C1IOISEUL-GOUFFIER 
CHOLERA 
509 
tempt that he was dismissed and banished to 
his estate at Chanteloup. The regard in which 
he was held followed him to his place of exile, 
and his friends resorted thither to pay their 
respects to the fallen minister. He had en- 
deavored, but in vain, to prevent the partition 
of Poland, and when the event took place Lou- 
is XV. said, “This would not have been if 
Choiseul had been minister.” He died child- 
less, and notwithstanding his income from his 
offices, and the large fortune brought him by 
his wife, the daughter of the wealthy financier 
Crozat, he was in debt to such an amount that 
all his estates were barely sufficient to satisfy 
his creditors. II. Clande Antoine Gabriel, duke 
de, a peer of France, nephew and protege of 
the preceding, born in 1762, died in Paris, 
Dec. 2, 1838. As colonel of dragoons, in 
1791, he was active in preparing the flight 
of Louis XVI. and the royal family. On the 
failure of this attempt he was arrested, but re- 
covered his liberty by the amnesty granted on 
the acceptance of the constitution by the king. 
Appointed first gentleman usher to the queen, 
he attended her until her imprisonment, and 
left France only when a miotjLwas set upon his 
head. Raising a regiment pf joined 
the royalist army, was taken prisoner, 
embarked for India, was wrecked on the coast 
of France, arrested and sentenced to 
the directory, but saved by tjie rewffiVffon of 
the 18th Brumaire. He kept aloorfrom public 
life during the reign of Xapofcon, hut on the 
restoration he was appointed a member of the 
new chamber of He refused to sen- 
tence Xey to death, pleaded for Gen. Merlin, 
implicated in a conspiracy, resigned on the ad- 
vent of the Villele ministry, in 1820, the rank 
of major general of the national guard, and 
when the revolution of 1830 broke out, he was 
without his knowledge nominated, with Gerard 
and Lafayette, a member of the provisional 
government. He was afterward appointed 
aide-de-camp to Louis Philippe. 
(IIOISEI'L-GOI FFIER, Marie Gabriel Florent Au- 
gnste, count de, a French classical scholar, born 
in Paris, Sept. 27, 1752, died June 20, 1817. 
He studied under the direction of Barthelemy, 
travelled several years in Greece, and in 1782 
published the first volume of his Voyage pitto- 
resque en Grece. He was then made ambas- 
sador at Constantinople. On the outbreak of 
the revolution he adhered to the king, and was 
proscribed by the revolutionary government, 
lie retired to Russia, where he was intrusted 
with the direction of the academy of fine arts 
and the imperial libraries. In 1802 he returned 
to France. The second part of his great work 
was published in 1809; the last part did not 
appear till after his death, in 1824. 
CHOISY, Francois Timoleon de, a French writer, 
born in Paris in 1644, died Oct. 2, 1724. His 
delicate appearance induced his mother to dress 
him in feminine attire; he continued to wear 
it for many years, and was in the early part of 
his life notorious for his dissolute habits. In 
1676 he accompanied the cardinal de Bouillon 
to Rome to attend the election of Pope Inno- 
cent XI. In 1685 he went on a mission to the 
king of Siam, of which lie has given an inter- 
esting account. On his return to France he 
devoted his whole time to literary pursuits, 
was elected to the academy in 1687, wrote the 
history of several French kings, and attempted 
to present the annals of the church in a more 
accessible form than the learned Fleury. His 
Me,moires pour servir d Vhistoire ,de Louis 
XIV., which have been printed in Michaud’s 
Collection de mernoires, and his Journal du 
voyage de Siam fait en 1685 et 1686, are writ- 
ten in a lively and agreeable style. 
CHOKE DAMP, the name given by miners to 
the irrespirable gas (carbonic acid) which fills 
the mine after an explosion of fire damp. This 
gas is also found in badly ventilated parts of 
mines, its presence being detected by the diffi- 
culty of making candles burn, and the violent 
headaches it brings upon those who remain for 
any time where it is abundant. When carbon- 
ic oxide is present, the gas is exceedingly dan- 
gerous to breathe for an instant; but one may 
sometimes stay with safety for a minute or two 
in an atmosphere of choke damp in which a 
candle cannot be lighted. - 
CHOLERA, a term used to designate a variety 
'of diseases characterized by profuse discharges 
from the stomach and bowels upward, but 
more especially downward, and in their ex- 
treme stages by cramps, absence of the pulse, 
coldness and blueness of the skin, and suppres- 
sion of urine. The name has generally but er- 
roneously been derived from Gr. x°dl and peu, 
signifying a flow of bile; but it properly and 
more appropriately comes from x°^Pai a rain- 
gutter, as marking the fluidity, rapidity, and 
copiousness with which the discharges take 
place. The principal varieties are: 1. Cholera 
morbus, or that induced by the use of indi- 
gestible food, unripe fruits, spoiled meats, 
mouldy or corrupt provisions, blighted grain, 
cucumbers, melons, fat pork, stale crabs, lob- 
sters, shell fish, incompletely fermented or sour 
liquors, bad drinking water, &c. The indica- 
tions are to empty the stomach and bowels of 
the offending substances, and then to give an 
anodyne. 2. Catarrhal or serous cholera, pro- 
duced by sudden check of perspiration, ex- 
posure to cold while heated, &c. The indica- 
tion is to reproduce heat of the skin by warm 
clothing, warm drinks, &c. 3. Bilious or com- 
mon cholera, produced in hot weather and by 
gross and luxurious feeding, &c. The indica- 
tions are to evacuate the excessive and un- 
healthy bile, and then check its further secre- 
tion. 4. Anabilious cholera, in which the bil- 
iary secretion is much diminished or entirely 
suspended, or else is of a very light color, 
dirty white, almost colorless, or milky, and 
when abundant resembling the rice water 
evacuation of epidemic cholera. . The indica- 
tion is to restore the healthy secretion of bile. 
5. Cholera infantum, a disease of warm sea- 510 
CHOLERA 
sons, commencing with the first heats of sum- 
mer, affecting almost exclusively infants and 
children in large towns and cities, prevailing 
in the parts most densely populated, and being 
most virulent in crowded courts and alleys, 
where the ventilation is very imperfect and 
the inhabitants most unclean. In fact it arises 
from a combination of hot weather and the im- 
pure air of cities, aided largely by bad food 
and poor milk. It somewhat approaches septic 
cholera in its nature. 6. Septic cholera, arising 
from the inhalation of air charged with organic 
impurities springing from decomposing vege- 
table and animal matter, sewer gases, and 
night soil. 7. True Asiatic cholera, a virulent 
form of septic cholera, always originating in 
Hindostan, and which, like the contagious 
forms of influenza, dysentery, or erysipelas, has 
become portable, communicable, and capable 
of reproducing itself in every body in which it 
gets lodgment. Hippocrates, 400 B. 0., makes 
remarks about cholera which scarcely allow 
us to doubt of the conveyance of the Asiatic 
disease to Greece in that early period. A re- 
tains of Cappadocia, A. D. 50, gives a correct 
description of it, even describing the spasms, 
coldness of the body, loss of voice, and suppres- 
sion of urine. Galen in A. 1). 131, and Cae- 
lius Aurelianus in 151, did the same; also Ora- 
basius of Pergamus (230); while Alexander of 
Tralles (525) speaks of the watery evacuations, 
suppression of pulse and urine, followed in 
some cases by secondary typhoid fever, or death 
in a few hours.—When the French and English 
struggled for the Coromandel coast of India, 
repeated epidemics were noticed near Madras 
and Pondicherry, in connection with the great 
Hindoo pilgrimages. The year 1756 marks the 
recognition of periodically returning 12-yearly 
epidemics, connected with the great 12-yearly 
Hindoo festivals at the great temples. The 
great 12-yearly epidemics of 1756, 1768, and 
1781 have been well described by Paisley, 
Girdlestone, Curtis, Sonnerat, Fra Bartolom- 
meo, Papin, Davis, and others. On March 
22, 1781, 5,000 English troops under Col. 
Pearse, marching near Ganjam, not far from 
the great temple of Juggernaut, and very 
shortly after the huge 12-yearly festival had 
taken place, were attacked by the disease 
very suddenly and with inconceivable fury, 
after camping on foul pilgrim grounds and 
drinking polluted water. Men previously 
healthy dropped down by dozens, and those 
less severely affected were generally past re- 
covery in 24 hours. Besides those who had 
died there were 500 on the sick list on the first 
day, and in two days more nearly 3,000 were 
affected. This epidemic was carried by re- 
turning pilgrims up to Calcutta and down to 
Madras. Three times 12 or 36 years subse- 
quently the great historical epidemic of 1817 
occurred; this proceeded up the Ganges as far 
as Allahabad, when it was deflected southward 
to the province of Bundelcund, in wdiich the 
marquis of Hastings was carrying on war 
against the Mahrattas with 90,000 men. Of 
the natives 10,000 had already died in* Allah- 
abad, and many others had joined the array 
as camp followers, among whom the disease 
crept about in its usual insidious manner for 
several days, until a sufficient number of foci 
of the disease had been developed for it to 
burst forth with irresistible fury in every di- 
rection. The natives deserted in great num- 
bers, and the highways and fields for many 
miles around were strewed with the bodies 
of those who had fled with the disease upon 
them. The encampments and lines of march 
of the army presented most deplorable spec- 
tacles ; hundreds of soldiers dropped down in 
every day’s advance, and on every night’s 
halt; so that the whole presented the appear- 
ance of successive battle fields and the track 
of an army retreating under every circum- 
stance of defeat and discomfiture. In two' 
weeks 9,000 men succumbed to the pestilence. 
A subsidiary force coming up from the south 
under Col. Adams to cooperate with the mar- 
quis of Hastings afforded the second striking 
instance of a large body of men in high health 
coming into the pestilential region and falling 
at once into a wretched state of sickness; 70 
cases and 20 deaths occutred on the first day, 
and many were attacked while loitering for 
water at contaminated springs and rivulets. 
Other reenforcements were advancing from 
Bombay in the southwest, and the course of 
the disease had long been so regular along 
the line of much travelled roads and the 
marches of troops that the Bombay authori- 
ties prepared for it when it was many hundreds 
of miles off Step by step the disease could 
be traced marching from town to town and 
creeping from village to village, by the arrival 
of persons affected with the disease from places 
where it was known to prevail. From Bombay 
it was carried up the Persian gulf to Bushire, 
the oidy port of southern Persia, from which 
it was transported by travellers to Shiraz; was 
excluded from Ispahan by a rigid quarantine, 
and deflected east to Yezd ; from there north 
to Teheran, and from thence to Eeshd, the 
principal Persian port on the Caspian sea; and 
from there both by land and water up to As- 
trakhan, at the mouth of the Volga, where the 
disease died out. From Bombay it was also 
carried up to Bassorah at the head of the Per- 
sian gulf, where 18,000 persons died in 18 days; 
and from there along the rivers Euphrates 
and Tigris to Bagdad, Damascus, Aleppo, and 
the Mediterranean coast, where it also faded 
away in 1821. Every successive epidemic of 
cholera has always been carried up the Persian 
gulf from Bombay, Surat, Kurrachee, and other 
ports on the western coast of India, and thus 
reached the Mediterranean, Black, and Caspian 
seas, and neighboring countries, by the so-called 
Persian gulf route. In the Bombay presidency 
there are 94 shrines to which large pilgrimages 
are made, and from which disease is brought 
to the seacoast. In India the epidemic of 1817 CHOLERA 
511 
spread in every direction with the march of 
armies, pilgrims, merchants, and travellers, 
often in the face of contrary winds and mon- 
soons, although the speed of its progress was 
accelerated by favoring winds which forced 
along vessels containing the disease. It was 
conveyed south in ships to Ceylon, and south- 
west to Mauritius, and over to Zanzibar on the 
east coast of Africa, and from there up to Mus- 
cat at the foot of the Persian gulf, in slave 
ships, and down again southeast to Bombay.' 
It was also carried east to Burmah, Siam, Ma- 
lacca, Sumatra, Java, Borneo, the Philippine 
islands, and northeast to Canton in China by 
ships. This epidemic and that of 1781 were 
distinctly Juggernaut-pilgrim choleras, and for 
years after we have a repetition of the old 
story: “ Cholera in Calcutta; the pilgrims at 
Juggernaut suffering severely.”—In 1826 the 
first indications of another pestilence appear- 
ed in the north of India; epidemic cholera 
broke out at Ilurdwar, the great place of pil- 
grimage at the source of the Ganges, where 
it first issues from the foot of the Himalaya 
mountains. A few hundred thousand pilgrims 
go to Ilurdwar every year; more every third 
year; still more every sixth and ninth years, 
and fully 3,000,000 assemble every 12th year, 
and a vaster number every 60th year. From 
Hurdwar cholera was carried back by the 
huge caravans which came down to the festival 
from central Asia, Persia, and Afghanistan, to 
Cabool. Then the disease advanced over the 
great northwest central Asiatic caravan route 
to Balkh, Bokhara, and Khiva, and to Orenburg 
in Russia; also from Cabool by the north Per- 
sian route due west to Herat, Meshed, Teheran, 
and Reslul, at the foot of the Caspian sea; and 
from there up to Astrakhan in Russia, both by 
sea and land. Cholera reached Orenburg on 
Aug. 26, 1829, and Astrakhan in September. 
From Orenburg it proceeded due west to Nijni 
Novgorod and Moscow; and from Astrakhan it 
advanced step by step up the Volga toward the 
same places, until the stream which had flow- 
ed through central Asia to western Russia and 
Orenburg formed a junction with that which 
entered southern Russia from the northern 
provinces of Persia. From Moscow the dis- 
ease was distributed all over northern and west- 
ern Russia, especially to Riga, on the Baltic, 
from which 60 or 70 English coal vessels fled 
in haste, carrying the disease to Sunderland 
and Newcastle in England. At this time the 
great Polish revolution of 1830—’31 was going 
on, and Russian troops carried the disease to 
Warsaw, whence it was conveyed due west to 
Posen and Berlin, and from there to Ham- 
burg and over to London. After the pesti- 
lence had prevailed in England, Ireland, and 
Scotland, it was carried by 10 or 12 Irish emi- 
grant ships to Quebec in the spring of 1832, 
and from there up the St. Lawrence and across 
the lakes to Detroit, where it met the United 
States troops going to the Black Hawk war. 
In a short time the whole force sent by way of 
the lakes was rendered incapable of taking the 
field; some were left behind, but the greater 
part reached Chicago in a most deplorable con- 
dition ; one company which had been mustered 
and inspected 14 days before without a man 
on the sick list, had dropped 47 men out of 78 
in that short time; and one regiment lost over 
200 men in a week. It was generally believed 
that the infection was contracted by the soldiers 
on the steamboats which had been previously 
engaged in transporting crowds of emigrants 
westward from Montreal and Quebec ; and the 
army surgeons agreed in asserting that previous 
to the arrival of these steamboats not a case had 
been observed in Chicago. It was distributed to 
all the national posts and forts in the extreme 
west, especially to Fort Dearborn at Chicago, 
Fort Crawford near Prairie du Chien, and Fort 
Armstrong at Rock Island. From there the 
pestilence was carried down the Mississippi to 
New Orleans by October, 1832; and Surgeon 
General Lawson says, “ One fact is certain: 
no case of cholera occurred in New Orleans 
until after the arrival of steamboats with cases 
of cholera on board, and after a number of 
their passengers had died of it; 6,000 died out 
of a population of 55,000.”—The next great 12- 
yearly epidemic commenced in lower Bengal 
in 1841, advanced over India and toward the 
N. W. provinces; was supplemented by a Hurd- 
war epidemic in 1843, and was found in Af- 
ghanistan in 1844, in Persia and Meshed in 
1845, advancing west in 1846 to Teheran, and 
up between the Black and Caspian seas toward 
southern Russia, reaching Astrakhan July 30, 
1847. But especially it was deflected west to 
Trebizond and Poti, on the southern and east- 
ern coasts of the Black sea, and from there 
carried over to Constantinople and Odessa, and 
up the Danube to Germany, whence it was 
carried to Holland and England. Toward the 
close of the year 1848 numbers of German 
emigrants arrived at Havre, and some of them 
were carried to New Orleans on the ship 
Swanton, with 13 deaths from cholera before 
arrival, and from which six cases were sent on 
shore. Dr. Fenner says, after the disease had 
once commenced in New Orleans, almost every 
vessel and steamer leaving that city had 20 or 
30 cases on board; and thus persons having 
cholera and dying with it were carried to all 
the landing towns and cities up the Mississippi 
and Ohio rivers as high up as Cincinnati. 
From St. Louis it was carried over the emi- 
grant route to San Francisco; more than 1,000 
emigrants died on the road, and many Indians 
who loitered along from curiosity and for the 
purpose of begging paid a terrible penalty. 
In the mean while the Austrian, Hungarian, 
and Russian armies contending in Hungary in 
the spring and summer of 1849 had become the 
principal centre and focus of the disease, whence 
it spread with terrible virulence into Poland 
and Germany.—The next and last great 12- 
yearly epidemic commenced in India in April, 
1865. By means of railroads and steamboats, 512 
CHOLERA 
it reached Mecca on the Red sea by May 2; 
in Alexandria, June 2, cases were frequent; 
from there it was carried by steamships to 
Smyrna, Constantinople, and up the Black sea; 
to Malta, Ancona in Italy ; to Marseilles, Gibral- 
tar, Barcelona, Algiers, Tunis; and to South- 
ampton in England by the steamship Poona by 
July 10, with 120 cases of cholera by July 24. 
But more especially the disease was conveyed 
up through France from Marseilles to Paris and 
Havre; and emigrant ships quickly transported 
the disease over to America, principally to New 
York. From New York it was distributed 
in 1866 in every direction over the United 
States, by railroads and steamboats, even as far 
west as the Smoky Fork river in Kansas; to 
Forts Riley and Harker, and to the new town 
of Ellsworth, then only six weeks old, be- 
cause soldiers, railroad laborers, and others 
from infected districts brought the disease to 
the new line of railroad then building.—Thus 
Ave have sketched the great route lines of 
cholera and the great 12-yearly epidemics. 
The next one, if our theory is correct, will be 
a Juggernaut one in 1877, supplemented by a 
Hurd war cholera in 1879; although the con- 
stant intercourse of Russia Avith central Asia, 
and her expeditions in Turkistan, may be the 
means of introducing a lesser epidemic into 
Europe, as they are doing at the present time. 
But in 1877 and 1879 we may expect an out- 
burst of the disease, such as there was in 1781 
and 1783, 1817 and 1819, 1829 and 1831, 1841 
and 1843, 1853 and 1855, and 1865 and 1867. 
As Ilindostan, in Avhich cholera always origi- 
nates, lies to the east and south of Europe and 
North America, the prevailing direction in 
which the disease always advances is to the 
west and north; but as it always proceeds 
along the lines of the greatest and most rapid 
travel, it often doubles back upon itself. Thus 
in 1832 it Avas carried south from England 
to Holland and France, doAvn to Marseilles; 
east to Italy, up toward Vienna, and south to 
Malta toward Alexandria; also doAvn to Spain 
and back through the Mediterranean. In 1841 
and 1842 it was carried by English troops from 
India to China, back toward Burmah, central 
Asia, and Bokhara, south into Ilindostan as far 
as the mouth of the Indus, and low down the 
Ganges. In the Crimean Avar it was carried 
east from France and Algiers to Turkey. In 
1865 it Avas taken from Alexandria to Constan- 
tinople, from there across the Black sea to Tre- 
bizond, Circassia, and Armenia, toward Per- 
sia. In our next contests with the disease 
our Avhole safety lies in quarantine and thor- 
ough disinfection. Bokhara, the holy city of 
central Asia; Meshed, the holy city of Per- 
sia; Mecca, the holy city of Arabia; and the 
huge pilgrimages to and from them, are the 
first great outposts of danger. Next come the 
great distributing ports of Alexandria, Trebi- 
zond, Poti, Astrakhan, and Orenburg; next 
Constantinople, Odessa, and the Baltic ports; 
next Marseilles, Havre, and Liverpool; finally 
our Atlantic ports. The disease can be stopped 
at any one of these outlets and inlets. It has 
never yet been carried across the Pacific ; but 
with the vast increase of our Pacific commerce 
with China and Japan, it must sooner or later 
reach California from that direction.—As all 
the most virulent epidemics, from Kurd war to 
London, have been connected with the con- 
tamination of drinking water by cholera evac- 
uations, there is but little danger of a very 
extensive outbreak of the disease in any city 
where the drinking water is originally pure and 
is conveyed in close and clean pipes. Water 
sources must he zealously guarded; and it 
should be regarded as a penal ofi'ence, always 
to be followed by prompt and severe punish- 
ment, to foul the tributaries of a stream fur- 
nishing drinking water to any community. 
Cholera pollution of wells, springs, fountains, 
pumps, and small streams is only too common 
in all parts of the world, and is the most pro- 
ductive source of severe local outbreaks of the 
disease, and may always be suspected in every 
instance in which many cases occur simultane- 
ously in one house, family, or neighborhood. 
There is even reason to believe that pure 
drinking water may become contaminated if 
left standing long in cholera wards, in open 
vessels; at least, a substance as virulent as 
croton oil has been condensed from the atmo- 
sphere of close and crowded cholera rooms. 
The ingestion of this water is vastly more 
fatal than the use of bad fruits or poor liquors; 
but its dangers may generally be prevented by 
simple boiling, or filtering through charcoal, or 
by adding a few grains of permanganate of pot- 
ash. With these precautions cholera patients 
may be attended with great safety, provided 
the nurses be kept scrupulously clean, and no 
cups, plates, or drinking vessels be touched 
with soiled hands. Dust inhaled from cholera- 
soiled clothes, carpets, or floors is the next 
most dangerous substance; but the efl'ect of 
this is confined to single rooms, houses, fami- 
lies, and confined spaces, and can never rise to 
the dignity of the cause of a great and extended 
epidemic. As the poison of the disease always 
proceeds from the cholera evacuations, these 
should be disinfected instantly and thoroughly; 
and common salt is perhaps as good a disinfec- 
tant as any. Strong solutions of salt, or weaker 
ones of sulphate of iron (copperas) or sulphate 
of zinc (white vitriol), 1 part to 10 of water, 
should be kept in the bed pans or vessels; 
soiled bed rfnd body clothes should be put, be- 
fore removal from the sick room, into a disin- 
fecting solution of salt, chloride of soda, weak 
carbolic acid, permanganate of potash, or clilo- 
ralum, and then subjected to careful washing 
out of doors. The floor of the sick room 
should always be bare of carpets, and may be 
sprinkled or washed with a strong solution of 
salt or chloralum, or the chloride of aluminum, 
all of which possess several advantages. They 
are not poisonous, are inodorous, and are very 
cheap. They prevent decomposition and re- CHOLERA 
513 
move the fetor of most animal discharges, either 
natural or the products of disease. They de- 
odorize sewage, and may be used for the disin- 
fection of rooms, and as a cleansing material 
for floors or furniture (2£ ounces to a gallon 
of water). But, not being volatile, they must 
be aided by aerial and diffusible disinfectants, 
the best of which are chlorine, iodine, and car- 
bolic acid. The unpleasant odor of chloride 
of lime or soda may be overcome by the addi- 
tion of a small quantity of nitro-benzole. Iodine 
placed in saucers in different parts of the sick 
room evaporates spontaneously ; and if its odor 
can be detected, it is in sufficient quantity to 
disinfect the air. Or £ lb. of carbolic acid may 
be mixed with 10 lbs. of wet sand, placed in 
shallow vessels in various parts of the room, 
and renewed when its odor has disappeared. It 
will be seen that the attempt to obtain a disin- 
fectant of universal application, and capable of 
fulfilling every indication, will always be attend- 
ed with disappointment. Some, like the chlo- 
ride of soda and the sulphates of iron and zinc, 
prevent fermentation and putrefaction ; others, 
like iodine, chlorine, and carbolic acid, resolve 
the products of decay and decomposition into 
harmless substances.—Although the first stage 
of cholera cannot be distinguished from a pro- 
fuse watery diarrhoea, the treatment is very 
simple. In the first place, it should be fully 
believed that nine tenths of all cases of diar- 
rhoea occurring in the summer season, even in 
cholera times, are not Asiatic cholera, and 
never will be. Even if the case be one of 
cholera, absolute repose in bed, between thin 
blankets, will cure at least one half of all cases 
without any medicine ; then one or two grains 
of sulphate of iron, with or without a quarter 
or half a grain of opium, every two or four 
hours, will cure a great many more. In the 
severest and most neglected cases no treat- 
ment is of any avail; but from 5 to 20 per 
cent, of these will recover if not too much in- 
terfered with. The preventive measures are 
equally simple. As drinking cholera water is 
almost the only cause, a rather free use of 
salt and vinegar, which are the great domes- 
tic disinfectants, may be all that is essential. 
It is certainly unnecessary to abstain from 
ripe and good fruits and vegetables, while 
all sweet, fresh meats and farinaceous sub- 
stances are beneficial. Even of those per- 
sons who swallow water into which chol- 
era dejecta have found their way, all with 
healthy stomachs, containing healthy acid gas- 
tric juice, and food in the process of normal 
digestion, wrill escape. In some instances 15 
out of 20 have escaped. But if cholera water 
be swallowed on an empty stomach some hours 
after taking food, then the cholera poison will 
set up its distinctive changes in the epithelium 
of the stomach, which speedily extend to that 
of the intestines, so that a robust, healthy, and 
otherwise prudent person may quickly succumb 
to the disease. Or, if more of such water be 
swallowed than the stomach will easily con- 
tain, some of it will at once pass to the small 
intestines, and their contents being alkaline, 
the specific action of cholera matter will at 
once take place. Hence persons with weak 
digestion, and those suffering from depression 
of the nervous force, whether following exces- 
sive fatigue or a debauch, are especially apt 
to be attacked. Therefore the poor of large 
towns, who are ill fed and suffer from want 
of a healthy acid secretion from the gastric 
walls, are especially liable to the disease. 
Hard drinkers increase their risk by drinking 
large quantities of water after a debauch, to 
quench their unnatural thirst. But even all 
these will escape if they be fortunate enough 
not to drink foul cholera water.—The pathol- 
ogy of the disease is equally simple. The 
cholera poison first produces a paralysis of the 
vaso-motor nerves and capillaries of the stom- 
ach and bowels, allowing the watery particles 
of the blood to exude as if from a relaxed and 
sweating skin. Next, the epithelium of the 
gastro-intestinal mucous membrane is shed in 
large quantities, leaving the latter bare and 
almost raw, red, and filled with blood. In 
this stage strong stimulants and irritants are 
very injurious, while a few teaspoonfuls of 
arrowroot with a little brandy, given very fre- 
quently, will prove quite beneficial; and sweet 
oil and lime water is far better than castor 
oil, or other so-called eliminatives. As the dis- 
ease advances the blood is drained of much of 
its serum or water, becomes thick, and stag- 
nates in various places. It is no longer prop- 
erly oxygenated, and becomes dark, marking 
the third stage of the disease, followed by 
exhaustion and perfect collapse ; from which 
a small number may slowly rally, if care- 
fully supplied with drink and weak stimu- 
lants in small quantities, frequently repeated. 
Of these, some will pass into a typhoid state, 
through retention of effete materials in the 
blood, especially of urea, from complete in- 
action of the kidneys. Then diuretics, more 
particularly nitre, cantharides, digitalis, or nux 
vomica, will save a small proportion. The 
great point in the whole course of the disease 
is not to be too hurried or agitated, nor too 
anxious to do too much and too quickly. Ab- 
solute rest and warmth, the careful use of 
food and weak stimulants, aided by small quan- 
tities of astringents and opiates, especially vine- 
gar of opium, with an absence of all unmanly 
haste and fear, will save a large number who 
would fruitlessly rely upon vaunted specifics. 
Dr. Macpherson, who had seen and treated thou- 
sands of cases, when attacked himself at night, 
remained quietly in bed, took nothing but a 
little arrowroot and brandy with a few drops of 
laudanum, and occasional sips of carbonic acid 
water. In the morning he directed that an 
old and experienced medical friend should not 
be sent for until after he had finished his break- 
fast, and the usual time for going on his rounds 
had arrived. With these simple means, and 
the careful handling of an old and tried hospi- 514 
CHOLESTERINE 
tal steward, he was saved when on the bor- 
ders of a profound collapse, and slowly and 
steadily brought back to life. All three of 
these wise and patient men were convinced that 
the more there was of haste, the moro pro- 
fusely food, stimulants, and drugs \tere plied, 
the more certainly fatal would be the result; 
and that the more steadily and quickly their few 
and simple means were used, the greater would 
be the chances of recovery. When he was 
cold and almost pulseless, and so exhausted as 
scarcely to be able to raise a finger or move 
his head, his courage did not fail him; and his 
skilled and wise attendants did not kill him 
with mistaken zeal and kindness. 
C1I0LESTERINE (Gr. bile, and oTepedg, 
firm, solid), or Biliary Fat, a non-nitrogenized 
organic substance, found in the bile and in 
other fluids or situations in the human body, 
or that of animals in which the biliary secre- 
tion is prominent, this substance when sepa- 
rately obtained having the appearance of sper- 
maceti, and differing from ordinary fats only 
in the fact that it refuses to form a soap with 
caustic alkalies, even under the action of pro- 
longed heat. Oholesterine is neutral, inodor- 
ous, insoluble in water, soluble in ether and 
hot alcohol. Its composition is usually repre- 
sented by the formula It is com- 
bustible and burns with a bright flame. It 
crystallizes in very thin, colorless, transparent, 
rhomboidal plates, frequently marked by a 
cleavage at one corner in a line parallel with 
the corresponding side, and often forming in 
layers, the Borders of the subjacent plates 
showing very distinctly through those above. 
Oholesterine was discovered in 1782, by Poul- 
letier de la Salle, in biliary calculi; its pres- 
ence in the blood was shown in 1830 by Denis. 
In a condition of health, oholesterine exists in 
the bile, blood, liver, brain and nerves, and the 
crystalline lens. It is also found in very large 
quantity in the meconium, in the fseces of ani- 
mals hibernating, and by some authorities it 
is said also in the feces generally in health. 
It occurs frequently as a morbid deposit or 
product. Biliary calculi consist wholly of 
oholesterine, coloring matter, and mucus. The 
tablets of oholesterine are found in or obtained 
from cancerous growths, encysted tumors, and 
atheromatous deposits in the coats of the ar- 
teries, and sometimes as forming distinct de- 
posits or tumors in the substance of the brain. 
Oholesterine is obtained also from the fluid of 
hydrocele, of ovarian cysts, of tubercle in the 
crude state, and from pus. Its quantity in the 
normal fluids is small, forming, according to 
Berzelius, 1 part in 1,000 of the bile in man, 
and according to Prof. Austin Flint, jr., of 
New York, only ’618 in 1,000. The analyses 
of the latter give as the proportion in 1,000 
parts, for the venous blood of the male, '445 
to '751; for the meconium, 6'245 ; for the hu- 
man brain (in two instances in which death 
was sudden), 7’729 to 11'456. The bile and 
some other fluids can hold the cholesterine in 
solution, though by aid of what other con- 
stituent is not known; while it may perhaps 
exist, in organic union with other components, 
in the nervous substance and the crystalline 
lens. While the chemical relations of choles- 
terine had been fully studied, its physiological 
relations long remained in doubt, or the sub- 
ject at the most of conjecture. According to 
the researches of Prof. Flint, cholesterine is 
constantly forming in the system, being always 
present in the nervous matter and the blood, 
but by far the most abundant in the former; 
it is a necessary product of the waste of the 
nervous matter, find being removed thence in 
the circulation constitutes one of the most im- 
portant of the materials to be excreted from 
the body. It is separated from the blood by 
the liver, appears constantly in the bile, and in 
this is poured into the alimentary canal. As 
in the case of urea, the most important excreted 
matter of the kidneys, so with cliolesterine, if 
its separation and removal through the liver 
ceases, or is not in due amount, this product 
accumulates in the system, producing its form 
also of poisoning or deterioration of the blood, 
and leading to a corresponding class of dis- 
eases. Thus the bile has two distinct functions 
answering to the presence of two entirely dis- 
tinct components in it. One of these embraces 
the glyco-cholate and tauro-cholate of soda, 
which do not preexist in the blood, and so do 
not accumulate in it when the liver is torpid 
or its action arrested; these are produced in 
the li,ver, serve a useful purpose in completing 
the process of digestion, are not discharged in 
the freces, and constitute a secretion only. The 
other function of the liver is the depuration 
of the blood by freeing it of excess of choles- 
terine; and to this end probably it is that se- 
cretion of bile continues in the intervals of di- 
gestion, though more abundant during the di- 
gestive acts. The ordinary faeces, according to 
Prof. Flint, do not contain cliolesterine, but 
contain stercorine; the substance thus named 
by the author being invariably found by him 
in the normal fasces, and regarded by hint 
as identical with that previously found in 
minute quantity ('02 to '025 part in 1,000) in 
blood, and named seroline. The transforma- 
tion of cholesterine to stercorine occurs during 
the digestive process; and that it does not 
take place before digestion commences, nor 
when it is for the time arrested, accounts for 
the presence of the former only in the me- 
conium and the excrement of animals hiber- 
nating. Stercorine is therefore the form in 
which cholesterine is discharged from the body. 
The facts explain the distinction of the two 
types of jaundice. In the mild type the bile is 
formed, but its discharge being obstructed, its 
coloring matter chiefly is reabsorbed, and the 
disease is attended with yellowness of the skin, 
but is comparatively harmless; in the other, 
the grave symptoms and almost invariably 
fatal character are due to cessation of the 
action of the liver, with retention of choleste-