Constitutional Whig. [volume] (Richmond, Va.) 1824-1832, 1832-09-07


qutsung place for il in your paper may be giving
To 1T publicity unexpected, it certainly is
thorizcd, by the author
Whatever offence may he committed in this way,
WILL trust, be amply aoned for by of the cha
racter OF the communication-is admirable adap ton
To the end OF tranqulzing public anxiety some
points and of leading medical practitioners in course
OF inquiry and practice. commensurate with the fear.
fu nature of the pestilenceof which IT treats
Most respectfully,
Your obedieni servant,
WIN. BRADLEY TYLER
Frederic City, ing. "a. ls3s.
MY DEAR Sui have delayed to answer your let
ter unii had formed some decision the nature
ana treatment of the presidential cholera which is now
prevailing. These are points on which much diff
ierenc" ct opinion existed, that found 1T impossible
tn make up mind to tleIn, without the lyhs of
actual observation and experience. | have now seen
the disease sufficiently to enable arrv. at salts
factory, and trust. just conclusions the subject
hut can present in The narrow compass of a letter
only very concise and imperfect exhibition of nv
views, and indeed, such are my inccssant occupations
that have scarcely leisure to execute even this slight
sketch
The disease. tcholiy Independent of contag zion. is
caused By an epidemic agency, of which we know
nothing with certainty. IL is not Improbable howe.
yer, that it is owing to Rriiorm poison winch act
ing through the medium of the stomach on the van
gionc nerves, impairs that system, that its iunc-
tons are iii u greater or less degree suspended As
always happens where scnsoria ar nervous influence
is withheld, there is in this Il ot the
blood from the peri pherv, and correspondent accuu-
ations of 1T i'll the deep seated vessels subversvc of
the proper distribution OF it i'll the circulation, attend
ed by vitlatlon or suppression of the sccretions.
This in word is my theory OF the disease. the truth
of which think is sustained by the symptoms, the
phenomena on dissection, and the mode of cure.
1t rs generally held here that cholera pretty uni
formly preceded by considerable disturbances of the
almentary canal by nausea purging, or the two
united. That affections of this sort. very
| mon III the city and elsewhere cannot he denied
But whether they constitute the preliminary stage of
| the disease is very doubtful 1T to me, they
ought rather to be considered condition, arising
from distinct of irritation predsposing the
disease Can it be credited. that cause ultimately
operating powerfully that of cholera, should Ell
dure for three or four five days merely teazng in
this slight manner the stomach bowels? The tran
stIon from these mild and lingering affections, to the
explosion of cholera in its fulles, force. is far sud
den and Violent to suppose that they and the
same diSease, varied only by stages | know not the
analoglcs by which the hypothesis can be supported
Nor is this precusive indHposton mentioned by any
of the writers Asiatic cholera whom have con-
suited 1t is scarcely To he presumed that prOmi-
nent and important, fact, had it existence, could
have possibly escaped the attention of these very able
and experienced historians of the disease. Being
tached TO armies and particularly from their po-
siton in hospitals they enjoyed the best and peculiar
advantages, for accurate and discriminating observa-
tions. 1t was first noticed and promulgated ny
of the British publications, though not sanctioned by
all, and from similar coincidence of gastric and
rec arrangement with the epidemic IN this country
the notion has been espousad by BE it it may,
such disorders should at be removed they
apt at all events, invite attack of cholera They
do not differ from the ordinary complaints of the
son, and require peculiar mana cement.
Genuine Cholera, for the most part comes with
little or no premonition. The earliest symptoms are
complaints of load and oppression and anxiety about
the prncorda. with internal of heat, reerI-
bic to the stomach bowels, with great thirst and
whsh tongue, and at the time, the head is
fused, the expression of cOuDenance laggard,
companled by slight nervous treinOr, muscular weak
ness, cool skim and ehera quick and somewha feeble
or a full and struggling pulse Copous excavations,
upwards and downwards, OF fluid resembling dirty
turbid rice water, with foccu mixed in it, soon oc-
cur, followed by cramps spasIns OF the muscles of
| the eXtremeties and abdomen. These are seldom so
violent as has been represented, and extend
the aliamcntary canal. An aggravaton of the pre-
cedng symptoms rapidly takes place, and in half
hour or more the tongue becomes icy cold, the skin
more chilled and soddcn thong feeling hot to the pa
| tent, covered with dcwy viscid perspration the
hands sriveleh or wtcd, as if mascreated, the nails
OF the fingers blue the pulse scarcely at all
perceptble, the face sunken, especially the eyes, a.
round which is a dark circle This color gradually
dfses isefover the entire surface, partakng of the
various shades oil Iivness from d saturrne to blue
sh or blackish hue.
During this period, the thirst is intense the heat of
the stomach in some instances is increased to Il burn
ing sensation the respiration greatly emharr assed the
air expired cold, the voice low, or whispering and
Planve, the diaphragm convulsed, and there is a to-
tai suppression of the urinary and otter secretons.
Discharges from the ala nentary canal and The spasms
likewise cease or are much diminished Death ult
nate!y takes place III sort oi tranquil stupor, with
understandable lactation and distress, the latter state
being by far the most common.
AS have briefly described the disease, such is the
tenor OF its character and progress though occasion
ally diversified in some respects. Thus | have seen
Its accession sudden the electric shock and have
met with cases without spasns, vomiting, purg-
ing. Many other anomalies might be mentioned,
could indulge in such details The disease may be
properly divided, i'll most instances, into two stages
that of aggression, and collapse.
Called at the commencement of an attack unless
there is extreme Depression bleed very freely from
the arm, and uniformly cup the epigastrum, and give
caomel largely, combined not with opium accord.
ing TO the severity of the spasms The case will al
most invariably yield to these remedies and have
no further trouble concerning it. But where the at
tack is confirmed or in other words the state of col
lapse exists, the difficulties Of manag ement are vastly
increased, and the practice is somewhat different
The first steps, under such circumstance. puke
actively with tepd salt aud water, tumbler full at
time. This usually settles tie stomach, aays thirst
produces some degree of reaction, a stronger pulse
increased warmth of surface and resolution of the
spaSms Cooperation in the same design OF arousnp
the vital forces, and exciting the skin particularly, the
body and eXtremitieS may be rubbed with warm fan
nels. Let vein be then opened, and if the blood
hows freely, take large Gulntty, and especially
should the pulse rise and tile blood become lorld-
But where the reverse happens yOu have slowly to
coax out the blood, the pulse is Sensiby weakened
by he loss oil 1T, stop the oPcraton and apply twenty
or thirty cups TO the abdomen, including the epiuas
tturn, which though they may not draw much blood
are eminenug serrjccable as revceuls The CUPS are
to be succeeded by blister 60 the same parts Gallo
mel is to- be given, in The dose of Eve ten or
twenty grains, frequently repeated till the aggregate
amounts to about dTdchm. and then worked of with
table spoonful of caster oil As the result of these
means here commonly bilious evacuations dis
charges of urIne and other proofs OF the restoration
OF secretary power Little more is demanded than
what has been mentioned | have however, some
times known, though rarely, that at this point of the
. IL Il