=A Typical Case of Cholera.=—The so-called prodromal or premonitory diarrhoea is not a feature of the onset of _cholera gravis_, the type of the disease which characterizes the cholera epidemic. The period of incubation is usually from one to five days. Longer periods are possibly explained by some exciting intestinal disorder in a cholera carrier. The course of the disease is conveniently divided into a stage of evacuation, an algid one and a stage of reaction. _The Stage of Evacuation._—A profuse and frequent diarrhoea comes on without colic or tenesmus. In fact the stools are voided with a sense of relief as when an enema is gotten rid of. The striking feature, however, of these movements is the sensation of prostration which accompanies them. The faecal character of these diarrhoeal stools is soon lost and the typical rice-water stool is now passed. This designation is very apt and the flocculi of intestinal epithelium, in a watery, slightly opaque fluid, suggests rice-water. The odor is slightly albuminous. Early in this stage cramps of the muscles set in. The muscles of the legs, especially the calf muscles and those of the feet, are particularly liable to these very painful contractions which may cause the patient to cry out for relief. The muscles of the abdomen and back may also be involved as may at times the muscles of the entire body. Vomiting, at first of the contents of the stomach and later of rice-water material, is a distressing feature to the patient and by reason of the manner in which it often gushes from the patient’s mouth is liable to contaminate the attendants. Along with the excessive loss of fluid the tissues, especially of the face, become shrunken, the eyeballs with their congested conjunctivae sink back in the orbits, and the nose becomes pinched. The pulse becomes more and more feeble and there is a steady diminution in the secretion of urine. An increasing duskiness of the skin, which is cold and clammy to the touch, denotes the setting in of the algid stage. _Algid Stage._—In this stage there is almost complete cessation of circulation, even the incision of a vein is only followed by a drop of black tarry blood. Anuria is practically complete. The vomiting, purging and cramps may or may not subside and in the patient, with his great thirst, intense exhaustion and cadaveric appearance, with mental faculties fairly well preserved, we have an example of a living death. The temperature of the sodden, inelastic, clammy skin is markedly depressed, even below 90°F., while the rectal temperature may approximate normal or be elevated. Some authorities consider a marked difference between the superficial and rectal temperatures as of bad prognosis. The voice becomes husky and finally so feeble that the patient can only whisper and the breath feels cold. The sodden shrivelled hands, as those of a washerwoman, are very characteristic. Thirst is intense.