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Page 24 of Account of spasmodic cholera as it appeared in the city of Lexington in June 1833 / by Lunsford P. Yandell, M.D.

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YANDELL on Spasmodic Cholera. perished. In Nashville it appeared towards the latter end of January, since which time it has never entirely subsided. About the time that it broke out in this place, it was raging there with some violence,as many as 7 dying onone or two days; butthe prevalence of the disease in that city has been more like that of endemic disorders. And the access, and progress of the indi- vidual cases, as of the epidemic, would appear to have been less sudden and violent, which is also true of Louisville. In both these townsAituated alike in many respects, the latter particularly, having suffered seriously, at one time, with bili- ous diseases, it has never assumed the truly epidemic form, nor attained to the height of malignity which marked it in Cin- cinnati or Lexington. Should it continue to hang upon them it is possible that, from first to last, they may not lose fewer of their citizens than fell victims to it in the latter places, in the few weeks whilst it raged. With all these facts before our eyes, it will scarcely be maintained that cholera is equally violent and incurable in every place where it appears;-that it is unaffected by the state of the Atmosphere, by local peculiarities, and possibly oth- er circumstances, which, in the present state of medical sci- ence, it is impossible to appreciate. It is well known that fevers, and many other diseases are influenced thus, and that they present very different grades of malignity in the differ- ent localities where they prevail. Such being true, it would seem scarcely necessary to look beyond these causes, in order to find additional ones for its mortality, in the plan of treat- ment pursued by the physicians of a place where it has chanc- ed to be peculiarly intractable. And yet as able and expe- rienced a writer as the Editor of the Western Journal of the Medical and Physical Sciences, has suffered himself to be be- trayed into this delusive way of viewing the subject. In the last number of his Journal he suggests, "that perhaps some part of the mortality at Lexington, is referable to a reliance, too exclusive, on certain remedies, and a rejection, not war- ranted by experience, of others possessing great power.' The possibility that this cause did something, will not be de- 24

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