not seize on its victims at hazard, as many say. It has been acertained that out of every hundred individuals who die of this disease, ninety are in the habit of drinking ardent spirits to excess."

Mons. Huber, who saw 2160 perish in twenty-one days of cholera in one town in Russia, says, "It is a most remarkable circumstance that persons given to drinking have been swept away like flies. In Tiflis, containing 20,000 inhabitants, every drunkard has fallen-all are dead, not one remains."

Dr. Rhinelander, visiting Montreal in 1832, states, "The victims of cholera are the intemperate." A Montreal journal states, "That not a drunkard who had been attacked had recovered, and almost all the victims have been, at least, moderate drinkers."

Dr. Bronsen of Albany, states, "Drunkards and tipplers have been searched out by cholera with such unerring certainty, as to show that the arrows of death have not been dealt out with indiscrimination; there seems to be a natural affinity between cholera and ardent spirits, and their habitual use in the smallest quantity seldom fails to invite the disease, and render it incurable when it takes place."

Professor Sewall, M.D., visiting New York, says, "That of 204 cases in the Park Hospital there were only six temperate persons, and that these had recovered."

Dr. Mussey, U. S., says, "Upon boats on the river the increase of brandy drinking, consequent on the approach of cholera, has been frightful, and the mortality on board these vessels has been terrible and unprecedented. When this dreadful scourge was raging in New Orleans, amongst the hundreds that were swept off by the disease, only two were sons of temperance, and among the 1200 of that city only three were attacked."

The great and good Mr. E. C. Delevan writes, "In 1832 when the cholera broke out in Albany I was engaged with E. Corning and J. T. Norton in erecting that large block of buildings on Green, Beaver, and Norton-streets. About 100 men were employed, they were all about abandoning their labour, when they were persuaded to remain. They all agreed to keep at their work and abstain from strong drink. A beverage of water, molasses and ginger was furnished them free, and of all those 100 men engaged on the work not one died, nor was the work intermitted a day; one man not under the control of the builders (those excellent mechanics, Fish and Mawley), but employed by the man who furnished the brick, would not adopt the simple beverage offered to him but resorted to the grog shops. He fell a victim."

Professor Miller says, " Of 70 male adults affected with cholera in

Edinburgh Hospital in 1848, only 17, according to their own account, had led tolerably temperate lives, and of 140 females attacked by the disease only 43 were reported sober."

Professor Mackintosh of Endinburgh, who was physician to an extensive cholera hospital, states, "It has been computed that 5-6ths of all who have fallen by the disease in England were taken from the ranks of the intemperate and dissolute."

Dr. Adams of Dublin, affirms, "Our foreign reports testify that drunkards are carried off at once by this dire disease; but those who by a daily use of a moderate quantity debilitate the tone of the stomach and biliary organs become easy victims to the cholera."

The Rev. Wm. Reid of Edinburgh, in his "Temperance Cyclopædia," says, "Dr. A. M. Adams, Professor of Medicine in the Andersonian University of Glasgow, has favoured us with a classified statement of the previous habits and conditions of health of 125 cholera patients treated by him during the epidemic of 1848-49. From this table it appears that whilst those patients, who were represented to him as being of temperate habits, died only in the proportion of 19-2 per cent., those who were of intemperate habits died in the enormous proportion of 91.2 per cent."

I might multiply statements such as these, but assuredly they ought to be quite sufficient to establish the principle of the imperative necessity of refraining from the use of alcohol, or a remedial agent for its cure. This latter I had an opportunity of testing during the dreadful invasion of 1832 as well as 1848, when I relinquished brandy for pure cold water with marked benefit. In corroboration of this statement, I eould quote those of some other medical men, but refer just now to only one detailed in THE PRESS of 27th December, 1865, in an article on cholera, translated from the French by Dr. T. M. Madden :

"The action of cold water in cases of cholera was, however, I believe, first pointed out thirty-two years ago by an Irish medical practitioner, Dr. McCoy, in the Dublin Quarterly Journal of Medical Science, and as the article in question is probably unknown to many readers of the PRESS, I shall quote the passage to which I refer :

"Among the strongest prejudices," says Dr. McCoy, "I brought into the hospital was that against cold water. One of the India reporters, I recollect, states that he never knew a patient recover who was allowed cold water to drink, and other writers denounced it, though not so emphatically. I accordingly requested the nurses not on any account to comply with the entreaties of the patients for cold water. On the 2nd May, a female named Margaret Tusky, aged 21, was admitted into one.

of my wards at four o'clock in the evening; she had been nine hours ill; the surface of her body quite cold; her feet, legs, hands, eyelids, and nose were blue; no pulse could be felt at her wrist; vomiting incessant of the rice-water kind; she had two or three alvine dejections before admission; eyelids half closed, and eyes turned upwards; thirst very great; calls for cold water urgent; cramps very distressing; tongue cold and white; pain just below the sternum, which she attributed to having drank two pennyworth of buttermilk during the morning. The necessary measures were resorted to for her. This girl, having observed that a pail of cold water had been left near her bed for some ward purposes, contrived during the evening to draw herself towards it, and putting her head into the vessel drank copiously; it was speedily thrown up again, but the draught was repeated as often as she could without being detected. When I heard of it, I was of course alarmed for the consequences. However, during the night, a patient in the same ward in a convalescent sate, who had felt the deprivation of water herself, not long before, got out of bed several times and supplied Tusky with cold This she told me herself the following morning after I had expressed my satisfaction at finding her so much better than when I left her the night before. She recovered. This incident demonstrated that the indulgence in drinking cold water was, at least, not certainly fatal. I therefore commenced giving it in small quantities when called for, and soon after allowed them to drink as much of it as they pleased. I found it the best drink of any I had yet tried, and by far the most agreeable."

water.

I could multiply cases exactly similar, one in particular detailed to me near Cork, confirmatory of the forgoing remarks, "Cold Water versus Brandy Cure;" but having already taken up so much of your valuable space, I think it not necessary, sincerely hoping by those few details to draw the attention of our noble and philanthropic profession to the disas trous evils resulting from the indiscriminate alcoholic medication of the present day.

Templemore, May 13, 1866.

BLEEDING IN CHOLERA.

By EWING WHITTLE, M.D. Lond., Member of the Royal Irish Academy; Sen. Hon. Surgeon to the Liverpool Dispensaries.

Though fully appreciating the justice of your observation, that a terrible responsibility rests upon any one who writes on the subject of cholera at present, I feel bound to lay before the Profession some observations on the views of the treatment of cholera lately set forth so forcibly by Dr.

George Johnson. This is a subject on which I have a right to speak with some degree of authority; in 1849 I devoted much time to a careful study of the history and pathology of the disease, I was largely engaged in the treatment of cholera cases during the epidemic of that year, and had the charge of the Cholera Hospital of Toxteth-park, a township then containing more than 60,000 inhabitants.

As the result of my practice I showed that the judicious use of the lancet (as practised nearly fifty years ago in India), was the key to successful treatment; that by its use four cases out of five could be saved; that next to its use administration of calomel was most to be relied on ; and I believe I was the first to show that the good effects of calomel had no reference whatever to the supposed action of that mineral on the liver. A further experience of the epidemic in 1854 confirmed these views, and you will find the results partially recorded in the Medical Times and Gazette for October, 1854. So much for my claim to some attention on this important and now anxious question.

I am quite satisfied that Dr. Johnson is right in his theory that the passage of blood from the right side to the left side of the heart is impeded; this arrest of the blood in its natural course is what calls for relief by blood-letting. Whether this is caused by spasm of the small vessels or whether it be the result of nervous paresis, the fact does not admit of dispute; but I cannot so readily admit the truth of Dr. Johnson's theory, that the vomiting and purging is an effort of nature to carry off the poison. How often is vomiting a symptom of sympathy with a distant organ, as in nephritis, in hydrocephalus, in pregnancy? So much for theory; now with regard to practice. I have invariably observed thatl if these symptoms can be relieved the severity of the disease is abated; and vice versa, everything which increases the vomiting and parging aggravates the disease, and precipitates the collapse. Under this head may be included all stimulants, astringents, and opium; all alike injurious, not by stopping the discharges, but by increasing them, particularly the vomiting, which is always a most harassing and exhausting symptom. On the contrary, the action of the calomel is the very reverse; it stops the vomiting immediately, and after a few doses the purging. This I have observed myself; it never purges unless it is continued until reaction is fully set up. In support of the correctness of this statement, I can refer you to all the old Indian authorities; for instance, Dr. James Johnson says "that twenty grains of calomel will act as a sedative; and, so far from griping and producing hypercatharsis, it will soothe uneasiness and rather constipate than purge. Annesley and other Indian authors have made the same observation. This appears to me to be the weak point in

Dr. Johnson's views and this I wish to combat-viz., that calomel is given as a purgative or a cholagogue. In fine, one word upon your own remark, that those who read Dr. Johnson's book will come to the conclusion that the best plan is to do nothing in the stage of collapse; if they do, I can assure you that they will lose more patients than they ought to do. Let them open a vein in the arm in all cases; if collapse has gone so far that no blood will flow, the puncture will do no harm; if only a little blood flows, some relief will be afforded; and if the stream continues until the colour changes from black to red (as Annesley long ago recommended), the relief will be very decided, and the patient will in all probability recover, particularly if he has not been previeusly injured by the administration of stimulants and opium or other irritants. It is generally sufficient to take three or four ounces of blood, the red colour becoming pretty well marked by the time that quantity is drawn from the vein. A few doses of calomel and a spoonful of gruel every now and then, and the application of dry heat and sinapisms to the surface, was the only additional treatment which I found necessary in 1854.

Believing that there is much truth in what Dr. Johnson has advanced, and knowing that his views have made a profound impression on the Profession, I feel bound to enter a protest against what appears to me to be the unsound point both in his theory and practice. However, I am glad that he so far concurs with me as to recommend bleeding at all; this, I think, he did not do in 1854. I practised it with success both in that year and in 1849, and I would beg most urgently of my Professional brethren to give this mode of treatment a fair trial. If they do, they will not be disappointed.

ICE IN CHOLERA.

A correspondent of the (Calcutta) Englishman gives an account of the successful treatment of a case of cholera, apparently in an advanced stage, by the application of ice to the spine, as recommended by Dr. Chapman. my The writer says:-On Sunday, the 25th Feb., about 10:30 a.m., servants requested me to go and see a man who, they said, was dying of cholera, and to give him some medicine. I proceeded to the place, where I found a man lying on the ground in the greatest agony, with the usual symptoms of cholora-vomiting, &c. He was much emaciated, and to me appeared rapidly sinking. I had no medicine in the house. I ordered one of my servants to go around among the neighbours and try to get some medicine, but in this I was unsuccessful. I recollected, however, having read in the Times an article bearing the signature of John