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10 > Page 10 of Account of spasmodic cholera as it appeared in the city of Lexington in June 1833 / by Lunsford P. Yandell, M.D.

YANDELL on Spasmodic Cholera. In laying down the treatment which I pursued, and should recommend in cholera, 1 am aware that I shall differ from many of the profession. Where plans have been so various, and often so contradictory, it is impossible to give satisfaction to the advocates of all. In no country, perhaps, have the extremes into which practitioners have run, been greater than in our own, and each party, as is natural, has the most unbounded confidence in its own method. By some, the salt emetic is recommended as almost infallible in the disease, while others proscribe emetics altogether, as unsafe if not injurious, and at the same time, indicate some other system which they have found unfailing. Thus, it is not difficult to find numerous infallible cures for cholera, announced in the journals of the west, while the disease has been marked in its progress by a frightful mortality. For myself, having witnessed most of these plans, I am obliged to confess that I have seen them all fail. That they have been attended with better success in other places, I cannot for a moment doubt, and this only confirms the truth of what has been of- ten remarked of cholera, that it is an ever-varying disease, in point of violence, sweeping over some places with the fury of a tornado, while it passes over others with the gentleness of a summer breeze. It is only in this way that I can understand the various results of the same remedy in different places. And it has at least impressed upon me this useful lesson-to be slow in condemning a practice which I have not tried, or which has not succeeded in my hands-a lesson which the history of medicine ought long since to have taught practitioners. Cholera may be divided into three stages, with refer- ence to the treatment. Thefirstis the stage of fmcal diarrhiea; 2nd, that in which rice water discharges and cramps are the prominent symptoms; and 3d, the stage of collapse. In those cases where the disease does not progress with extraor- dinary vehemence, these stages arepretty clearly marked: but in its most malignant form, the patient is precipitated. almost from the commencement, into the last fatal stage. 10