l relationships, these two diseases may
in individual cases present many symptoms of mutual resemblance.

SIMPLE CHOLERA (synonyms, _Cholera Europaea_, _British Cholera_,
_Summer_ or _Autumnal Cholera_) is the cholera of ancient medical
writers, as is apparent from the accurate description of the disease
given by Hippocrates, Celsus and Aretaeus. Its occurrence in an epidemic
form was noticed by various physicians in the 16th century, and an
admirable account of the disease was subsequently given by Thomas
Sydenham in 1669-1672. This disease is sometimes called _Cholera
Nostras_, the word _nostras_, which is good Latin and used by Cicero,
meaning "belonging to our country." The relations between it and Asiatic
cholera (see below) are obscure. Clinically they may exactly resemble
each other, and bacteriology has not been able to draw an absolute line
between them. The real difference is epidemiological, cholera nostras
having no epidemic significance.

The chief symptoms in well-marked cases are vomiting and purging
occurring either together or alternately. The seizure is usually sudden
and violent. The contents of the stomach are first ejected, and this is
followed by severe retching and vomiting of thin fluid of bilious
appearance and bitter taste. The diarrhoea which accompanies or succeeds
the vomiting, and is likewise of bilious character, is attended with
severe griping abdominal pain, while cramps affecting the legs or arms
greatly intensify the suffering. The effect upon the system is rapid and
alarming, a few hours of such an attack sufficing to reduce the
strongest person to a state of extreme prostration. The surface of the
body becomes cold, the pulse weak, the voice husky, and the whole
symptoms may resemble in a striking manner those of malignant cholera,
to be subsequently described. In unfavourable cases, particularly where
the disorder is epidemic, death may result within forty-eight hours.
Generally, however, the attack is arrested and recovery soon follows,
although there may remain for a considerable time a degree of
irritability of the alimentary canal, rendering necessary the utmost
care in regard to diet.

Attacks of this kind are of frequent occurrence in summer and autumn in
almost all countries. They appear specially liable to occur when cold
and damp alternate with heat. Occasionally the disorder prevails so
extensively as to constitute an epidemic. The exciting causes of an
attack are in ma