On the origin, habits & diffusion of cholera and what may be done to prevent or arrest its progress and to mitigate its ravages / by Sir J. Fayrer.

  • Fayrer, Sir Joseph, 1824-1907.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: On the origin, habits & diffusion of cholera and what may be done to prevent or arrest its progress and to mitigate its ravages / by Sir J. Fayrer. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    1 earliest being merely malaise and general uneasiness; this is followed by the more serious symptom of bowel de- rangement, which soon passes into incessant catharsis and emesis of clear rice-watery fluid; this—very rapidly in some cases—causes a state of collapse which frequently proves fatal, or, if reaction occur, fever follows, with a variety of complications not less dangerous. The mortality of cholera is great when it has advanced to the condition of collapse or secondary fever. In an epi- demic, perhaps half die. Death is generally due to ex- haustion from depression of vital energy and the loss of the serous part of the blood, from ursemic poisoning or from pulmonary or cardiac embolism, or from the complications attending consecutive fever. In some severe outbreaks death occurs very rapidly, as if from shock, in a few hours. The fatality appears to vary in different outbreaks, which are influenced in intensity by local causes as well as by epidemic force. The part played by meteorological condi- tions, no doubt, is important, and the effects of season and locality are marked, as I shall have to tell you later. The suddenness and violence of some attacks are so re- markable as to make it obvious that some factor—apart from contagion or insanitary conditions—is at work. It has generally been observed that the cases at the outset of an epidemic are more numerous and fatal than later on, and as it gradually declines in intensity, the cases become less severe in character, next less numerous and severe, and finally cease altogether. This is not peculiar to cholera; it occurs in other epidemics, and was specially noted by Defoe in his account of the plague in London in the 17th cen- tury. The patient's appearance and condition are strikingly sig- nificant when the disease has as.sumed its developed stage. The pinched, shrunken, livid face, hollow eyes with darkened areola;, the cold clammy skin, the corrugated fingers, the cold breath, the sunken, hollow, husky voice, the incessant discharges, the raging thirst, the cramped extremities, the faihng pulse,—all eloquently and sadly proclaim the true state and extreme danger of the suflcrer. I shall give you .some illustrations of the extent of this danger. Now to proceed to the history of cholera. In the pre- Chnstian era cholera is described by Hindoos, Chinese, and Greeks. Ancient writers on Hindoo medicine do not give a very