If the choking occur in the windpipe or trachea, it is usually dislodged by the paroxysm of coughing which accompanies the act. Should it fail to be so, and a sense of suffocation ensues, accompanied with blueness of countenance and difficulty of breathing, place the patient, and follow the directions given in the article “Suspended animation,” while a medical man is immediately sent for.
Treatment for Horses or Cattle.—Remove any foreign body by hand, as directed above, or have recourse to the probang. It may perhaps be necessary to call in a veterinary surgeon, in case the above methods fail, to extract the obstruction by cutting into the gullet.
CHOLAGOGUES. Medicines which promote a flow of bile.
CHOLALIC ACID. C24H40O5. Syn. Chol′ic acid. A non-nitrogenous acid existing in bile. It is best prepared by boiling the resinous mass precipitated by ether from an alcoholic solution of ox bile with a dilute solution of potassa, for 24 to 36 hours, till the amorphous potassa salt that has separated begins to crystallise. The dark-coloured soft mass is then removed from the alkaline liquid, dissolved in water, and hydrochloric acid
added. A little ether will cause the deposition of the CHOLALIC ACID from this solution in crystals. With sulphuric acid and solution of sugar it strikes a purple-violet colour; this constitutes Pettenkofer’s test for bile.
CHOLE′IC ACID. Syn. Tauro-cholalic acid. A peculiar conjugated compound of cholalic acid with a substance called taurine, which contains both nitrogen and sulphur. In combination with soda, choleic acid constitutes a principal ingredient in bile.
CHOL′ERA. This word, which, from its derivation, can be only applied correctly to a bilious affection of the stomach and bowels, has been of late years very loosely extended to a malignant disease, the most marked characteristic of which is a total suspension of the functions of the biliary organs.
Cholera, En′′glish. Syn. Com′mon cholera, Bil′ious c.; Chol′era mor′bus, L. A disease characterised by bilious vomiting and purging, accompanied by more or less pain and debility. Diarrhœa is the most common precursor of the disease, and ought to be attended to without delay, particularly if the weather be warm. Cholera most frequently occurs towards the end of the summer and early in the autumn, when the increased heat of the sun stimulates the liver to an inordinate secretion of bile, by which the whole system becomes overloaded with it. Among secondary and accidental causes are sudden changes of temperature, checked perspiration, and the use of indigestible food, and food and beverages in a state of incipient decomposition. It is usually accompanied by fever, thirst, and severe colic, and sometimes by cold sweats, extreme debility, feeble pulse, &c., under which the patient sinks in 24 hours.
Treat. In most cases this complaint is not dangerous, and yields to proper treatment in a few days. As soon after the commencement of the attack as possible, some mild aperient should be administered. Opiates may be employed, both topically and by the mouth. Jeremie’s solution is stated to be very efficacious in the diarrhœa which so generally precedes cholera. A teaspoonful or two of laudanum, rubbed over the region of the stomach and bowels, is a simple application which will generally allay the pain. 10 to 20 drops of laudanum, mixed with a table-spoonful of good brandy, or a few grains of cayenne pepper, may also be taken every hour if the pain is severe. Should the stomach reject the medicine, or the vomiting be apparently increased by drinking warm diluents, a few spoonfuls of ice-cold water, or of a mixture of lemon-juice and water, may be taken instead, until the sickness abates. Dr Copeland recommends spirit of turpentine in violent attacks, both internally and as an external application in the form of warm epithems. When the violence of the symptoms has abated, tonics and bitters (as calumba, gentian, orange-peel, &c.) may be advantageously had recourse to. Calumba, in the form of a weak infusion, conjoined, if necessary, with aromatics, is, perhaps, the most valuable agent we possess for the after-treatment of the disease. See Diarrhœa.
Cholera, Malig′nant. Syn. Asiat′ic cholera, Epidem′ic c, Blue c, Pestilen′tial c, Spasmod′ic c.; Chol′era Asiat′ica, C. asphyx′ia, C. malig′na, L. This fearful disease first became known in this country in the autumn of 1831. The attack usually begins with sickness and purging; this discharge, however, is not bilious, as in ordinary cholera, but a thin, colourless fluid, like rice-water; at the same time there is great prostration of strength, and cold, clammy sweats. In a short time dreadful cramps assail the extremities and afterwards the abdomen; the body becomes bent, the limbs twisted, the countenance cadaverous, the pulse almost imperceptible, and the eyes sunken; the patient sinks into a state of apathy, and unless a favorable change speedily takes place, soon expires from exhaustion. When there is a reaction the pulse gradually returns, the natural warmth of the body is restored, and the spasms and difficulty of breathing give way. Frequently, however, the reaction is accompanied by fever closely resembling typhus, and which often terminates fatally in from four to eight days. The symptoms of epidemic cholera are not always of this terrible character.