ZYMOTIC DISEASES. 



797 



after destroying many lives, took up its line 

 of march, visiting almost every inhabited por- 

 tion of the earth. Russia was reached in 1830, 

 Germany in 1831, and England in 1832. The 

 first death by cholera in North America oc- 

 curred in Quebec, early in June of 1832 ; on 

 the 22d of the same month its arrival in New 

 York city was announced, and its journey 

 westward to Cincinnati and New Orleans be- 

 gan. Great consternation and many empty 

 households were created in the little villages 

 upon the banks of the Ohio and Mississippi 

 rivers. Not satisfied with this invasion, the 

 destroyer again visited our country in 1834, 

 1849, 1852, 1866, 1867, and finally in 1873. 

 In 1883 Egypt suffered from an extensive out- 

 break, and from this has, no doubt, originated 

 the pestilence that has been raging in southern 

 Europe during the past two years. In the lat- 

 ter part of March, or early in April, 1884, cases 

 appeared at Toulon, which were closely traced 

 to contact with persons that had arrived in a 

 vessel coming from Tonquin. The affection 

 spreading, the inhabitants became alarmed, 

 and left the city in great numbers before any 

 sort of quarantine had been established. 



Within a short time cases appeared in Mar- 

 seilles and the surrounding villages, carrying 

 off many of their inhabitants, but by the" end 

 of September the epidemic in France had 

 ceased, the number of cases reported being 

 from 8,000 to 12,000; deaths, from 3,000 to 

 6,000. Owing to more favorable conditions, 

 climate, and habits of the people, Italy suf- 

 fered much more severely than did France 

 from this epidemic. The pestilence appeared 

 at Naples about the middle of July, brought 

 by a vessel that had on board many persons 

 who had fled from Toulon, and the cases are 

 said to have been fully 15,000, and the deaths 

 over 10,000. In Genoa the disease appeared 

 at the time it was abating in Marseilles, and 

 being of a very virulent type, carried off an 

 unusually large percentage of those afflicted. 

 Many of the villages of Italy suffered, the type 

 of the disease not seeming to be influenced by 

 the distance it traveled from great centers ot 

 population. It spread to Spain, not to any 

 great extent, but sufficiently to find a resting- 

 place until ready to break out in the great 

 epidemic of 1885. 



Spanish statistics are often falsified, and are 

 generally incomplete, but investigation shows 

 that the epidemic was following a progressive 

 march, for on Jan. 1, 1885, a dispatch from 

 Madrid acknowledged the existence of cholera 

 in Spain. There had been cases in Valencia, 

 Catalonia, and Toledo for some time, but the 

 first cases acknowledged occurred at Jativa, 

 whence, following the course of the Jucar, it 

 invaded the towns along this stream, and from 

 these the infection was carried to the other 

 cities, in the center and north of the Peninsula. 

 The type was the same virulent one that had 

 raged in Genoa during the previous year. At 

 some points in Murcia and Valencia the mor- 



tality averaged 50 per cent. On April 7 the 

 Valencia authorities begged for assistance from 

 the Government, as the disease was spreading 

 with alarming rapidity, and the people were 

 panic-stricken. In this province vaccination 

 for cholera was first practiced to any consid- 

 erable extent, the first operations being per- 

 formed in the latter part of April, many in- 

 habitants being inoculated. All the provinces 

 of Spain sent doctors to Valencia to study 

 the method. By the middle of May, over 4,700 

 persons had been inoculated with cholera-mi, 

 crobes by Dr. Ferran. The new system was 

 regarded as successful. An English commis- 

 sion, consisting of four physicians, was ap- 

 pointed ^ to visit Valencia and investigate the 

 matter in company with Ferran, and to ex- 

 amine also those upon whom the operation 

 had been performed, and report whether the 

 operation entailed any danger and conferred 

 protection. Some grave doubts as to the value 

 of cholera inoculations now arose, and the 

 Spanish Government, on May 25, prohibited 

 further inoculation, pending the decision of a 

 board of investigation that had been appointed. 

 This order, however, was rescinded, and on 

 June 4 the Government granted permission to 

 inoculate people with cholera-virus. In the 

 mean time another commission had been ap- 

 pointed by the Belgian Minister of Public In- 

 struction. The commissions carefully investi- 

 gated the subject, and made their reports. It 

 was shown that the new discovery did not 

 confer protection, and that the alleged results 

 were erroneous, and the method was quickly 

 abandoned. 



Ferran published early in March, in "La In- 

 dependencia Medica," of Barcelona, the details 

 of some investigations and experiments he had 

 been making concerning the comma-bacillus, 

 which Koch had previously described. Ferran 

 had been making an exhaustive study into its 

 natural history, and claimed that he had fol- 

 lowed the microbe through all the phases of 

 its existence, and had found it, in certain pe- 

 riods of its evolution, under forms never before 

 described, and that he had always, been experi- 

 menting in the direction of the attenuation of 

 the virus of cholera, in order, by inoculation 

 with it, to produce a modified form of the dis- 

 ease, which would secure immunity for the 

 subject from the graver malady. His method 

 consisted of two inoculations: the first, when a 

 principle of immunity seemed established ; the 

 second, when this immunity seemed to become 

 absolutely complete. For performing the in- 

 oculation in man, according to Ferran, a cer- 

 tain quantity of the culture of the specific 

 microbe is injected under the subcutaneous 

 cellular tissue, one gramme of fluid being suf- 

 ficient. At once a smarting is felt at the 

 point of puncture, but this soon disappears. 

 Within two or three hours a small red point is 

 seen, corresponding to the portion punctured, 

 and a considerable amount of swelling sur- 

 rounds the orifice. The temperature near the 



