28 DUDLEY on Epidemic Cholera.
coldness of the surface, or much perspiration. This feature
in its history was not confined to the aged, as young persons
sunk under circumstances of a similar kind.
In different climates, seasons, localities, constitutions, and
in different periods of the disease, a variety in treatment is
demanded. At one time and place it is mild and gentle in
its progress, and is manageable on the system of practice of
the French School. In other localities, its march is as de-
structive and rapid as the hurricane, calling for the most
prompt action, and the most powerful remedies.
After all my recent experience in this epidemic, added to
that of my friends, which has been made known to me, the
confidence I had reposed in the efficacy of emetics, in the
early stage, as preparatory to the exhibition of calomel, is
not only unabated, but confirmed.
A gentleman of great intelligence and moral worth, whose
family was among the first to be invaded by the epidemic, and
who became satisfied of the superior efficacy of emetics,
as well in the spasmodic form of the disease, as in the earlier
stage, with a view to the subsequent, and more successful ad-
ministration of ca!omel, observed to me, that in the decline
of the epidemic, where he could "safely calculate on six hours,"
he relied on calomel alone; but that in more doubtful cases
the emetic was used first.
I have lost patients who went into collapse six hours after
the exhibition of 20 grain doses of calomel with opium; but I
did not lose one, when the operation of the emetic wasfull
and complete, before any symptoms of collapse supervened.
Half an hour was sufficient to accomplish this object. One
gentleman of the city had forty-seven cases in his family.
Of this number eleven reached the spasmodic form of the
disease. Forty-six of them were treated by emetics and
calomel, taking care, to maintain as much heat of surface as
practicable. One out of the entire number thus treated was
lost. Fifty cases were prescribed for among my relatives of
this vicinity, and of these, twelve were in the spasmodic
form of the malady before any thing was done: one indivldu-