Licence: Public Domain Mark
Credit: Cholera asiatica maligna / by Norman Chevers. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![with red patches. Large intestines filled with a dark-yellow fluid. Six months later, a prisoner, aged thirty, complained of fever for two days, for which he only sought admission to hospital on the third day. He had vomiting and purging that morning. In the afternoon he had two copious watery stools of a deep dark-red colour, with flocculent yellowish deposits, and vomited thrice—bile and mucus. He was found with sunken eyes and very feeble pulse, abdomen sunken and free from tenderness, very restless. He had one scanty stool at night of a deep red colour. On the following morn- ing collapse had passed away, but there was sickness and retching. He had strong fever at noon, which left him in the evening with a weak pulse. On the next day he had fever with sickness from noon till 4 p.m., less strong than on the preceding day. Quinine had begun to tell. On the following day he felt pretty well, but very weak. He had no further bad symptoms. 5. I twice saw, in Bengal, an outbreak of a disease which wanted none of the usual characteristic symptoms of true Asiatic Cholera, except that the rice-water stools were blood- tinged. [In another similar outbreak I would recommend careful thermometrical observations.] In the museum at Haslar Hospital there used to be a dried preparation of the lower part of the ileum taken from a patient who died in the first Epidemic outbreak of Asiatic Cholera in England in 1832. For about a foot above the csecum it was of a deep mulberry-red colour. In the only outbreak of truly Epidemic Cholera that I chanced to see in Bengal, in 1849, I found, in all of my numerous fatal cases, intense redness of the lower part of the small intestine (over which there was great tenderness during life). The stools were rice-water-like without the slightest tinge of blood. This was accounted for by the presence of a condition which I have never again met with in cholera. The congested mucous membrane was evenly coated by a strongly adherent, croupous-like, white exudation, nearly as thick as the intestine itself. From the inner surface of this, thin white processes floated convergently towards the axis of the canal into shreddy rice-water fluid. Clearly, all passage through the inflamed gut had ceased some time before death. Mentioning this to the intelligent Madras Dresser who assisted me in my military hospital, I was told that the regiment had suffered from such a type of Cholera in Madras some years previously; and he showed me, in some of the older men, huge cicatrices in the right iliac](https://iiif.wellcomecollection.org/image/b22313436_0007.jp2/full/800%2C/0/default.jpg)
