Distribution 



447 



or upon their clothes must be great, for there are few months 

 in the year when the city is exempt from cholera. 



The pilgrimages and great festivals of the Hindoos and 

 Moslems, by bringing together enormous numbers of people 

 to crowd in close quarters where filth and bad diet prevail, 

 cause a rapid increase in the number of cases during these 

 periods and facilitate the distribution of the disease when 

 the festivals break up. Probably no more favorable con- 

 ditions for the dissemination of a disease can be imagined 

 than occurs with the return of the Moslem pilgrims from 

 Mecca. The disease extends readily along the regular lines 

 of travel, visiting town after town, until from Asia it has 

 frequently extended into Europe, and by steamships plying 

 foreign waters has several times been carried to our own 

 continent. Many cases are on record which show conclu- 

 sively 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. 



Specific Organism. The discovery of the spirillum of 

 cholera was made by Koch, who was appointed one of a 

 German commission appointed to study the disease in Egypt 

 and India in 1883-84. Since his discovery and published 

 investigations, 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 epi- 

 demic of a few years ago, 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 water from polluted gutters; how they enter milk 

 with water used to dilute it ; how they appear to be carried 

 about in clothing and upon food-stuffs; how they can be 

 brought to articles of food by flies that have preyed upon 

 cholera excrement; and other interesting modes of infection. 

 The literature is so vast that it is scarcely possible to men- 

 tion even the most instructive examples. A bacteriologist 

 became infected while experimenting with the cholera spirilla 



