A comparison between the spasmodic and non-spasmodic variety of cholera at the stage when vomiting and purging is fully developed, would hardly lead to any pathological or even symptomatic differentiation. The spasms at that stage, are as severe in the one variety as in the other; and whatever slight difference there may still exist, it is sure to disappear altogether, in the measures as our hypothetical patients respectively approach the stage of collapse. Pathologically and symptomatically they then present the same phenomena; they only differ with regard to the etiology of their respective sufferings. The one began with a sudden seizure of spasms; the other began with a slight malaise, with a disturbed digestion and uneasiness, which may have gone on for days. The one might have been able, as far as the state and the predisposition of his alimentary organs are concerned, to withstand any epidemic influence; his seizure is simply owing to a deficit innervation of his vascular system. Vomiting and purging have been forced upon stomach and intestines by no fault or forced upon stomach and intestines by no fault of deficiency of their own. While the cholera patient of the non-spasmodic variety might just reverse the tale. As far as his vascular, or nervous system in general is concerned, he might have withstood any epidemic influence; it was the relaxed state of the intestinal canal which prepared the way to choleraic evacuations and the consequent spasms. For I hop to show you when we next meet, that there exists an intimate and natural, although by no means necessary connexion between choleraic evacuations and the subsequent spasms.
