Zymotic and Germ Diseases. 263 



organism, which could be supposed to be concerned with this disease, has been found in 

 the Talood or any of the tissues. The period of "incubation," or the time elapsing from, 

 the time of exposure to the disease to that in which the disease is developed in a patient, 

 is frequently but two days, but generally somewhat more, sometimes the period is as 

 much as 15 days. The attack is generally abrupt, and after a preliminary chill, fever 

 sets in and the temperature soon reaches from 102 to 110 F. This stage of the disease 

 lasts from a few hours to three days. After the cessation of the fever the disease may 

 last from 1 2 hours to three or four days. The mortality ranges from ten to seventy-five 

 percent., differing greatly in different epidemics. The general average is estimated at 

 43 per cent. An epidemic generally terminates within 60 or 70 days, the general aver- 

 age being stated at 58 1 A. The contagium of the disease is certainly to be considered as 

 being an infectious miasm. Hence persons may be near patients affected by the disease 

 without taking it, while others secluded completely may still get the disease. The de- 

 jecta are supposed to furnish germs to the air more abundantly than the gaseous emana- 

 tions from the body, if indeed the latter are not entirely harmless. 



Epidemic Cholera. This disease is said to be indigenous and endemic 

 in India. There are two opinions in regard to its relationship to sporadic cholera, or 

 cholera morbus, as it is called in this country, and to cholerine or diarrhea. In some 

 cases, during a cholera epidemic, persons are affected by the diarrhea, and their symp- 

 toms end with that. It is adjudged often that such persons have had the cholera, be- 

 cause cholera begins with such symptoms and usually passes on to the more violent and 

 serious symptoms, unless suppressed by proper treatment. It is therefore held by some 

 authorities that these diarrheas always represent a simple form of endemic cholera 

 which, under proper conditions, might expand into epidemics. 



Mr. McNamara, of Calcutta, is quoted by Dr. Bastian as saying that " Cholerine is 

 simply a modified form of Asiatic Cholera, and is capable of engendering this more 

 deadly form of the disease in other people by means of the dejecta." The Asiatic Chol- 

 era after becoming epidemic is apt to extend into other countries. It reached the United 

 States in 1832, again in 1834, was here again in 1849, and was not got rid of till 1852. 

 It came again in 1866 and remained during that year and the next; and lastly came in 

 1873. Notwithstanding its migratory character it is said not to be contagious after the 

 manner of typhus or small-pox, but, like yellow fever, to supply the germs for dissemina- 

 tion in air from its dejecta both the matter vomited and purged. This matter while 

 fresh is not capable of producing the disease. But as soon as voided, fermentation pro- 

 ceeds from the action of germs which were developed in the fluids before their evacua- 

 tion from the alimentary canal, the conditions of this fermentation involving several 

 days time and hot weather. It is favored by being mingled with quantities of the fer- 

 mentable and putrifiable filth of sewers, cess-pools and stagnant water. This theory is 

 fortified by the fact that the fresh excretions have failed to produce the disease even, 

 when taken into the stomach or by inoculation, or any kind of exposure to them or to 

 the sick. This theory is held by many doctors. " It is supposed that these germs are 

 produced within the alimentary canal, not only in the cases of fully developed or well 

 marked cholera but in cases of so-called cholerine, the latter as well as the former affec- 

 tion being caused thereby." ( Flint.) If the virus of the excretions from cholera patients 

 is allowed to set up fermentation in any sort of reservoirs, or accumulations of stagnant 

 filth, these become breeders of the miasin, which, taken up by the air, may be carried 

 many miles and produce the disease in localities free from any suspicion of contagium. 

 This miasm is likewise transportable in clothing, &c., and frequently travels along the 

 great public thoroughfares of river or rail. An obvious way to get clear of the disease 

 is to clear away all the possible nesting and breeding places, and to burn up the excre- 

 tions from the patients. The cremation of the victims would do no hurt. Many low 

 vegetable organisms have been found in the dejecta of cholera patients, as sarcinse and 

 bacteria, both ovoid and rod-shaped, but none of them have been shown to be character- 

 istic of this disease or have anything to do with its cause. The same forms of organisms 

 may occur in ordinary diarrhea. From this it seems as reasonable to suppose these organ- 

 isms may be begotten from broken down tissue cells in the body, as in an organic infu- 

 sion out of it. 



Erysipelas, or St. Anthony's fire, consists of " a superficial inflamma- 

 tion of the skin, with general fever, tension and swelling of the part ; pain and heat 

 more or less acrid;" accompanied at times with small vesicles upon the inflamed part, 

 which dry up and scale off. (Dunglison.) It is sometimes a merely local affection con- 

 fined to one spot, often the head. At other times it is accompanied by a continued fever, 

 to which the name Erysipelatous fever is given. This is sometimes sporadic ; at other 



