=Definition.=—An acute, gastro-intestinal catarrh of sudden onset,
characterized by violent abdominal pains, incessant vomiting and
purging.
=Etiology= and =Pathology=.—This disease greatly resembles Asiatic
cholera; so much so that one seems justified in suspecting that cholera
morbus, like true cholera, is due to a specific organism. No single
bacillus has yet been designated as the specific germ, although one
has been recognized resembling very much the common bacillus of true
cholera. Until this has been fully decided, cholera morbus must be
regarded as severe inflammation of the mucous membrane of the stomach
and intestines, due to some poison generated from the improper food,
which seems to be the cause of the disease, such as indigestible
fruits, cabbage and cucumbers. It is most prevalent in hot weather,
but is also caused by exposure to cold and damp. The condition of the
mucous lining of the intestines is the same as in acute diarrhea.
In fatal cases of cholera morbus there is the same shrunken, ashy
appearance of the skin that characterizes cholera.
=Symptoms.=—The onset is sudden, with intense cramps in the epigastrium
and frequently in the lower limbs; nausea; vomiting, and purging of
bilious material, which later becomes almost like water, and in severe
cases the discharge becomes serous, finally resembling the rice water
discharges of true cholera. There are also intense thirst, moderate
fever, rapid emaciation and loss of strength; the surface becomes cold
and covered with clammy sweat; the pulse is frequent and feeble. The
patient becomes restless and anxious.
=Diagnosis.=—=Asiatic Cholera.=—There is no way of distinguishing
between Asiatic cholera and cholera morbus, except by examination
of the discharges for the bacillus. Similar attacks are produced in
poisoning by arsenic, corrosive sublimate and certain fungi, and are
only discriminated from it by clinical history and cause.
=Prognosis.=—In the majority of cases the prognosis is favorable, death
rarely occurring. The duration is from twenty-four to forty-eight hours.
=Treatment.=—A strong inhibitory treatment to the gastro-intestinal
nerves is at once demanded. This relaxes the muscles of stomach and
intestines, dilates the blood-vessels and lessens peristalsis. The
treatment should be kept up until relief is given. In some cases,
gentle treatment over the stomach and intestines quiets the distress.
Inhibition at the occiput gives relief, especially to the nausea and
vomiting. Hot applications should be applied to dorsal and lumbar spine.
The vomiting is relieved principally at the fourth and fifth dorsal
vertebræ on the right side near the angle of the ribs. Cold carbonated
water and pieces of ice swallowed are useful. The diet must be
regulated, the further after treatment being symptomatic. Clear the
bowel by warm enema if any irritating matter is still present.
Inasmuch as food passes through the small intestine in 4 to 6 hours,
and requires 20 hours to pass through the colon, the colon should be
emptied by high irrigation in all acute intestinal disorders.