n6 INFECTION AND IMMUNITY 



and 1886; Spain, 180,000 in 1884 and 1885 ; Aus- 

 tria-Hungary, 4000 inhabitants in 1886; Italy, about 

 50,000 inhabitants in 1884, 1886, and 1887." 



In Japan, the epidemic of 1885 was attended with 

 a mortality of 109,434. 



In 1891 cholera prevailed extensively in India, 

 Syria, Arabia, Siam, and Japan, and was introduced 

 into Austria by way of Persia. By November, 1892, 

 it is estimated that half a million cases had occurred 

 in Russia with a mortality of at least 50 per cent. 

 A severe outbreak of the disease occurred in the city 

 of Hamburg during the month of August of this 

 year, resulting in 8005 deaths. From Hamburg the 

 disease was brought to New York harbour on sev- 

 eral ships carrying immigrants, but owing to the 

 vigorous measures adopted by the local health author- 

 ities, assisted by the Marine Hospital Service, the 

 disease was arrested at the threshold of the country 

 and an epidemic was averted. The success obtained 

 at this time shows what can be accomplished by sani- 

 tary measures based upon an exact knowledge with 

 reference to the specific cause of the disease (cholera 

 germ) and its mode of transmission. The extension 

 of cholera from its home in India to the countries of 

 Europe and America, which first occurred during the 

 nineteenth century, was no doubt due to the increased 

 facilities for rapid transit, especially by steamboats 



