Sanitary measures and their results : being a sequel to "The history of cholera in Exeter in 1832," to which is now added a short account of its occurance in 1849 / by Thomas Shapter, M.D.
- Thomas Shapter
- Date:
- 1866
Licence: Public Domain Mark
Credit: Sanitary measures and their results : being a sequel to "The history of cholera in Exeter in 1832," to which is now added a short account of its occurance in 1849 / by Thomas Shapter, M.D. Source: Wellcome Collection.
Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.
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![So far, then, from the collapse depending on, or being caused by, these discharges, it would rather appear that they are, to a certain extent, the means whereby a materies morbi is eliminated, and are therefore to be esteemed, so long as the immediate cause of the disease exists, as beneficial and conducive to reaction. As the collapse, which is the chief character of this disease, is not therefore the effect of exhaus- tion consequent upon too free and excessive discharges, it be- comes necessary to inquire on what other cause it may be de- pendent. The slow and almost imperceptible circulation, the laborious breathing, the absence of secretion, &c., all indicate that the great organs of organic life are peculiarly affected, and that the due performance of their functions is interfered with, or even entirel}' suspended ; that there is, in fact, the presence of that state of atony which is one of the causes of congestion. It must, then, be ascertained whence this state arises. For the solution of the question we natu- rally look to the nervous or the circulating systems : as regards the circulating system, there can be no doubt that the heart's action is early implicated, but it is by no means so at first, nor I indeed, prominently so, until other large organs of the body : genei'ally are affected, and an universal prostratioii of strength, and cramps, indicate that the rest of the muscular system is involved ; nor can all the symptoms accompanying the charac- ] teristic collapse be referable to disorder here : collapse from the heart would not cause the peculiar discharges nor the i cramps; hence the phenomena exhibited cannot be referred, j apart from the blood being a medium whereby, in the first instance, the specific poison is transmitted to the various tissues of the body, to primary errors in the circulating system. To the nervous system, then, are we driven to look for the proximate and immediate cause of the disease, and a careful examination of the symptoms shows every reason for concluding this to be its seat; the uneasiness in the heart, the oppressed breathing, the pains about the prsecordia, the sinkings at the stomach, the hoarse whisper, the general depression and prostration of strength, the suppressed func- tions of the secreting organs and chylopoietic viscera, the dis-](https://iiif.wellcomecollection.org/image/b21451990_0025.jp2/full/800%2C/0/default.jpg)
