drachm of Squibb's mixture was given every three hours. Had during the day four evacuations of watery character; an occasional vomit.

"At 10 o'clock a. m., September 5, temperature 980.5. Had a pure rice-water evacuation. Introduced a catheter, but found bladder empty. Exhibited hypodermically morphia sulph., gr. ; atropia, gr. o.

"At 10.30 a. m. had another rice-water discharge, and vomited. Hydrg. submur., gr. x, ordered to be taken every hour until five doses have been taken.

"At 4 o'clock p. m., another evacuation; consistency and color imimproving.

"At 7 o'clock p. m., another dejection; urinated freely.

"At 8 o'clock p. m., another action of the bowels; color improving. Temperature 98°.

"Convalesced rapidly."

CASE S.-Reported by S. P. Craig, M. D., of Stanford, Ky.-CholeraFully developed-Death in twenty-three hours.

Mrs. Jos. L., æt. 31 years, a resident of the infected portion of the town of Stanford, but who had left the town as soon as cholera became epidemic, and did not return until ten days or two weeks had elapsed from the occurrence of the last case, was taken Sunday, September 28, about 12 o'clock m., with looseness of the bowels. Dr. Craig, having been called, prescribed some powders of opium and tannin, which temporarily checked the tendency to diarrhoea. At 6 o'clock p. m., the looseness continuing, a powder was administered containing opium, gr. j; plumbi acet., gr. iij, and she was requested to inform the doctor at once if this failed to check the discharges.

"At 5 o'clock a. m., September 29, was informed that Mrs. L. had a very profuse diarrhoea during the night. On reaching her residence was informed that she had passed two ordinary-sized chamber-vessels full of thin watery fluid since midnight, and that there was another one still full in the house. Examination of this chamber determined it to be full of rice-water dejections. The patient was much prostrated, but quite cheerful. Her thirst was intense, and she complained of great internal heat. Crampings and vomiting soon came on; the skin of fingers and toes became shriveled, and the countenance became anxious; eyes sunken, voice changed, and became low and husky; pulse smaller and smaller. Collapse quickly followed.

"Succeeded in getting her quite warm several times after the collapse, by means of hot water, atropia, &c., and she died with a warm surface. The contractions of the muscles after death were astonishing; an hour after death, they were observed.

"The residence of this lady was about fifty yards from where there had been three cases of cholera during the second week of the epidemic; but, from the fact of the absence of the family the house was closed, and Mrs. L. was not attacked until a full week after their return. The water used was brought from a well in town at some distance from their residence, and the same well had been used by a number of families without developing any disease."

"On the same day, Mr. L., æt. 33 years, was taken with looseness of bowels, and frequent disposition to go to stool, for which he was treated, but without effect. On the morning of the 29th, this looseness threatening to become violent, he was placed in bed, dry heat applied to surface of his body, and morphia sulph., gr. 1, exhibited hypodermically, and a powder, containing calomel, gr. ij, camphor, gr. ij, was given

every hour until he had taken eight doses. During the next twentyfour hours the morphia-injection was repeated two or three times, and several weak brandy-toddies were given. Reaction was fully established, and at 11 o'clock a. m. he had two dejections containing a little fecal matter. Convalesced slowly."

CASE 9.-Reported by W. W. Cleaver, M. D., of Lebanon, Ky.—CholeraFully developed-Death on the tenth day.

Miss B. S., æt. 16 years, residing upon the Rolling Fork, while on a visit to the house of an aunt on the 29th of August, was, during the night, taken with vomiting and purging. Had eaten her supper, and retired to bed in her usual health, but, about 11 p. m., was awakened by violent nausea, followed by profuse vomiting. In a few moments a dejection occurred. The vomiting and purging continued for the space of an hour, when cramps in the lower extremities were established.

An express rider was dispatched to Lebanon, a distance of seven miles, for Dr. Cleaver, as soon as the cramps occurred, and, by using all haste, the patient was first seen by Dr. C. at a little before 3 o'clock a. m. of the 30th.

"The vomiting and purging at the time of this visit consisted of pure rice-water; violent cramps of both extremities occurred. The surface of the body was covered with a profuse perspiration. Extremities icycold; skin of fingers and toes shriveled; tongue cold. Slight pulse could be distinguished in the radial, and was counted to 130 beats to the minute. Features contracted, anxious, and pinched; eyes sunken; voice changed and scarcely audible. Complained of the most intense thrist. Dejections involuntary; complete suppression of the urine. A sinapism was applied to the abdomen, and covered with a large, hot poultice; dry heat to the spine and extremities. Hydrg. submur., gr. ij, with opii pulv., gr. ss, was exhibited every hour until three doses had been taken, when the same powder, with the addition of bismuth subnit., gr. iv, camphor, gr. j, was given until three doses had been taken, when the interval was increased to three hours. This was continued during the day, with the addition of occasional doses of quiniæ sulph., gr. ij, and a drachm of spts. æther. nit., the last to be given at threehour intervals.

"After the first three powders had been taken, the vomiting and purging were notably lessened, and the interval between the paroxysms much increased.

"August 30, at 7 p. m., found the pulse increased in volume. Surface of body moist with perspiration; extremities warm. Face less anxious. Voice stronger. Thirst still excessive, but vomiting and purging had ceased. No urine had been voided. The treatment was continued.

"August 31, 10 o'clock a. m., general condition was found much improved. Reaction established. Had slept some during the night, and on awaking had vomited slightly. No urine yet secreted. Discon tinued the calomel-powder. Substituted bismuth, gr. iv, every four hours, and the following mixture, a teaspoonful of which to be taken every three hours:

"R. Tinct. opii camph.,

Ext. ginger fluid, aä 3ij.
Tinet. camphor,

M. Tinct. capsici, aä 3ij.

"The quinine and nitre to be continued.

"September 1, at 10 o'clock a. m., found the patient decidedly improved. During the past twenty-four hours had but three dejections, still watery, but colored. No more vomiting. No urine yet passed. Expressed a desire for food. Treatment of previous day was continued. Milk and a light soup allowed.

"September 2, early in the day the patient was removed to her father's house, a distance of three-quarters of a mile; but by the time she reached the house vomiting and purging were re-established. At 5p. m. of the same day the pulse was found to be thread-like. Skin warm, except at the extremities. Countenance anxious and distressed. Complaining of intense abdominal pain. Having thin watery discharges. Had passed several ounces of urine.

"Placed her upon powders of calomel, opium, and bismuth, one every hour, and in the interval the camphorated mixture was continued. Discontinued quinine and spirits of nitre.

"September 3, 11 a. m., diarrhoea arrested. Skin dry and warm. Pulse small, hard, and rapid. Tongue brown and dry. Urinary secre tion nearly natural. Had slept none during the previous night. Continued treatment and nourishment, with the addition of milk-punch.

"September 4, 11 a. m., no change in her condition; still complaining of the intense abdominal pain. This pain was constant. No improvement occurred in the next three days, when the patient died."

CASE 10.-Reported by B. E. Avritt, M. D., of Lebanon, Ky.—Cholera— Fully developed-Recovery.

M. A., æt. 12 years, female, white, living on the Rolling Fork, from the 1st to the 5th of September complained of diarrhoea, for which no treatment was asked, although the county was suffering severely from the epidemic.

At 12 o'clock m. of the 5th was taken with violent purging, which was soon followed by vomiting and cramps of the feet and hands.

At 1 p. m. she was first seen by Dr. Avritt. The vomit and dejections were of "pure rice-water." Her face was livid. Eyes shrunken and surrounded by a discolored ring. Extremities cold; skin of fingers and toes shriveled. Tongue cold as ice. Extremely restless, tossing from side to side, and complaining of burning heat. Voice nearly lost. Thirst most intense, calling constantly for water, which her friends had refused. A powder, consisting of opium, gr. ss, plumbi acetatis, gr. ij, bismuth, gr. v, was given, but it was immediately ejected. Morphia acetatis, gr. 4, was given hypodermically. She became quiet; vomiting was arrested. Chloroform, 3ss, brandy, 3j, in water, was given, and repeated every fifteen minutes. The powder, of lead, opium, and bismuth, was given and retained, and was ordered to be repeated every two hours. Dry heat was applied to the body, sinapisms to abdomen and extremities. Ice-water and cracked ice allowed freely. The diarrhoea became less frequent and the quantity of water lost at each discharge was diminished. Extremities became warmer. Gradually, reaction was estab lished. Urine was not secreted freely for seventy-two hours. Convalescence slow and tedious.

CASE 11.-Gooden family-Reported by Drs. Cleaver and Arritt-Cholera-Death and recovery.

On the morning of August 31, Robert Gooden, æt. 20 years, single, white, was taken with vomiting and purging, attended with prostration,

while on a visit to the town of New Market. Dr. Porter prescribed for him; he was placed in bed; and the severity of the symptoms was relieved. On the 3d of September he returned, on horseback, to his father's house, a distance of a mile and a half, reaching home about 5 o'clock p. m. Said he felt well but tired, and soon went to bed. At midnight he was taken extremely ill, vomiting and purging, with cramps of his hands and feet, soon extending to the entire limbs. His mother described the rice-water discharges exactly. In a very few mo ments he became perfectly collapsed, and he died at 10 a. m. of the 4th. His father describes him as "the coldest and wettest human" he ever saw. No physician could be found until just before his death. This young man had attended the Marion County fair.

On the 6th, James, æt. 22, single, the eldest son of the family, was attacked with a looseness of the bowels, which continued all day. At 3 o'clock a. m. of the 7th was vomiting, and had profuse watery evacuations, which rapidly assumed the rice-water characteristics. Cramps commenced in his feet and rapidly involved the entire body. Became icy-cold, but had but a slight perspiration. Complained of intense internal heat, and the most excessive thirst. Skin of fingers and toes became shriveled. Urine suppressed. Sinapisms were applied to his body, with dry heat, and he was supplied with all the ice water he wished. (This had been denied to his brother.) No doctor could be procured until the 8th, when Dr. Palmer saw him. The collapse was fully developed. Bags of salt were heated as hot as possible and packed around him. Heat to abdomen. Chloral hydrate administered freely. Calomel and morphia were exhibited. Reaction was gradually estab lished, and in twelve hours from Dr. Palmer's visit the case was considered out of danger.

The father, Lewis Gooden, æt. 50 years, was attacked on the 9th with excessive purging of a watery character, which soon became "ricewater." They were attended with excessive prostration and intense thirst, but which yielded to absolute rest and the calomel and opium treatment, and, as the patient insists, the free use of ice-water.

Three other members of the same family were on the 10th attacked with symptoms identical with those presented by the father; but in each the disease was arrested in the first stage.

The family resided in an isolated position among the "Knobs," north of the Rolling Fork. No local influences could be discovered, and all the family were in their usual health until the return of the son, Robert, from the Marion County fair.

No efforts at disinfection or the use of prophylactics were attempted. CASE 12.-Reported by B. E. Avritt, M. D., of Lebanon, Ky.—Cholera— Second stage-Recovery.

Charles, a negro, æt. 35 years, single, after a few hours of diarrhea, was attacked with vomiting and purging, attended with excessive prostration. Cramps of hands and feet were rapidly developed. The discharges assumed the rice-water character. Skin of fingers and toes was shriveled. He was first seen by Doctor Cleaver at 6 o'clock p. m. of September 10. The patient was in an old shanty, without any of the comforts of a sick-room. Some one had made up a bed for him, but at the time of the visit he was alone. He was placed upon full doses of opium, calomel, and bismuth, and Doctor Avritt was asked to take charge of the case.

At 7 o'clock p. m., Doctor Avritt exhibited a full dose of chloroform;

continued the powders. At 8 o'clock p. m. the chloroform was repeated, and quinine, gr. ij, was added to the powder already noted. Finding it impossible to obtain any nurse for this man, Dr. Ävritt made him as comfortable as the circumstances would admit; placed by the side of his bed a bucket of ice-water and a glass, and visited him as often as possible during the night. The vomiting and purging continued during the night, but at lengthening intervals, and as water from the tumbler did not satisfy him, he drank from the bucket as long as he could tilt it to his mouth. During the night he drank all the water that was provided. At 6 o'clock a. m., September 11, surface of his body was not so intensely cold, a slight pulse, no vomiting or purging; by noon was fully reacted; and on the 13th was able to sit up.

CASE 13.-Reported by W. W. Cleaver, M. D., of Lebanon, Ky.-Cholera -Fully developed-Recovery.

W. E. R., æt. 35 years, male, white, residing in the Pleasant Run district of Marion County, was attacked September 10, 1873, at midnight. His father-in-law had died of cholera a few days before. His wife was at that moment in articulo mortis of the same disease.

At 11.30 p. m. of September 9, this gentleman left the room of his wife, went into an adjoining chamber, and threw himself for a few moments upon a lounge, fell asleep, and, as he had been in constant attendance upon his wife for three days and nights, his friends permitted no one to disturb him. A few minutes before midnight he was awakened by sudden and uncontrollable nausea; springing to his feet, he shook Dr. Cleaver, who was sleeping in the same room, and before a vessel could be secured vomited upon the floor. Expressed a strong desire to evacuate his bowels; the borborygmus being distinct to all in the room. He was at once placed in bed, and at the earnest solicitation of Dr. Cleaver made effort to restrain the inclination to evacuate the contents of his rectum. Hydrg. submur., grs. iij, opii pulvis, gr. j, was administered, and in less than an hour the same amount of calomel with half a grain of opium was given. Sinapisms and dry heat were at once applied. In twenty minutes' time, his extremities were very cold; his face was pinched and contracted; his voice was husky; and he had slight cramps of the hands and feet, and, shortly, of the abdominal muscles. Intense thirst was at once established. Ice was allowed freely. From 1 o'clock a. m. he slept for about half an hour, (probably from the exhaustion of his previous watching.) On awaking, he still complained of his desire to go to stool. Vomiting recurred. Becoming extremely nervous, potass. bromid., gr. xxx, was exhibited, and, in a few moments, a third powder of calomel and opium. He again slept for nearly half an hour. On awaking, he insisted on going to stool, but yielded to the desire of his attendants, and made no further attempt. He rested quietly, with occasional naps, unti 5 o'clock a. m. of the 11th instant, when a fourth powder of calomel and opium was given. No more vomiting had occurred, but his extremities were much colder, his body was bathed in perspiration, and his pulse was small, weak, and rapid.

At 7 o'clock a. m. had vomited once more, a tinged fluid. A fifth powder of calomel and opium was given. He was growing decidedly Ordered calomel, gr. ij; opium, gr. ss; plumbi acet., gr. ij; to be given every two hours.

Up to this time, Dr. Cleaver had remained in constant attendance, and by his personal control over the patient had restrained him from