(continued from last message) Cholera. An acute, infectious disease, endemic in India and China and now occasionally epidemic elsewhere??characterized by profuse diarrhea, vomiting, and cramps. It is caused by a potent toxin discharged by the bacterium Vibrio cholerae, which acts on the small intestine to cause secretion of large amounts of fluid. The painless, watery diarrhea and the passing of rice?water stool are characteristic. Great body?salt depletion occurs. Cholera is spread by feces?contaminated water and food. Major epidemics struck the United States in the years 1832, 1849, and 1866. In the 1830s the causes were generally thought to be intemperance in the use of ardent spirits or drinking bad water; uncleanness, poor living or crowded and ill?ventilated dwellings; and too much fatigue. By 1850 cholera was thought to be caused by putrid animal poison and miasma or pestilential vapor rising from swamps and marshes??or that it entered the body through the lungs or was transmitted through the medium of clothing. It was still believed that it attacked the poor, the dissolute, the diseased, and the fearful?? while the healthy, well?clad, well?fed, and fearless man escaped the ravages of cholera. Cholera infantum. A common, noncontagious diarrhea of young children, occurring in summer or autumn. In the nineteenth century it was considered indigenous to the United States; was prevalent during the hot weather in most of the towns of the middle and southern states, as well as many western areas; and was characterized by gastric pain, vomiting, purgation, fever, and prostration. It was common among the poor and in hand?fed babies. Death frequently occurred in three to five days. Synonyms: summer complaint, weaning brash, water gripes, choleric fever of children, cholera morbus. Chorea. Any of several diseases of the nervous system, characterized by jerky movements that appear to be well coordinated but are performed involuntarily, chiefly of the face and extremities. Synonym: Saint Vitus' dance. Chronic. Persisting over a long period of time as opposed to acute or sudden. This word was often the only one entered under "cause of death" in the mortality schedules. The actual disease meant by the term is open to speculation. Colic. Paroxysmal pain in the abdomen or bowels. Infantile colic is benign paroxysmal abdominal pain during the first three months of life. Colic rarely caused death; but in the last century a study reported that in cases of death, intussusception (the prolapse of one part of the intestine into the lumen of an immediately adjoining part) occasionally occurred. Renal colic can occur from disease in the kidney, gallstone colic from a stone in the bile duct. Congestion. An excessive or abnormal accumulation of blood or other fluid in a body part or blood vessel. In congestive fever (see text), the internal organs become gorged with blood. Consumption. A wasting away of the body; formerly applied especially to pulmonary tuberculosis. The disorder is now known to be an infectious disease caused by the bacterial species Mycobacterium tuberculosis. Synonyms: marasmus (in the mid?nineteenth century), phthisis. Convulsions. Severe contortion of the body caused by violent, involuntary muscular contractions of the extremities, trunk, and head. See epilepsy. Coryza. See catarrh. Croup. Any obstructive condition of the larynx (voice box) or trachea (windpipe), characterized by a hoarse, barking cough and difficult breathing occurring chiefly in infants and children. The obstruction could be caused by allergy, a foreign body, infection, or new growth (tumor). In the early?nineteenth century it was called cynanche trachealis. The crouping noise was similar to the sound emitted by a chicken affected with the pip, which in some parts of Scotland was called roup; hence, probably, the term croup. Synonyms: roup, hives, choak, stuffing, rising of the lights. Debility. Abnormal bodily weakness or feebleness; decay of strength. This was a term descriptive of a patient's condition and of no help in making a diagnosis. Synonym: asthenia. Diphtheria. An acute infectious disease caused by toxigenic strains of the bacillus Corynebacterium diphtheriae, acquired by contact with an infected person or a carrier of the disease. It was usually confined to the upper respiratory tract (throat) and characterized by the formation of a tough membrane (false membrane) attached firmly to the underlying tissue that would bleed if forcibly removed. In the nineteenth century the disease was occasionally confused with scarlet fever and croup. Dropsy. A contraction for hydropsy. Edema, the presence of abnormally large amounts of fluid in intercellular tissue spaces or body cavities. Abdominal dropsy is ascites; brain dropsy is hydrocephalus; and chest dropsy is hydrothorax. Cardiac dropsy is a symptom of disease of the heart and arises from obstruction to the current of blood through the heart, lungs, or liver. Anasarca is general fluid accumulation throughout the body. Dysentery. A term given to a number of disorders marked by inflammation of the intestines (especially of the colon) and attended by pain in the abdomen, by tenesmus (straining to defecate without the ability to do so), and by frequent stools containing blood and mucus. The causative agent may be chemical irritants, bacteria, protozoa, or parasitic worms. There are two specific varieties: (1) amebic dysentery caused by the protozoan Entamoeba histolytica; (2) bacillary dysentery caused by bacteria of the genus Shigella. Dysentery was one of the most severe scourges of armies in the nineteenth century. The several forms of dysentery and diarrhea accounted for more than one?fourth of all the cases of disease reported during the first two years of the Civil War. Synonyms: flux, bloody flux, contagious pyrexia (fever), frequent griping stools. Eclampsia. A form of toxemia (toxins??or poisons??in the blood) accompanying pregnancy, characterized by albuminuria (protein in the urine), by hypertension (high blood pressure), and by convulsions. In the last century, the term was used for any form of convulsion. Edema. See dropsy. Effluvia. Exhalations or emanations, applied especially to those of noxious character. In the mid?nineteenth century, they were called "vapours" and distinguished into the contagious effluvia, such as rubeolar (measles); marsh effluvia, such as miasmata; and those arising from animals or vegetables, such as odors. Emphysema, pulmonary. A chronic, irreversible disease of the lungs, characterized by abnormal enlargement of air spaces in the lungs and accompanied by destruction of the tissue lining the walls of the air sacs. By 1900 the condition was recognized as a chronic disease of the lungs associated with marked dyspnea (shortness of breath), hacking cough, defective aeration (oxygenation) of the blood, cyanosis (blue color of facial skin), and a full and rounded or "barrel?shaped" chest. This disease is now most commonly associated with tobacco smoking. Enteric fever. See typhoid fever. Epilepsy. A disorder of the nervous system, characterized either by mild, episodic loss of attention or sleepiness (petittnal) or by severe convulsions with loss of consciousness (grand mal). Synonyms: falling sickness, fits. Erysipelas. An acute, febrile, infectious disease, caused by a specific group ~4 streptococcus bacterium and characterized by a diffusely spreading, deep?red inflammation of the skin or mucous membranes causing a rash with a well?defined margin. Synonyms: Rose, Saint Anthony's Fire (from its burning heat or, perhaps, because Saint Anthony was supposed to cure it miraculously). Flux. See dysentery. (continued in next message)