CHOLERA, ASIATIC. 



161 



autumn prevailed with considerable severity in 

 Paris and the north of France, and attacked a 

 few of the inhabitants of the southern seaports 

 of England. It was also brought to the port 

 of New York by a ship from Havre, but a rigid 

 quarantine being maintained the disease gained 

 no foothold on the laud. In view of the strong 

 probability of its reappearance both in England 

 and America in the summer of 1866, it may be 

 well to give a brief history of its progress in 

 the past, its causes, diagnosis, prognosis, and 

 treatment. The home of the disease is, and has 

 been for centuries, in the East. The low marshy 

 grounds overflowed often by the great rivers of 

 India, Siam, Burraah, and Cochin China, reek- 

 ing with abundant filth and vegetable decay, to 

 which the abject poverty and degradation of the 

 miserable inhabitants of those regions largely 

 contribute, are fitting nests for breeding and 

 nursing the pestilence. Accordingly we find that 

 for the last five hundred years it has been endem- 

 ic in all these countries, and that every few years 

 it has assumed an epidemic form and ravaged 

 the territory for hundreds of miles, slaying its 

 tens of thousands of victims. In the year 1629, 

 Bontius, a Dutch physician residing at Batavia, 

 described to the medical profession in Europe 

 this formidable and deadly disease, and his de- 

 scription was preserved and repeated by other 

 medical writers ; and perhaps a hundred years 

 later, British and French physicians in India, 

 who had witnessed its ravages, confirmed the 

 description of Bontius, and sent home ac- 

 counts of the destructive character of the 

 plague. Outside of the profession, however, 

 in Europe and America, intelligent citizens 

 knew little and cared less in regard to the 

 diseases of India and the East. So remote 

 was the country, and so slow and difficult 

 the communication with it, that it never entered 

 the minds even of professional men, that it 

 could find its way to the distant shores of Eu- 

 rope, or the still more distant ones of America. 

 The time came, however, as intercourse with 

 the East grew more frequent and easy, when 

 the pestilence began to move out from its nest 

 and march eastward and westward. Why, at 

 the precise period when it first started upon its 

 travels, it should have invaded countries hith- 

 erto free from it, is one of those inexplicable 

 facfs in the history of epidemics, upon which 

 speculation is useless. It is, nevertheless, well 

 ascertained that after remaining stationary for 

 centuries, in the year 1817 it raged with great 

 violence at Jessore, a large town near the mouths 

 of the Ganges. It spread, not very swiftly, but 

 yet with awful certainty, in all directions, and 

 by August of the following year had reached 

 Bombay, on the western side of the peninsula. 

 Thence it travelled through Arabia, Persia, Me- 

 sopotomia, Syria, etc., on its westward course, 

 and, continuing to extend itself eastwardly from 

 its place of origin, invaded the Burmese empire, 

 Siam, Java, China, and the other populous coun- 

 tries of that portion of the earth. 

 Still, its progress w r as very slow. Several days 

 VOL. v. 11 A 



frequently lapsed before it passed from one town 

 to another only a few miles distant. The means 

 of communication were, in the regions where it 

 prevailed, very imperfect, and to this cause its 

 sluggish movements must be attributed. In 

 these days of steam its course is more rapid. 



Up to 1823 its ravages had not extended be- 

 yond Asia ; but in that year it appeared at 

 Orenburg and Astrachan, two towns situated 

 on the eastern frontier of Russia. Here it re- 

 mained until 1828, when it increased in vio- 

 lence, attacking a tenth of the inhabitants of 

 the province of Orenburg, and proving fatal to 

 a fourth of those affected. 



In 1830 it reappeared at Astrachan. In less 

 than a month 4,000 persons died of it in that 

 city, and over 21,000 perished from it in the 

 province. Ascending the Volga, it reached 

 Moscow, destroying thousands in that city; 

 and, continuing its fatal course, appealed at 

 St. Petersburg on the 26th of June, 1831. 

 From Astrachan it also diverged along the 

 northern coast of the Black Sea, and thence 

 spread into Austria, Poland, Prussia, and North- 

 ern Germany generally. In August, 1831, it 

 was conveyed to Cairo by a caravan from Mecca. 

 Thousands perished from it on the road, and 

 over 15,000 died of it in the former city. 



On the 26th of October, 1831, the disease ap- 

 peared for the first time in England, at Sunder- 

 land, a town situated on the North Sea, near 

 Newcastle. It was supposed to have been in- 

 troduced from Hamburg by a returned collier. 

 It showed very little disposition for some time 

 to pass beyond the limits of this city, and was 

 mainly confined to the worst parts of the town ; 

 according to a statement made at that time, it 

 crept like a skulking hyena from one dirty lane 

 to another, affecting localities remarkable for 

 their filth, poverty, and wretchedness, and car- 

 rying oif those who, from decrepitude, drunk- 

 enness, hunger, or uncleanliness, were already 

 fit subjects for the grave. 



From Sunderland it spread slowly through 

 the northern part of England and Scotland, 

 and did not break out in London till the 14th 

 of February following, when some persons liv- 

 ing in the immediate vicinity of the shipping 

 were attacked. In this city, as in all others in 

 which the disease had made its appearance, the 

 districts mainly affected were those chiefly dis- 

 tinguished for their filthiness and an utter dis- 

 regard of all sanitary regulations. Thus, for 

 instance, the streets of St. Olive, St. Thomas, 

 and Whitechapel, which were the most urn- 

 healthy districts, were stated to be " a disgrace 

 to the civilized world." In Whitechapel, the 

 great majority of its confined and crowded 

 streets, courts, and alleys were without ventila- 

 tion, water, or sewerage. In Lambeth, where 

 the cholera also prevailed extensively, the 

 cleansing, drainage, and water supply were 

 either totally wanting or grievously defective. 

 It was invariably noticed that the disease was 

 especially prevalent in those sections where 

 typhus and typhoid fevers and other affections 



