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
  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