and attacks a large number of people in a particular locality. There seems little doubt that it is extremely infectious. The micro-organisms Microccocus roseus and Streptococcus seiferti are associated with this disease.
Symptoms.—The disease begins suddenly with headache, pain at the back of the eyes, and in the back and limbs. The temperature is raised, and usually there is running at the nose, and frequently some bronchitis.
The abnormal temperature continues for 3 or 4 days, there is loss of appetite, with great thirst, and the sufferer is quite incapacitated from work. When the fever declines there is a feeling of great exhaustion or weakness, which may persist for a long time; in fact, the return to the former state of health is usually slow. Unfortunately one attack is by no means protective, and many people who have suffered from an attack of influenza, whenever the disease is prevalent again fall victims to it.
Treatment.—Absolute rest in bed, with light nutritious diet. A purge should be taken at the onset of the attack. During the fever a mixture containing salicylate of soda (10 grains every 4 hours) relieves the pains and reduces the fever. Later, Easton's syrup after meals is one of the best tonics for the feeling of exhaustion and weakness. A change of air is always beneficial.
Cholera.—Cholera, as known to us, is of two kinds—what is known as British cholera, a disease bad enough, but not particularly fatal—and that terribly fatal disorder, Asiatic, malignant, or epidemic cholera. This last disease seems to have been known in India for centuries, and to have its natural home or headquarters in the Delta of the Ganges. In this country the disease has almost always prevailed in its worst form in poor, crowded dwellings, among those whose food supply was bad, and whose hygienic conditions were otherwise unfavourable, but especially among those who had a tainted supply of water. Very frequently cholera and diarrhoea prevail together.
Causes.—The disease is usually due to drinking water contaminated with sewage containing the cholera vibrio, a twisted motile bacillus (comma-bacillus), the cause of the disease.
Symptoms.—In a case of ordinary intensity, Asiatic cholera is ushered in by an attack of diarrhœa. This may last a longer or shorter period, but speedily the matters passed by the bowel assume a flocculent or rice-water character. Vomiting, too, comes on, the fluid being thin and colourless. Then follow severe cramps, especially of the abdominal muscles and legs. The flow of urine ceases, the body becomes icy cold on the surface, the tongue is cold, and so even is the breath. The lips are blue and shrivelled, the face pinched, the voice is hardly audible. This is called the cold or algid state of the disease. The condition may go on getting worse till the heart stops, the patient being quite conscious to the end. Frequently it is impossible to tell whether the patient
