that two days before his admission he had been drinking quite hard; had a slight diarrhoea for two days; had not eaten anything for twelve hours; and had slept the night previous in the open air. On the morning of July 23, was taken with vomiting and purging. When admitted to hospital, his eyes were sunken, surfaces were cold and clammy, pulseless; thirst intense; severe cramps down the thighs and legs; subsultus tendinum marked; voice shrill and weak; urine totally suppressed; nausea and vomiting. He had no operation after admission.

At 7.20 o'clock p. m., temperature at axilla 96°; in rectum 990. Sulph. morphia, gr. 1, given hypodermically.

At 7.40 o'clock p. m., gave him, in same manner, gr. sulph. morphia and gr. atropia.

At 8 o'clock p. m., cataplasms of mustard applied to abdomen and lower extremities.

At 9 o'clock p. m., pulse could be felt for the first time, beating 120 to the minute.

At 9.30, temperature in axilla 994; in rectum 1010; and at 10 o'clock he commenced sinking rapidly. Five minutes before death, which ocearred at 11 o'clock p. m., his respirations were, 1st minute, 20; 2d, 15; 3d, 12; 4th, 6; 5th, 1 deep inspiration. After death, muscular contractions were very marked.

CASE (21) of Asiatic cholera brought from Evansville, Ind., to Louisville, on the 8th of June, 1873-Reported by Dr. J. A. Metcalf, of Louisville, Ky.

"John Rankin, æt. 29 years, a native of Indiana, arrived in Louisville June 8, 1873, at 5 a. m., after a trip from Terre Haute, Ind., via Evansville. Was taken sick with vomiting and purging at 5.30 a. m., half an hour after arrival from Evansville, where there were cases of cholera. The above symptoms continued increasing in severity until 5.45 a. m., when he was so much prostrated as to be forced to lie down on the sidewalk. He was brought to the city-hospital a short time afterward by the police. When I first saw him, he had very much the appearance of a eyanotic child; his extremities were cold; and there was profuse sweating, principally of the hands and feet. He had a peculiar, anxious stare, which, however, soon passed away. He was put to bed after a warm bath, (being filthy when taken to the ward,) and tr. opii, gtt. xl, administered, which checked the purging immediately. The vomiting continuing, I gave him small bits of ice instead of water, which he begged for constantly. Every two minutes, there were well-marked spasmodic contractions of the muscles of the entire body; gave him hypodermically morphia sulph. gr. 4, with sulph. atropia, gr., gradually increasing both Had one action from the bowels half an hour after admission. He was ordered the following mixture:

A dessertspoonful every two hours until easy; then as needed.

"After taking of this mixture two doses, the bowels were perfectly quiet. There was excruciating pains during one of the crampings, and the nurse gave him tr. opii, 3ss. After this, at 9.30 a. m., the cramps seemed almost confined to the inner side of the thighs and the whole of the arms. His face was wet, and as cold as if it had been bathed in

ice-water. Cataplasms of mustard were applied to the abdomen and inner side of the thighs.

"June 8, 11.30 o'clock a. m., the cramps are very much less severe from the subcutaneous use of morphia sulph., gr. 4, and atropia sulph., gr. 3. He constantly spoke of his condition in the most indifferent manner, saying if he recovered from this attack, which he did not think he would, he wanted his feet cured;' there being ulceration of the stumps, after Hayes's operation through the tarso-metatarsal articulations. 3 o'clock p. m., patient's respiration assumed a gasping character, and he gradually became worse and died at 4.37 p. m.

"There was 'complete suppression of urine from the first. The fingers were of the peculiar shriveled appearance characteristic of this condition. This case was treated by Dr. Frank C. Wilson and myself. It was seen by a number of medical gentlemen, all of whom were of the opinion that there was no doubt of its being genuine cholera of the Asiatic type."

CASE 22.-Reported by Turner Anderson, M. D., of Louisville, Ky.—Chol era-Fully developed-Death.

W. R., æt. 56 years, male, white, single, subject to paralysis agitans for seven years, was attacked June 16 with diarrhoea, at 5 o'clock a. m. No medical aid was called until 11 o'clock a. m., when he was found fully collapsed; livid; cold tongue; profuse perspiration; complete suppres sion of urine; shriveled hands; great restlessness; intense thirst. Vomiting and purging were arrested. Saw him about 12 o'clock m. Treated by albuminous drinks; injections of tepid water. Died at 4 o'clock p. m., without having made any effort at reaction.

CASE 23.-Reported by Turner Anderson, M. D., of Louisville, Ky.—History of Bauer family.

Residence on south side of Green street, between Fourteenth and Fif teenth. Frame cottage, low and damp; kitchen floor several inches . below the surrounding ground. No provision for drainage. Privy, wash-house, and coal-shed under one roof, and all in dirty condition.

Family consisted of mother, two single daughters, two married daughters with their husbands, and two grandchildren. On the 30th of July, at 11 o'clock p. m., was called to see a married daughter, Mrs. G. Found her with vomiting, purging, and cramps. The attack was sud den and without any known cause. Morphia was exhibited, hypodermically, and quinine, gr. v, ordered for every second hour. This treatment was followed by the relief of all symptoms, and in forty-eight hours she was out of bed. On the 22d of August, this lady went to Bowling Green to visit her husband, who was detained by business in that city. On the 25th, while in Bowling Green, she was taken with cholera, and died after twelve hours' illness. Her body was brought to Louisville to her mother's house on the 28th prior to burial. The coffin was opened, and the remains viewed by her friends.

On the 2d of September, the child of Mrs. G., two years of age, was taken with vomiting and diarrhoea, which were attended with great prostration. Treatment: albuminous drinks, soda, morphia, and mintwater. Recovered. Quinine was used for several days.

September 4, was called to see one of the single daughters (æt. 14 years) at 7 o'clock a. m. Found that she had been taken ill at 5 o'clock

a. m. When first visited she was fully collapsed, and died at 1.30 o'clock p. m.

The same day, a child of Mrs. G., four weeks old, was taken with cholera, and died in forty-eight hours.

September 6, the second married daughter, Mrs. A., was taken with cholera at 10 o'clock p. m., after a slight premonitory diarrhoea, and died within twenty-four hours.

All the remaining members of Mrs. Bauer's family (after the death of Mrs. G.) took quinine in decided doses, except Mrs. A., who was afraid to do so from the fact that she was seven months pregnant. All the other members of the family had more or less diarrhoea, and suffered severely from fright, but all escaped the disease.

CASE 24.-Reportel by Dr. S. A. Foss, of Jefferson County, Ky.-Cholera -Death.

Mathias Hahn, native of Würtemberg, Germany, æt. 68 years, farmer, married, in comfortable circumstances; residence eleven miles south of Louisville, Jefferson County, on right bank of Bearcamp Creek, bed of which had been dry for three weeks, and south of Pond Creek five hundred yards. Elevation of dwelling 45 to 50 feet above bed of nearest stream. Stable 150 feet south of house. Drinking-water from well 15 feet deep, situated 50 feet north of house, and protected from surface-drainage. Water soft. No privy on premises.

After slight supper, retired. Slept well till 12.30 a. m., August 17, when he awoke with desire to purge. Had seven stools of thin fecal matter in two hours and a half; stools then became watery, apparently containing bile; passages every 45 or 50 minutes for two hours, when they assumed a rice-water character. Had six rice-water dejections up to 12 o'clock m., when I saw him. Pulse 92, very feeble. Surface blue, cold; features pinched, hands and feet shriveled; bathed in cold perspiration. Tongue nearly clean, cool, lessened. Respiration 30. Voice husky. Since 9 a. m., cramps in muscles of abdomen and extremities almost constant. Thirst not great. Did not complain of feeling hot. Complained of mustard on extremities, but jugs of hot water pleasant. Insisted that he had voided urine frequently up to 9 a. m.; passed none after I saw him. Had only one stool of about 8 ounces "rice-water" after I saw him. He declined steadily; pulse barely perceptible at 6 p. m., extinct at 9 p. m. Died at 12.30 a. m. August 18. Mind clear throughout illness. Cramps ceased 30 minutes before death.

Hahn had not been near or in contact with any person suffering with disease for weeks; had habitually slept in second story of house, which was occupied by self and wife only. Six persons, aged from 15 to 70, assisted in nursing him; none were attacked with the disease.

CASE 25.-Reported by Dr. S. A. Foss, of Jefferson County, Ky.—Cho'era -Death.

"M. Russell, negro, æt. 55 years, farm-laborer, married, loaded his farm-wagon on the evening of August 17; took supper; was unusually cheerful; slightly intoxicated; slept well till 1 a. m. August 18, when he was awakened to go to market. Said he did not feel very well, turned over, and began to vomit. Purging immediately followed. Both continued at short intervals, accompanied by cramps in voluntary muscles. Thirst urgent; complained of great heat, and died in three hours from commencement of attack.

"This man resided eight miles south of Louisville, on east side of Salt River turnpike. House one and one-half story log; sanitary condition better than usual for that class of people. No stagnant water within half a mile. Drinking-water brought one-third of a mile, from a well fifty feet deep to coarse sand and gravel. One hundred people using same well with no bad effect. No stable or privy on premises. Ground thoroughly dry under and around the house. Russell had been in the habit of visiting the Louisville market weekly. He slept on first floor of house.

"Two people in contact with him during illness, six after death; none were attacked with disease. The locality where these cases occurred is decidedly malarial, but there have been fewer cases of malarial disease this autumn than since 1854."

History of a case of cholera, by Assistant Surgeon Charles Styer, U. S. A.

Edgar M. Cummings, private Company E, Second United States Infantry, æt. 21, admitted to post-hospital, Chattanooga, Tenn., June 23,

1873.

Was admitted to hospital at 8 p. m., at which time he was first seen. He stated that he had slight diarrhoea for several days, but not severe enough to induce him to apply for treatment. During the afternoon, he had been working, assisting in repairing a gun-carriage, and felt pretty well up to sunset. Shortly before I saw him, the diarrhoea had become worse, and he had cramps.

When I saw him in the barracks at the above hour, he was lying in his bunk with his limbs drawn up, and complaining of severe cramps in legs and arms. Pulse at the wrist barely perceptible, and sweating profusely. I ordered his immediate removal to the hospital, where he had to be carried.

I then found his legs up to the knees and his arms to the elbows were of dark-purple appearance, and no pulse perceptible in radial or tibial. The skin felt doughy and clammy, and the capillary circulation seemed to have entirely ceased. The cramps were of terrible severity, the countenance anxious, and the eyes sunken. His thirst was extreme, but there was no vomiting, nor was there any up to his death, although there was considerable retching. The symptoms indicated cholera; and, as this disease was reported in the town of Chattanooga, I so diagnosed the case.

I ordered pulv. opii, gr. j; calomel, gr. iij, mixed, which dose was repeated at 9 p. m., and again at 12.

June 24, but little change took place until 2 a. m., when he became more easy and fell alseep. During this time, the cramps had been incessant. Turpentine and chloroform were used freely externally, and also hot blankets dry.

I saw him again at 6 a. m. The attendant reported that from 2 to 6 he had slept at intervals, the cramps had not been troublesome, his stools had been infrequent; there was, however, no change in his gen eral condition. His answers to questions were coherent and his mind rational, but the circulation in the limbs showed no sign of returning, The discharges during the night were characteristic of cholera in color, consistence, odor. Mustard had been used freely all night externally over the whole surface of the abdomen. At 8.30 a. m., he rallied, seemed better than he had been during the night, and asked for a cup of tea. In about ten minutes, when the tea was made, he was utterly speechless, unable to swallow, and comatose, evidently dying.

Death occurred about 9 a. m., (24th.) There was no true collapse until just before death. At 6 a. m., I thought his recovery probable; at 8.30, I considered him out of danger; and at 9 he was a corpse.

I learned subsequently that, on the 23d, this man had eaten largely of unripe blackberries and had drank enormous quantities of water. He never indulged in alcoholic drinks, and was one of the most robust men in the garrison. He had not been to the town of Chattanooga for several days.

Case reported by Dr. Edgar, of Saint Louis, Mo.

Mr. P., æt. 62 years, merchant, remained late at his store on Fifth street, between Olive and Locust, actively employed until 11 o'clock, when he complained of feeling too tired to go to his dwelling on Pine street, between Eleventh and Twelfth. Having a bed in one of the upper stories over the store, he retired on that a little before 12 o'clock at night. At about 2 a. m. he was called up to the water-closet, which was in the building, hence the character of the stool was not known further than that it was "thin as water;" from this time until 6 o'clock in the morning he had six more stools, all of the same character, during which time nothing had been taken, except a spoonful of brandy occasionally with the water he drank. He now, at 6 o'clock, vomited freely a liquid thin as water, after which he was so exhausted as to alarm his clerks, who were with him, and who procured a carriage and removed him to his residence on Pine street, as above. A few moments after his arrival, about 63 o'clock a. m., I saw him, and the stool which had just passed him, which was copious and rice-water in character; also the vomited matter was similar; skin cold, and covered with perspiration; no discharge of urine since the attack; cramps were slight, voice husky and feeble. The patient was placed on a mattress, head low, extremities at once enveloped in flannels wrung out of hot mustard-water; also the same were placed over the bowels and chest. Pounded ice, with a few drops of whisky, was fed to him almost constantly; and twenty drops of the following recipe, commonly known as Hartshorn's mixture, was given every fifteen minutes, viz:

R. Chloroform,
Tr. opii.,

Tr. camphor,

Arom. spts. ammonia, aa 3iss.
Creosote, gtt. iij.

Oil cinnamon, gtt. vij.

M. Spts. vini gallici, ii.

S. Dose, 20 drops every 10 or 15 minutes until relieved.

The mustard-fomentations were kept up faithfully, and all the ice allowed that was desired.

The vomiting continued more or less for an hour, the intervals of relief being prolonged until it ceased; also, but one discharge took place from the bowels after the first portion of medicine was taken. As a slight acid odor seemed to come from the vomited matter, chalk was added, five grains to each dose, until thirty grains had been taken. As the circulation improved (the pulse having been 60 and small) and the surface became warm, he was wiped dry, and lightly covered with a blanket; no food allowed for twenty-four hours after the vomiting ceased, only ice and brandy in small quantity, and not the slightest muscular effort permitted. Convalescence commenced about twelve