The Massachusetts spy. [volume] (Worcester [Mass.]) 1831-1858, 1832-09-12


My Dear SRI have delayed to answer
your letter, til had formed some DECISIONS
TO the nature and treatment of the PestIlen-
nal Cholera which is now prevailing
These nre points on which so much differ
ence of opinion existed, that found II i'm
possible 10 make up my mind as to them,
without the lights of actua! observation and
experience. | have now seen the disease
sufficiently to enable me to nrriye at satls-
tartorv, and trust. ust conclusions on the
subject. Blu, can present in the narrow
compass of letter, only n very concise and
Imperfect exhibition of my views, and in
deed, such are nv inressant occupations,
that have scarcely leisure to execute even
this slight sketch.
The disease, rholiy independent Of contd-
giOn is caused hy an epidemic agency, of
which we know nothing with certainty. 1t
| is not improbable, however, that 1t is owing
to an @Tiform poison, which acting through
the medium of the stomach on the gangh-
one nerves. so lmrairS That system, that us
/ functions are IN IL greater or less degree
suspended. As always happens, where sem
snrlal or nervous influence is withheld,
there is in this ease Il recession of blood
from the periphery of the body, and cores
pondent Accommodations of it in the deep
seated vessels suhversve Of the proper dis
/ tribution Of it in the circulation, attended
by vltiatiOn or suppression of the srcre-
tons. This in word, is my theory of the
disease, the truth of which, think is sus-
tuned by the symptoms, the phenomenon
on dissection, and the mode of cure.
/ 1t is generally held here, that Cholera IS
almost uniformly preceded by considerable
disturbances Of The almentary canal. Nv
Nausea or purglng, or the two united. That
affections OF this sort are very common in
the city and elsewhere, cannot lie denied
But whether they constitute the preliminary
stage of the disease is very doubtful. 1t
seems TO Inc, they ought rather TO be con-
sIlered as condition, arising from distinct
sources of irritation predlsposng TO the dis
ease Can it he credited, that Il cause ulti-
mately operating so powerfully as that of
Cholera, should endure for three or four or
five days, merely teasing in this slight man
ner, the stomach or bowels The transition
from these mild aud lingering affections, 10
the explosion OF Cholera IN its fullest force
Is far too sudden and violent, to suppose that
they are one and the same disease, varied
only by stages know got the analogies
by which the hypothesis can lie supported.
Nor is this prelusive indisposiiIon mention
ed by any of the writer's ON Asiatic Chole-
be presumed, that so prominent and impor-
I tant fact had it an existence, could have
possibly escaped the attention of these very
able and experienced historians of the dis
ease.
Being attached TO armies and more par
ticularly from their position in Hospitals,
they enjoyed the best and peculiar advan-
tages, for accurate and discriminating OH
servationS. 1t WIS first notired, and pro-
mnlgated by some Of the British pubca-
lions, though not sanctioned by all, and
from similar coincidence of such deraGge-
ments with the epidemic in tins county,
tho notion has been espoused by us. Be it
as it may, these disorders should at once DO
removed, as they are apt at all events, to
invite an attack of Cholera. They do not
differ from the ordinary complains of the
season, and require 10 peculiar manage
. ment.
Genuine Cholera, for the most part, comes
on with little or 10 premoni.ion. The ear
lest symptoms are complaints of load and
oppression, and anxiety about the preror-
dia, with an internal sense of heat referri-
Bile TO the stomach or bowels, with great
thirst and whtIsh tongue, and at the same
time, the head is confused, the expression
Of countenance haggard, accompanied by
, cool skim and either a quick and somewhat
! feeble, or full and struggling pulse Co.
pious excavations upwards and tlownwards.
of fluid resembling dirty or turbid rice
: water, with horcul mixed in it, soon occur.
followed by cramps or spasms of The mus
cles Of the eXtremltles and abdomen. These
are seldom violent as has been reurc-
scented, and never extend 10 the alimeniarv
&, canal. An aggraVaton of the preceding
: symptoms rapidly takes place, and in nm
hour or more, the tongue becomes lev cold.
the SKIN more chilled and suadcn, thouoh
feeling hot 10 the patient, covered with
dewy vlScld perspiratlon, the hands shrivel-
ed or wilted, as II masceratetl, the nails of
l the fingers blue, the pulse scarcely or not
Mt all perceptibe, The face sunken, especial
" the eyes, around which is a dark circle.
This color gradually dlffuses itself more or
less over tie entire surface. partnKino of
the various shades Of lividness, from n sat.
urnine to bueish or blackish hue. Dur.
ing this period the thirst is intense, the heat
of the stomach IN some instances is ipcreas
cd to a burning sensation, the respiration
Il greatly embarrassed, The air expired cold.
the voice low, or whispering and pluntiye.
the diphraghm convulsed, and there is to-
tai suppression OF the urinary and other Sc
cretl0n6. Discharges from the alimentary
canal, and the spasms. likewise cease or are
much diminished. The intellectual acul-
ties, Though obtnsc, are seldom otherwise
affected, and in some instances, their entire
+, integrity Is throughout preserved. Dearl,
ultimately takes place in sort Of tranoul
stupor, or with understandable iactitation and
distress, the latter state being by far the
more common.
As have briefly described the disease.
such Is the tenor Of It's character and pro.
gress, though occasionally diversified in
some respects. Thus | have seen its nc.
cesslOn us sudden rs the electric shock. and
have met with cases without spasms. or
vomiting or purging. Many other unoma.
lies might be mentioned could indulge in
such details. The disease may be properly
divided in most in4tanres, into two STAGES.
that of aggression and collapse.
| Called at the commencement of an at
tack, unless there is extreme depression.
bleed freely from the arm, and uniformly
cup the epcastrum, and give caomel large
ly, combined or not with opium, according
to the severity OF the spaslns. The case
will almost invariably yield to these reme-