CHOLERA, ASIATIC. 



163 



rienced its attacks, and the mortality from it in 

 California was fearful. It did not entirely dis- 

 appear from the United States till 1855, and in 

 1854 became very violent in some localities. In 

 1853 and 1854 it prevailed again in Great Brit- 

 ain, and in 1855 and 1856 the allied armies in 

 the Crimea suffered intensely from the pesti- 

 lence. 



After a period of nearly ten years it again 

 commenced its westward march, and in the be- 

 ginning of May, 1865, it broke out with terrible 

 fury among the pilgrims to Mecca, who congre- 

 gated in that city to the number of more than 

 200,000, and under the circumstances of priva- 

 tion, filth, and suffering, best calculated to ag- 

 gravate its intensity. It is stated that, within 

 the space of less than three weeks, more than 

 a million sheep and camels were slaughtered as 

 sacrifices, and their offal left to putrefy in that 

 tropical climate. This alone is sufficient to ac- 

 count for the fearful mortality which so speed- 

 ily followed. It was said that fully 150,000 of 

 these poor wretches were attacked by it either 

 at Mecca or on their way to or from that city, 

 and the pilgrimage routes were marked for 

 long distances by their bones. 



On the 10th or llth of May, the first death 

 from cholera occurred at Alexandria, in Egypt, 

 the disease having been brought to that city by 

 pilgrims returning from Mecca. From that 

 date to the 16th of July, 3,300 deaths had en- 

 sued from the pestilence, and there had been 

 about 10,000 cases in a population of less than 

 60,000. Eosetta Santa and Zagarig were at- 

 tacked about the same time. In June it had 

 reached Cairo. On the 3d of July it appeared 

 at Constantinople, and almost simultaneously 

 several cases occurred at Ancona. From Alex- 

 andria it was imported into Marseilles in a 

 steamer. Its ravages in Cairo were frightful, 

 nearly 500 perishing from it in a single day. 

 In Constantinople, where it produced a terrible 

 panic, under the influence of which one hun- 

 dred and fifty thousand of the inhabitants fled 

 from the city, many of them only to perish by 

 the way, its malignity was remarkable. The 

 authorities carefully concealed the number of 

 deaths, which were believed in the height of 

 the epidemic to have exceeded 2,000 per 

 day7 A terrible fire which occurred on the 

 5th of September and lasted till the 8th, de- 

 stroying 15,000 houses, checked it completely, 

 as the great fire in London did the plague in 

 1666. Some of the cities of Italy, Ancona in 

 particular, were terribly scourged, the want of 

 cleanliness and sanitary measures furnishing 

 the disease with a great number of victims, 

 while other cities, establishing a rigid quaran- 

 tine, and maintaining strictly their sanitary po- 

 lice, were able to keep it at bay, or at most had 

 but a few isolated cases. In Marseilles it was less 

 virulent, though still formidable. It was car- 

 ried to Paris from Marseilles by travellers, but 

 great efforts had been made to place the city in 

 a favorable sanitary condition, and though many 

 were attacked, the disease was milder and more 



amenable to treatment in most cases than in 

 the East. On the 24th of October there were 

 two well-marked cases of it at Southampton, 

 England. The disease spread to some of the 

 neighboring towns, but the timely appearance 

 of cold weather soon checked its progress. 



On the 3d of November the steamship Ata- 

 lanta came into the lower bay of New York 

 having cholera on board. She was last from 

 Havre (12th October), where she had received 

 about 400 German passengers, mostly in the 

 steerage, who had passed through Paris where 

 cholera was then prevailing, and on the second 

 day out a child died from a mild attack of 

 cholera; others were attacked soon after, and 

 during the voyage sixty were taken ill, some of 

 them, however, with small-pox; sixteen died, 

 and the remainder for the most part began to 

 recover. After her arrival at quarantine thirty- 

 six more were taken ill, of whom four died. 

 The survivors who were ill were removed to 

 the floating hospital, Florence Nightingale, 

 where they recovered. There were 525 pas- 

 sengers in the steerage. None of the cabin 

 passengers took the disease. None of the small- 

 pox cases proved fatal. The vessel was de- 

 tained at quarantine and thoroughly purified, 

 and the disease did not spread, though there 

 were in the city of New York in November and 

 December a number of cases presenting to some 

 extent the symptoms of cholera. There has 

 been hitherto a remarkable uniformity in the 

 mortality from cholera.. In 1830-'32 in Great 

 Britain and on the Continent, the deaths in 

 private practice were about 39.5 per cent., in 

 hospitals 57.25 per cent. In 1849 in New 

 York the whole number of cases reported out- 

 side the hospitals in fifty-two days were 2,631, 

 of which 915 died, or 34.78 per cent. ; in the 

 hospitals there were 1,621 cases, of which 880, 

 or 53.71 per cent., died. In Egypt, Turkey, and 

 Italy, during the present epidemic, the number 

 of deaths was about 55 per cent, of the whole 

 number of cases. In Marseilles the mortality 

 was less, and in Paris not over 30 per cent. 

 The disease was carried in November from Mar- 

 seilles to Point-a-Pitri in the island of Guada- 

 loupe, and there it has raged fearfully, nearly 

 6,000 of the inhabitants of that island and those 

 immediately adjacent having fallen victims to it. 



The CAUSES which produce cholera and aid in 

 its dissemination are of two kinds, the remote 

 and the proximate. The remote causes are the 

 existence of extensive vegetable decay, pro- 

 ducing malarious and depressing influences, 

 want of cleanliness, want of efficient ventila- 

 tion ; the poisoning of the air by the escape of 

 foul and noxious gases from sewers, vaults, and 

 privies, imperfect drainage and sewerage, the 

 accumulation of decaying garbage in the streets, 

 cellars, and elsewhere. The presence of the 

 noxious odors and gases from these sources, and 

 their absorption into the human system by the 

 lungs and the absorbents, will of itself produce 

 diarrhoea, nausea, prostration, the congestion 

 of the blood upon the vital organs, and often 



