The Indianapolis journal., 1883-07-07
THE CHOLERA.
where the Dread Disease Comes From-The-
ories Of It's Nature-Its symptoms.

most deadly OF all diseases. Unuer the gen
eral name of cholera tao distinct forms of
disease are included, differing in cause, in
symptoms, and in effects, and requiring diff
serent methods of treatment. These two
classes are Asiatic or malignant cholera, and
European or summer cholera. The first,
which is by far the most severe and fatal
form of the disease, originally arose in
Asia, its central location being in India,
where epidemics are known to have oc-
cured at various periods for several centu
ries. In 1917 the attention of physicians was
especially directed to it by the outbreak of
" violent epidemic of the disease in Jes-
sore, in Bengal. Thence it rapidly spread
over British India, causing immense
destruction of life both to Europeans and
natives. For the six years following it con-
tinued to spread over greater area, in
vading China on the east and Persia on
the west and gradually extending into
Asia Minor and Russia in Asia with a slow,
but steady movement in a westward direc-
ton. In 1880 it entered Russia in Europe
and rapidly spread through the whole EN-
pire. In 1882 it ravaged Great Britain and
Ireland and extended into all parts of Europe,
and subsequently crossed the Atlantic and
spread through North and Central Amer
lea. In 1887 the epidemic disappeared, hav-
ing thus within twenty years visited nearly
the whole of the civilized world.
In 1S41 another great epidemic ap-
peared in India and China, which
spread to Europe in 1847, then passed over to
America, and subsequently appeared in the
West Indies. A third great outbreak took
place in the East in 1850, and entered Europe
in 1853 1t ragged on the continent during
the Crimean war, and crossing the Atlantic
became exceedingly severe in both North and
South America A fourth epidemic visited
Europe in 1866 -66, which was not quite so
destructive as its predecessors Since that
date cholera has appeared in the form of
limited epidemics in various districts OF Rus
sia, Turkey and Western Asia, while sudden
outbreaks in India have been of frequent oc-
currence
Cholera has been the" subject OF extensive
investigation by the leading scientific physi-
clans in all countries, but especially in Eng
land. Germany and India. Many conflicting
theories have been propounded regarding
the nature of the disease and the conditions
favoring its propagation. The result of the
Investigations, however, has been the collec-
ton of an amount of information sufficient
to form the basis of Il rational theory of
cholera, though no positive means to check
efectually the spread of the disease have as
yet been discovered. The best authorities
are agreed on the following points regarding
the nature of cholera and the mode of propa-
CATION:
First, that cholera is specific disease de-
pending on the action in the human system
of a morbid material-whether of the nature
OF a parasitic germ or a poisonous miasm
being still undetermined-which is originally
generated in certain parts of India, particu-
larly~fn the delta of the Ganges and the fiat
lands around Madras and Bombay; second,
that this infective material is capable of
spreading indefinitely from it's center of
origin, and thus cholera has appeared in
an epidemic form in almost all countries
also, that the disease may become acclima-
fized in some places; third, that when it
spreads abroad the vehicle of its transmission
is the discharge from the bowels of persons
already affected, and that from these the
cholera-infecting matter is exceedingly apt
TO be dfused through the air to contanii-
nate water and to become attached TO cloth
ing, bedding, furniture, ETC., and in these
various w2ys to find ready entrance through
the lungs or alimentary canal into the bodies
of healthy persons, where it is capable of
developing the disease in more or less Sc
we're form, according to tine quantity intro
duced; fourth, that cholera is thus in
certain sense contagious; fifth,
that overcrowding and other unsanitary.
conditions, particularly the presence of de-
composing organic matter afford the condi-
tions favorable to the multiplication of the
cholera matter, and thus tend to spread the
disease, although of themselves incapable of
originating it.
These propositions, however are INSULT
cient to explain the intense tendency of
cholera to spread widely at some times more
than others As general rule a high tenn.
perature favOrS the deveOpment of cholera
1T has been thought possible that the disease
may be carried by the winds from one coun-
try toanother Local conditions. however
are believed to be an important factor in the
spread of cholera. The disease has been
found to be more virulent in low-iying than
in elevated districts. Investigations have
clearly proven that the prime factor is the
Introduction into the locality of the snecific
injecting matter, this being accomplished
generally by the arrival of infected persons.
1t is well known that cholera epidemics
spread most in the line of human inter-
course and travel
The symptoms of cholera are first severe
attack of diarrhea followed two or three
days later by the second or asphyxial stage.
when the diarrhea becomes of a most violent
character. Copious discharges of a whey-iike
appearance, vomiting, intense pain in the
pit OF the stomach, burning thirst, cramps
in the legs, feet and muscles OF the abdomen
all these are the especial phenomena of
the second stage. The surface OF the
body becomes cold and purple the skin
is dry and sodden, the pulse is almost i'm
perceptible, and the voice is reduced to
hoarse whisper In this condition death
may take place at any lime. In epidemics
the collapse is often SO sudden and COM
pete as to prove fatal in one or two hours.
Reaction, however, may take place, and
this is known as the third stage of cholera.
The severity of the symptoms
gradually decreases, and some of
them soon disappear, but recovery is
still doubtful for considerable period. An
exhaustng fever often sets in during conya-
lescences, and various other complications
may arise attended with much danger. II is
estimated that about one-half the eases OF
fully-developed cholera prove fatal, death
taking place in most instances in from
twenty-four to forty Ell ht hours