In 39 cases calomel was given in doses of 5 grs. every half-hour.

There is no mention of obvious effects, immediate or remote.

Of the 39 recoveries, 17 had consecutive fever; of the 31 deaths, 7 had consecutive fever.

In 14 of the worst cases a salt-and-water emetic was given. In 11 venæsection was used; in 2 the hot-air bath; some took saline draughts, containing chlorate of potash.

In 27 other cases, stimulants were given with the calomel. They were males.

16 died without passing into consecutive fever; 9 had consecutive fever ending in coma.

Dr. Shapter makes a return of 11 cases treated by mercury in small doses; of these, 6 recovered and 5 died. 6 had secondary fever, of which 2 recovered and 4 died.

Dr. Hawkins returns 37 cases treated with calomel in the Middlesex Hospital. The dose was, in most of the cases, gr. ii. every half-hour. In some the intervals were longer or the doses larger, according to the urgency of the symptoms. The deaths were 20, the recoveries 17. In addition to the employment of calomel, a salt-and-water emetic was given when the patients were first admitted, and the vomiting was encouraged by copious draughts of warm fluids. With a few exceptions, they were all placed in a hip bath of 104° Fahr. for ten minutes, and with marked relief to the spasms. The hot-air bath produced a distressing oppression of the breathing, and was therefore discontinued.

Salines were given with the calomel, and occasionally stimuli, as ammonia and brandy.

Dr. James Hill, Peckham House Lunatic Asylum:

"In 2 cases I employed calomel and opium in small doses frequently repeated, as recommended so highly by Dr. Ayre, of Hull, and most faithfully carried out his plan to the letter. Both cases, however, proved fatal, as likewise did all of those (and they were several) treated in a similar manner during the prevalence of the epidemic in November last. As the epidemic did not leave us for a month after this, and the balance of evidence was much in favour of Dr. Ayre's plan, I resolved on giving it a further trial, notwithstanding its previous ill success in my hands. I accordingly adopted it in 10 other cases, and most attentively carried out his recommen. dations in every point, but with the same fatal results; so that out of 12 cases treated on this plan I was so unfortunate as not to save one."

Dr. McIntyre, of the Western General Dispensary, records 12 cases, 4 females and 8 males, all but 2 being between the ages of 30 and 40. The deaths were 5, recoveries 7.

The treatment consisted in small and frequent doses of calomel, with occasional stimuli and salines, according to the urgency of the symptoms. 4 of the cases which recovered were mild. Salivation occurred in one of these.

Dr. McWilliam :

"Thus much I can say for calomel, when it was given before collapse, so as to be taken into the system, the bilious tinge given to the stools and the discharge of urine were coincident events. Until there was sure evidence of mercurialization upon the general system I have seen no benefit from its use."

Of 16 cases treated principally with calomel by Dr. McWilliam, 12 died.

This is termed the "rational method" of treatment, Treatment by and was intended to combine those remedies which calomel, opium, and stimulants. seemed best fitted to fulfil the supposed indications of this stage. The calomel was given to restore the functions of the liver, and as an alterative of the morbid action in the gastro-intestinal mucous membrane ;-the opium to allay irritation and arrest the discharges;-and the stimuli to counteract the depression of the nervous system. Experience did not confirm the theory the results were unfavourable, and not altogether so indifferent as when calomel was exhibited by itself.

Although opium and diffusible stimuli, brandy, camphor, and ammonia were useful at an early stage of the disease, as collapse set in, they not only failed to produce any favourable result, but often aggravated the symptoms.

It seems well ascertained that opium in large doses was at this period injurious; by increasing the cerebral oppression and embarrassing the system during reaction. It was probably less and less applicable as the disease advanced to its characteristic development.

Stimuli, especially the various preparations of alcohol, did not act as restoratives in collapse, but often increased the irritability of the stomach, and added to the sense of oppression at the præcordia.

The expectations excited by the early success apparently obtained by the use of chloroform, were not realised in its subsequent employment. It not unfrequently allayed the vomiting and cramps, but did not in any degree arrest the course of the disease.

The perchloride of carbon in 5 or 10 grain doses, and a solution of camphor in chloroform, acted as powerful stimuli, but the results did

not indicate that they possessed any especial therapeutic value. Although they produced symptoms of reaction, this apparent improvement was generally, in severe cases, but transient, and their continued use seemed to exhaust the little remaining power, rather than to restore the patient.

21 cases were treated by calomel, opium, and stimulants, in St. Bartholomew's, by Dr. George Burrows, from July 19th to 25th, 1849-12 males, and 9 females.

The dose of the medicines was calomel five grains, opium one grain, every two or four hours; the first dose being sometimes double. All the patients had a warm bath. According to the urgency of the symptoms, ammonia, brandy, wine and chloroform were given, and they were also allowed to take freely cold water and ice. Sinapisms to the epigastrium.

The results were as follows: 5 died within 24 hours, the shortest time of the treatment being 94 hours; and 6 in from 3 to 5 days; 10 recovered; Dr. Burrows adds:

"During this period of the epidemic the remedies employed seemed to have little or no influence; the patients were neither salivated by the mercury, nor narcotized by the opium."

In contrast to the above, Dr. Burrows gives 14 cases treated from September 20th to 25th-7 males and 7 females.

The treatment was that employed in July. Dr. Burrows says:

"In July the mercury and opium produced no effect on the symptoms, whilst in September, the same remedies appeared to give relief, and in several cases quickly produced their respective specific effects on the system."

16 cases (9 males, 7 females) were treated by Dr. Basham with calomel and opium, brandy, ammonia, chloroform, sinapisms, and the warm bath. In some cases, enemata of acetate of lead were used.

The recoveries were 2, deaths 14. 11 of the cases were in marked collapse when the treatment was commenced; in the other 5 diarrhoea was urgent, with symptoms of depression. 8 of the deaths took place in collapse, with symptoms of coma; 6 died in consecutive fever. The two cases of recovery had mild consecutive fever. Except in one instance, where slight reaction followed the application of the wet sheet, no obvious effects resulted from the means employed.

Dr. Shapter, Exeter, gives the results of 68 cases treated with calomel and opium, 41 recovered, and 27 died; 24 had consecutive fever, of which 18 recovered, and 6 died. He adds :—

"This combination appears to avert death more successfully than mercury by itself; nevertheless, those cases which recover, whether from incipient or complete collapse, are, if the use of the opium be long persevered in, more likely to pass into consecutive fever than if no opium be given."

Drs. Dunn and Milner, Wakefield Prison. In the prison at Wakefield, in January, 1849, 27 cases of Cholera occurred. They were all males.

The deaths were 16, recoveries 11. In 16 cases diarrhoea preceded the symptoms of collapse, and the discharges were in 11 of these characterised as bilious. The whole 27 cases had symptoms of collapse, viz. cramps, feeble or imperceptible puise, cold dusky surface, &c. They were treated in the following manner :—