By rubbing the affected areas with a piece of ice, cramps—an excruciating symptom—are relieved with rapidity. Pasalsky (Provincial Med. Jour., Nov. 1, '93).
Salol is an excellent remedy against choleraic diarrhcea, provided it is ad ministered in larger doses than are usu ally given; 2 to 2'/, drachms during the 24 hours, 30 grains to begin with, fol lowed every 3 hours by a dose of 15 grains. Walkowitch (La Sem. 21.W., .No. 56, '93).
Salol in 5-grain doses recommended, repeated hourly as long as required by the necessities of the case. The .drug mitigates all choleraic symptoms. Plat nitzky (Nang. Dis., S, p. 97, '93).
Against hyperthermia and general poisoning quinine by hypodermic injec tions should be resorted to. Gastro-in testinal disorders (tympanites, abdominal pains, fcetid diarrlicea) must be treated by cold applications to the abdomen, by internal use of calomel, and by rectal injections of detergent and disinfecting solutions (hyposulphite of sodium 2 to 5 to 1000, boric acid and tannic acid, 5 to 10 to 1000), etc.
Fifty-one cases with but 5 deaths under immediate use of calomel, not forgetting to give hydrochloric acid at the same time. The calomel is mixed with a little water and gum powder, placing the mixture on the tongue, thus avoiding touching the teeth. The first dose is 15 1/2 grains, repeated several times. Opium avoided. Van Hasselt (Nederlandsch Tyd. voor Genees., vol. xxxii, '93).
The administration of calomel in doses of 1/2 to 1 grain strongly advocated? given every hour. Treymann (Med. Press and Circular, Apr. 19, '93).
Calhoun many years ag,o obtained far superior results to those reported. He prescribed calomel, 10 grains; gum cam phor and tannin, each 5 grains; every half-hour or hour, aS the urgency of the symptoms demanded, until the diarrhcea was checked and the secretions restored to a healthy state. In combination with the above substances he occasionally pre scribed opium. F. Peyre Porcher (Med. Rec., NOV. 26, '92).
Calomel most highly recommended as far back as 1855, beginning its use as soon as the choleraic diarrhoea appeared. Two or three doses of 71/, grains each are administered, followed by small doses of 5/„ grain every two hours. A portion of the calomel becomes changed in the in testine to corrosive sublimate; and as corrosive-sublimate solutions have a fun gus-destroying action in a strength of 1 to 30,000, it is easy to believe that the bacilli in the intestine are directly killed hy the calomel. Zienissen (Then Gaz., Mar. 15, '93).
During this period, activity of the blood must be guarded against; and to • this end enteroclysis with a salt solu tion of 10 or 15 per cent. is very useful, and, if need be, hypodermoclysis with Cantani's solution can be continued.
Cholera Nostras.
This form of cholera resembles very closely Asiatic cholera in its -Clinical aspects; so that the distinction between the two diseases is sometimes most dif ficult. Many authors, indeed, believe in
their identity. Guerin, for example, claimed that cholera is always the same disease in every place, and that isolated cases, such as are met with every year in Italy, in the hot season, are identical to those which are developed in India. Leyden, also, does not think that there is a wide difference between cholera nostras and Asiatic cholera. Lastly, Talamon argues in favor of their identity, basing his theory on the fact that epi demics of choleriform diarrhoea occur from time to time without its being pos sible to attribute them to importation, in praces where true cholera had been previously observed. This author refers to two epidemics in the neighborhood of Paris, Which had been recognized as cholera nostras, but in which the bac teriological investigation had plainly shown the presence of the comma ba cillus.
On the other hand, several authors hold the view that cholera nostras is a disease etiologically different from Asi atic cholera, appearing generally in spo radic cases, but sometimes becoming epi demic. It is produced very often by dietetic errors, or by the action •of cold, or by the ingestion of iced draughts in persons exposed to intense heat.
Finkler and Prior found in the stools of patients affected with cholera nostras an organism in the shape of a comma bacillus, and therefore greatly resem bling the cholera, vibrio. It differs from the latter, however, by the fact that, when cultivated in gelatin, it very soon becomes liquefied, and does not give the cholera-red reaction. But in many cases, instead of the vibrio of Finkler and Prior, other organisms (bacillus subtilis, bacterium coli commune) have been found; so that the etiological question is still unsettled and no decided opinion can be formed about the real nature of cholera nostras.
Symptoms of cholera nostras are very like those of Asiatic cholera; very often, however, the stools are not riziform, but bilious and serous; vomiting is not corn: mon, and cooling of the skin does not reach an advanced degree. Moreover, the period of reaction is not accom panied by the serious inflammatory changes which are so common in Asiatic cholera; finally, the disease shows a more marked dependence upon seasonal influences. "When cholera nostras ends in death, this takes place after the signs of collapse have grown progressively worse in persons weakened by previous illness or in children and old people. Generally the disease lasts only twenty four to forty-eight hours; then convales cence ensues, leaving often a feeling of extreme weakness.
The treatment of cholera nostras is essentially the same as in Asiatic cholera; and prophylactic measures are of no less practical import, though the contagious ness of cholera nostras does not seem to be as great as that of Asiatic cholera. (See CHOLERA MORBUS.)