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8 > Page 8 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. or two before the access of more formidable symptoms, but the disease itself, in its first stage. It is true, that in a few instances, it ran on for one or two days without the super- vention of spasms, coldness and collapse. But this was not the usual course of things. In nearly every bad case, after a few copious discharges of water tinged with faeces, the characteristic rice water passages appeared, which were soon followed by spasms, more or less general, pulseless wrists, cold, shrivelled skin, attenuated voice, and finally, death. Such was the order in which the symptoms appeared when the case had been trusted to nature-too often, in spite of all the resources of art. Seized, as many were, at night, when medical aid could not be procured, it was not uncommon to find them in the extremity of the disease when visited by the physician for the first time. It was hazardous to allow the diarrhcea to run on for a single hour. Very often, in that time, indeed, the patient was sinking, and hence the on- ly safety consisted in treating every case of diarrhoea, as one of cholera. If this truth could have been impressed early upon the minds of all the people, there can be no doubt that numbers, who perished through neglect of the disease; might have been saved. In confirmation of this, it has been re- marked, that few negroes, comparatively, died at the factories, because masters and overseers were on the alert to detect and meet the first indications of the disorder. And yet it is known, that about such establishments there are all the circumstances to excite the disease in its most malignant form. Vomiting was only an occasional symptom, occurring, in my practice, about once in twenty times. In many of the worst cases the stomach was not at all disturbed. The tongue at first was generally natural, or covered with a white slime. The pulse was most generally either small and fre- quent, or slow and laboring, but inmany cases itwasbutslight ly affected until the vital powers began to decline. In no in- stance did I find it tense or hard, at the commencement of the disease. The temperature of the skin was generally