usually supposed to be derived from the two Greek words χολή and βία, bile flux, but more probably from the Greek word χολητικός, a rain-gutter, when the affix of the word morbus showed it was the disease which was spoken of, and not the channel for water. Two principal forms of this disease occur: the first, the ordinary bilious or autumnal cholera; the other, the epidemic, malignant, or Asiatic cholera. In the bilious cholera, which prevails to a greater or less extent every autumn, violent vomiting and purging occur, but the discharges contain a large quantity of bilious matter. There is much pain in the stomach and bowels, with more or less spasms of the muscles of the abdomen and extremities, with great prostration of strength, &c. In epidemic or malignant cholera, after the contents of the stomach and bowels are evacuated, the discharges consist of a nearly colourless fluid, filled with flocculi, and resemble water in which rice has been boiled. No bile nor urine is secreted; the whole surface of the body is cold, shrunk, collapsed, with a leaden cadaverous hue, and severe spasms both of the muscles of the abdomen and of the extremities. This stage of collapse and prostration sometimes occurs quite suddenly, but usually is preceded by ordinary diarrhoea, or bowel complaint, of some hours or days continuance. When the person rallies from the stage of collapse, he usually passes through a febrile stage before returning to health, as if the cholera were but a plague variety of epidemic typhus fever.

Malignant cholera has been long known in India; but it is commonly stated that it has only been of late years that it has extended its ravages over the rest of the world. Like all epidemic plagues, it has in its course followed the great leading tracks of commerce or of the march of armies, stealing slowly but surely along the banks of rivers, the great roads, and the lines of traffic, and attacking in succession city after city. No barriers, natural or artificial, nor military cordons have been able to arrest its progress in the slightest degree. It has crossed rivers, mountains, seas, and deserts, always falling most heavily on the inhabitants of those towns, hamlets, or houses where deficient drainage and ventilation, accumulations of putrescent matters, want of personal cleanliness, and intemperance, were most prevalent. In the European cities it has selected as its especial site all the usual haunts of typhus fever, and has attacked the inhabitants of almost every locality where typhus fever was known to prevail and be endemic. It has ever shown itself most fatal in the neighbourhood of rivers and marshes; and the able report of Mr Farr on the cholera in England clearly demonstrates that in London the mortality from cholera bore an exact arithmetical ratio to the height of the districts above the level of the Thames: the higher above the level of the Thames the less was the mortality from the disease.

When this virulent disease attacks an army or a town, the most effectual remedy seems to be to leave the ground or town immediately, and scatter the people over the face of the country. Even in crowded cities it has been found that by removing the inhabitants from the localities where it breaks out, and locating them in airy and well ventilated and well drained situations, they remain free from the disease, which they could not do were the disease contagious in the proper sense of the word. As to treatment, when the disease prevails epidemically, the very first symptoms of diarrhoea must be watched and treated instantly by the usual remedies, as chalk mixture, or with tincture of catechu and opium. When the disease passes to the stage of collapse, it is remarkable that, whether treated or not, just about a half recover; and as the disease abates, this proportion increases to two-thirds. The treatment by salines, that is repeated drinks of carbonate of soda and tartaric or citric acid, and also the administration of diluted sulphuric acid, 20 to 40 drops every half-hour, have been highly praised as the remedies most likely to conduct the patient through the disease; and where a fair trial has been made of these remedies, they happen to have answered the purpose better than any others. (J.S.K.)