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ACUTE INFECTIOUS DISEASES. 



stances for increasing ; with us cholera is never miasmatic. (I shall 

 not dwell on the question whether Hallier and Kloll, who have found 

 numerous fungi in the dejections of cholera patients, have actually 

 discovered the cholera germ, for I do not feel competent to decide it.) 

 Cholera is not contagious in the strict sense of the word, for a healthy 

 person never takes cholera from contact with a patient having that 

 disease. (My experience in the first cholera epidemic that I saw, 

 where I wrapped many naked patients hi blankets, and often held 

 them in my arms for some tune, made me a decided anti-contagionist, 

 and I took this ground in my first publication, some twenty years 

 since.) But, as the word contagion is universally used in the sense, 

 that diseases which are transferred from sick to healthy persons are 

 contagious, and as this is very decidedly the case in cholera, we must 

 class cholera among the contagious diseases. The vehicle of conta- 

 gion is not, as in the acute exanthemata and exanthematic typhus, the 

 exhalation from the skin and lungs, but the dejections of cholera pa- 

 tients. It has been certainly proved that fatal cholera epidemics have 

 broken out in places previously free from it, because some traveller, 

 having cholera germs in his intestines, has used a privy, or that the 

 dejections of a cholera patient have been emptied into a privy, fre- 

 quented by other persons. In 1848, a transport of recruits from Stet- 

 tin, where cholera was raging, came to Magdeburg ; two of these re- 

 cruits sickened of cholera the night of their arrival. They were imme- 

 diately taken from their quarters to the military hospital, which was 

 some distance off, without coming in contact with the inhabitants. A 

 few days after, the cholera broke out in the house, and in the street 

 where they had passed the night. The fatal epidemic did not spread 

 to the rest of the city for some weeks. In large, thickly-populated 

 cities, where there are numerous cases of the disease, the extension of 

 an epidemic is more difficult to follow than it is in small, thinly-settled 

 towns where the number of cases is limited. A small epidemic in Greifs- 

 wald gave me an excellent opportunity for observing the spread of 

 cholera. In almost every case I could find that the patient had used 

 the privy of some house containing cholera patients, or one whose cess- 

 pool communicated with that of the privy of affected houses, or that 

 they had used a privy in common with persons from these houses who 

 had diarrhoea. Since it has been known that cholera is only trans- 

 ferred to healthy persons through the dejections of cholera patients, a 

 series of previously enigmatical and apparently contradictory observa- 

 tions, concerning the spread of the disease, have been satisfactorily ex 

 plained. We may readily understand that cholera should spread from 

 place to place more rapidly than it formerly did, since in these days of 

 railroads and steamboats people travel more quicklv than thev used to 



