YANDELL on Spasmodic Cholera.



less to do with such cases during the raging of the epidemic
in this place.
  2d Stage.-The first stage, it has been remarked, is one of
comparatively little suffering. The patient may feel some
burning or pain in his stomach and bowels, slight nausea, a
sense of oppression about the pracordia, giddiness, c. But
in most cases, he is able to go about, and would not consider
himself indisposed, but for the presence of the profuse diar-
rhoea. With the coming on of the second stage, the urgency
of all the symptoms is increased. The discharges have now
assumed the appearance, so often described, and so charac-
teristic of cholera-of dirty rice water. Spasms are felt in
the extremities, the skin is covered with a profuse perspiration.
and acute pains occur in different parts of the body.
"Called, for the first time, to a patient with these symptoms,
when I did not deem the salt emetic advisable, I gave, at
lirst 60 grains of calomel, and in an hour or two, according
to the urgency of the case, 120 more. In my own case,
when attacked with considerable severity, 1 took this quanti-
ty in less than three hours, after taking an emetic. And in
some very violent cases, I even transcended these doses. To
one patient, in whose case vomiting was a distressing symp-
tom, and who was cramped in almost every muscle, I gave
an ounce at three doses. I saw her at 1 o'clock, when she
had labored tinder the disease 24 hours. The rice water pas-
sages were copious and frequent. She was exhausted, and
nearly pulseless. I gave her 120 grains of calomel, ordered
cold drinks, with mustard to the epigastrium. At 6 o'clock
when I visited her again, all the symptoms were aggravated.
I then gave her 135 grains, and in a few minutes a similar
dose, as she almost immediately vomited, and it was suppos-
ed, probably threw up a portion of the -first. In the course of
the night the character of the stools was changed. She
continued to pass dark, green matter for 48 hours. and re-
covered rapidly, with scarcely a slight salivation. Besides
calomel, on account of the distressing vomiting, this patient
T-ook laudanum for a few hours. It did not. however, sensi-



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