On the Causes and Symptoms of Acute Diseases (2.5)

CHOLERA is a retrograde movement of the materiel in the whole body on the stomach, the belly, and the intestines; a most acute illness. Those matters, then, which collect in the stomach, rush upwards by vomiting; but those humours in the belly, and intestines, by the passages downwards. With regard to appearance, then, those things which are first discharged by vomiting, are watery; but those by the anus, liquid and

fetid excrement, (for continued indigestion is the cause of this disease); but if these are washed out, the discharges are pituitous, and then bilious. At first, indeed, they are borne easily, and without pain; but afterwards the stomach is affected with retchings, and the belly with tormina.

But, if the disease become worse, the tormina get greater; there is fainting, prostration of strength in the limbs, anxiety, loss of appetite; or, if they take anything, with much rumbling and nausea, there is discharged by vomiting bile intensely yellow, and the downward discharges are of like kind; spasm, contractions of the muscles in the legs and arms; the fingers are bent; vertigo, hiccup, livid nails, frigidity, extremities cold, and altogether they are affected with rigors.

But if the disease tend to death, the patient falls into a sweat; black bile, upwards and downwards; urine retained in the bladder by the spasm; but, in fact, sometimes neither is there any urine collected in the bladder, owing to the metastasis of the fluids to the intestine; loss of utterance; pulse very small, and very frequent in the cases affected with syncope; continual and unavailing strainings to vomit; the bowels troubled with tenesmus, dry, and without juices; a painful and most piteous death from spasm, suffocation, and empty vomiting.

The season of summer, then, engenders this affection; next autumn; spring, less frequently; winter, least of all. With regard to the ages, then, those of young persons and adults; old age least of all; children more frequently than these, but their complaints are not of a deadly nature.