Distribution 



569 



Europe, and by steamships plying foreign waters has several times 

 been carried to our own continent. Many cases are on record which 

 show conclusively how a single ship, having a few cholera cases on 

 board, may be the starting-point of an outbreak of the disease in 

 the port at which it arrives. 



The most recent great epidemic of cholera began in 1883. From 

 Asia it spread westward throughout Europe, extended by means 

 of the steamship lines to numerous of the large ports, of which Ham- 

 burg in Germany suffered most acutely, and even extended to some 

 of the ports of Africa and America. Russia probably suffered more 

 than any other European country, and it is estimated that in that 

 country there were no less than 800,000 deaths. During 1911 the 

 disease again appeared in Europe and invaded the countries along 

 the Mediterranean coasts. 









Fig. 235. Cholera spirilla. 



Specific Organism. The discovery of the spirillum of cholera 

 was made by Koch while serving as a member of a German com- 

 mission appointed to study the disease in Egypt and India in 1883-84. 

 Since its discovery the spirillum has been subjected to much careful 

 investigation, and an immense amount of literature, a large part of 

 which was stimulated by the Hamburg epidemic of 1892, has 

 accumulated. 



Distribution. The cholera spirilla can be found with great 

 regularity in the intestinal evacuations of cholera cases, and can 

 often be found in drinking-water and milk, and upon vegetables, 

 etc., in cholera-infected districts. There can be little doubt that 

 they find their way into the body with the food and drink. Cases 

 in the literature show how cholera germs enter drinking-water and 

 are thus distributed; how they are sometimes thoughtlessly sprinkled 

 over green vegetables offered for sale in the streets, with infected 



