be taken in a glass of wine, at least twice a-day, for eight or ten days. The patient’s food ought to be nourishing, but taken in small quantities, and he should use moderate exercise; as the stomach and intestines are generally much weakened, an infusion of the bark or other bitters, in small wine, sharpened with the elixir of vitriol, may be drank for some time.
Though physicians are seldom called in due time in this disease, they ought not to despair of relieving the patient even in the most desperate circumstances. Of this I lately saw a very striking proof in an old man and his son, who had been both seized with it about the middle of the night. I did not see them till the next morning, when they had much more the appearance of dead than of living men. No pulse could be felt; the extremities were cold and rigid, the countenance was ghastly, and the strength almost quite exhausted. Yet from this deplorable condition they were both recovered by the use of opiates and cordial medicines.