l888.] NEW-YORK MICROSCOPICAL SOCIETY. 18 



1868 it was very severe in South America. In 1872, and again 

 in 1873-74 it was destructive in Hungary, Poland and Prussia. 

 In 1873 it caused great mortality in several towns in theMississippi 

 valley. Yokohama, Japan, and Canton, China, were severely 

 visited in 1877. Cholera seems to have spread East, South, 

 West and North from its birth-place in Bengal, which became 

 but the centre of an epidemic area, comprising nearly all the 

 world. It travelled slowly at first, and not continuously, but in 

 irregular waves — checked sometimes, but not destroyed by 

 winter's cold. Neither climate, nor season, nor earth, nor 

 ocean seem to have arrested its course, or altered its features. 

 It was equally destructive at St. Petersburgh and Moscow, as it 

 was in India ; as fierce and irresistable amongst the snows of 

 Russia as in the sunburned regions of India ; as destructive in 

 the vapory districts of Burmah as in the parched provinces of 

 Hindostan. 



The onset of this malady may be gradual or sudden. After 

 exposure to the exciting cause of the disease, there is a period 

 of incubation, which is believed to be generally two or three 

 days, but sometimes not more than twelve or twenty-four hours. 

 Dr. Goodeor, in Reynold's System of Medicine, cites an in- 

 stanccj recorded by Dr. Barry, in which a detachment of Sepoys, 

 on their march from one place, free from Cholera, to another 

 passed through a village where it was raging. One of the 

 Sepoys was attacked after forty hours, and fresh cases appeared 

 subsequently. 



When the disease sets in gradually the earliest symptom is 

 generally diarrhoea, which is often called " premonitory," 

 and which may be attended with a sense of exhaustion. In 

 some cases occur depression of spirits, malaise, headache, vertigo, 

 noises in the ears and oppression of the epigastrium. The 

 countenance of a patient during the premonitory stage is often 

 pallid, anxious, and sorrowful. Cases have been cited where 

 the approach of Cholera has been suspected mainly from the 

 aspect of the patient, hours before the characteristic symptoms 

 appeared. The premonitory stage may last from a few hours 

 to two or three days. In many instances it is altogether absent. 

 In more than half the cases it is said to begin in the early morn- 

 ing, perhaps waking the patient up from sleep. It sets in with 

 violent purging. The contents of the bowels are rapidly swept 



