Memphis daily appeal. [volume] (Memphis, Tenn.) 1847-1886, 1866-02-01

Variations in the Symptoms.
The general features-whAt one ma!
term the contour-Of Cholera AsTbgTia
that compendium Of the prominent phe
nomena from which, in all ATTITUDES, sea
sons, localities and classes, the diseas'
may be easily and certainly made out
being sharply defined and uniform tht
same SYMPTOMS, nevertheless, vary in
finitely in the degree Of their intensity
q" according 10 circumstances ~ interna
or external TO the individual-from the
simplest diarrhOaa with little pain and NJ
cramps, and no graver arrangement o.
the circulation and temperature Of the
surface than occurs from the operation o
an ordinary purgative, up 10 the over.
whelming attack Of a prostratiOn so par
aliZing that the person stricken has
scarcely become sensible Of pain when
the secretions are suppressed and the
hearts action sinks suddenly.
Sometimes the premOnitory symptoms
are prOtracted, and the patient has a
week or more Of warning, IN the form OF
diarrhOsa, unessiness, and s sense Of heat
and thrill in the stomach and bowels
in some cases, not CiarrhOea, but Obsti-
nate cOStineHeSS, prevails. Sometimes
he "falls dead in his tracks" like the
men in the army Of the Marquis Of Has
tings. At Bellamy, in India, a tailor
wss attacked while at work, and died iu
his working attitude, cross legged on his
mat: and a merchant, concluding a bar
gain, vomited twice aud instantly ex-
uired. At Mecca, individuals in perfect
health were suddenly stricken 10 the
earth, vomited, turned cold, and died
Between these two extremes the merci-
fUl admOnitiOns are Of various duration,
from a few hours TO a few days; in the
large majority of cases the disease takes
from six to tWenty-fOur hours 10 fully
develop itself, and terminates by death
or convaleseence in from one to two days
from the inception Of collapse.
Sometimes the patient sinks at once,
after discharging & small quantity Of
coi0rle7s fluid 10y vomiting and stool;
sometimes the venting and purging are
preceded by the spasms. Sometimes the
matter yomited, instead of being color
less OF WLey-hke, or like seething Of Oat-
meal, Is green, and the objections in
stead OF being thin, and whitish and
muddy, are red and bloody, or they may
even consist Of a greenish pulp, like half
digested vegetables.
We have described the cramps a.
usually beginning in the eXtremiues,
and then creeping gradually to the trunk;
but in some cases they are simultaneously
in sn: and sometimes the order of sue
cession is reversed, the abdomen being
first effected, and then the hands and
feet. Generally, neither the vomiting
nor the purging are symptoms OF long
continuance: either they are checked by
art. or the enfeebled body is 10 longer
able % perform these violent motions
so that they, together with the cramps,
usually disappearsone time before death.
After the first emptyings Of the bowels
the stools have been observed TO be yell
loH-ish. turbid, or frothy like yeast, and
though generally inodOrOus, they some
times emit q rank, fieshy smell The de-
fections are seldom attended with much
griping. and sometimes they are effected
without effort or unessiness, though gem
orally the calls are sudden and irresisti-
ble and the discharges expelled with
slarming force. Tenderness Of the belly, I
on pressure, is not among the most COM I
mon symptoms, nor, we repeat, are the I.
vomiting and purging by any means the .
most important or dangerous; In great I
number Of fatal cases they have not been |
profuse, and have ceased, even without .
remedies, early in the attack.
The cramps sometimes precede the /
vomiting and purgiug, but in the low I.
and most dangerous form OF cholera I
spasm Is often absent, or is present In 8 4
very slight degree. Ietauic spasms Of .
the legs thighs and loins have been Ob- 4
served, but there Is no general tetanus .
dock law, or even trismus. Hiccough I
in cholera l. not indicative Of danger; on /
the contrary, when il OccurE in the in /
terval Of struggle between death and re- /
action, il IS q favorable sign, and gene .
rally announces the return Of circulation. I
The spasm at the Dit Of the stomach j. .
often very acute, and the belly Is almost .
always drawn toward the spine by re-
markable permanent contraction Of the .
abdominal muscles.
The pulse occasionally, though rarely,
keeps Up tOlerably for several hours after 4
the disease has plainly declared itself. /
Generally il becomes small and acceie- .
rated At an early stage, and on the acces- I
sion Of spasm or vomiting, suddenly dis
appears from the extremities. On the /
cessation Of the vomiting or spasm, and 4
sometimes, apparently from the eKhibl-
ton Of remedies, the pulse VIII return % .
the exuemities for a short time, and /
then again be lost. In the less severe
cases II is not wholly eXtlnguished, I
though much reduced in volume, and
thread Of pulse, however small, Is always 4
felt at the wrist, where recovery from the I
blue or cold stage Is 10 be expected. The 4
sinking o. the pulse IN cholera is a symp- /
tom not less characteristic than the ca
dsverous c0untenauce, or the hOarse,
plaintlve whisper tu0r chOleTicd, or the /
discolored skin, OF the chilled breath
when It can be felt, il is generally regu-
lar and extremely feeble, something
soft, not very quick, usually ranging
from eighty 10 one hundred"
In the state Of the skin, as In the other
symptoms Of cholera, striking variations
are found. The surface Is sometimes Oh
served 70 be dry, though cold; and in a
few rare cases, natural" nay, Of prefer
natural warmth A rise Of temperature
has been repeatedly observed 10 take
place Just before death but the develop
ment Of heat under such circumstances
appear 70 be confined % the trGnk and
head, and in almost all cases may be re-
garied ss a fatal symptom. 10 Is not
indicative Of any restoration Of the diff
fused energy Of the arterial system or Of
any Improvement in the function OF res
pirati0n. The heat, ia such instances,
has continued well marked for some
hours after death. TIE skin, in com
plete collapse, IS generally insensible even
70 The action Of chemical agents, and
hence the usual vesicatofies fail % hlis-
ter. The application Of mineral acids or
Of boiling water, In this condition of the
and then a patient j. found who is in
sensible 10 the operation; nor can
leeches draw blood from an early period
OF the attack
The IHe7css, SO characteristic Of ohol-
era in the East, has bV 10 means been
found an invaEiable, OF even a very com
mon phenomenon In England or the
United States. DR.. White. one OF the
physicians to the Gateshead Dispensarv
and Cholera Hospital states that in
scarcely one case IN ten, ia his practice.
did the discolorati0n ASSUME that form
but there is often a deep, broWuish hue Of
the face and hands. This hlueness or
browpness can often be temporarily dis
Fipated by energetic friction. Absence Of
tie peculiar "cold sWeais' Is rare,
and, We believe, a decidedly unfsyorahie
sign.
The urine. from having been limpid
and free WIN become more and more
scanty, and It's passage VIII s0meumes
be attempted with such diinculty as
almost % amount 70 strangury gul as
the c0Ilapse advances this condition
gives place TO that IN which the kid
ueys have ceased 10 perform their or
fee, and there Is no more secretion.
some patients complain Of an urgent
and painful desire TO empty the bladder
bul Tue bladder ls empty AlEeddff anu
after death is found 70 be dwindled 70
the smallest size: the desire may arise
from the contraction OF the pOsterior
disk Of the bladder, hard against the in
ternal meatus, as disclosed inPost morteW
examinations.
The pains Of Cholera are agonlzing 70
the sufferer and at times so pitiful a. 70
move the attendants 10 tears. The
patient tOsses incessautly from side 70
SIDE, and complains Of intolerable weight
aud anguish at his heart As he strug-
giles for breath, his imploring looks and
gesters make you almost feel the horror
mat i burning and gnawing, and
Wrenehing ami strangling at his stomach
and chest AT times, especially when
The cfamps are most severe, be rolls
about and screams-and then there Is
that weary, weary cry for water, water,
water " aHd that hsartrsnding, haunt