, 1873-08-16
Symptoms---Not Observation-Disclosures
.-.Excitlng Cause.-,PredIspo"
sing Causes.
Moae Of Approach."Fact Concerning Epi'
lcmies-.-hlortality- -.Sanitary .
Measures. ~ =.
Duties Of Municipal Authorities and Of
Individuals .Prophylaxis-.-
Treatment.
HISTORY. .

cr1l times dato from tho visit Of tho Portuguese,
in tue yonr 1000, to India, whore tlloy found tho
endemic prevailing. Tho llrRt record Of It's I'D
vanco beyond the area Of Inda dates from 1877.
During tic tlftoon years following this date It
trnveracd almost evory country, visiting America
1t, 1882, 80, mud "a. In 18l7, 1t II second timo
left India, rcnching tho United states through
EUROPE, in 184o. and continuing TO appear in diff
forcnt pnrtB Of this country, with moro or loss
sovority, In 20. 81, 49, aud '54. In 1866 1t agan
extended from India, invading Europe, md
rosching Amorica in 1866. In 1870 1t appeared
In Russin and III Cuba. In 1871 1t prevailed in
Persia and Gern,any, - fow casoH alto occurring
in London and Paris in August Of TINT year.
TERRITORIAL RANGE.
The cholora Ruong indigenous to certain woll-
doiinod portions Of India. Within those limits
it prevails with moro or loss intensity from your
to gear. From tine to tino, It ovoratepa these
hounds, md tho cholera-wavo advances moro or
less generally over tho earth. somo countries
have MS got beon oxompt from it's inroads
Among .hoso arc Australia, Now Zonla1d,
and Bonlo portions Of tho southern coast Of
Africa aud Of South America, Iceland, Bormuda,
tho Faroe, Azoro, and other islands.
ORDER AND MODE OF PROGRESS.
Tho orlor Of tho progrohs Of tho dsoaso from
place to place is apparently irregular mud CO.
pricionH. Tho moro recent theories rs to its do
volopmont, however, tend to reconcile those
Irregularities. It generally purR,les tho line of
travel, taking localities In roguiar order; but
tho1e aro many marked exceptions to this rs,lo.
It noyor travels fastor thnn man, and its rate of
speed increases with tie facilities Of locomo-
tion. In India it moved Is milos q week in
crossing tho Atlantic 1t has moved 800 or 400
mil In lin INN
pursued the Hamo course from India through
Europe, but tho line of it's advance ia not always
the salno. Sometimes it radiatoa from tho initial
points; sometimes it affects belts Of country, aa
doaa storm. Tho wind presents no obHtaco to
Its progress. It has advanced moro rapidly in
tho face Of strong wind, in ono direction, than
with it in an opposite course.
Thoro ID reason to suppoao that cho1era-pof-
sou, liko material substances, is occasionally
carried by wl,ir1wiudB or by clouds to very great
diHtnnccl, an illustrated in tho case OF it's occur
romeo among soldiers in an iaolatod camp imme-
diatoly after n heavy full Of rain. Tho theory
that tho poison was brought by tho storm in thiH
instance would acom to receive corroboration
from tie fact TINT, upon remoyal Of the Holdiors
from this camp, tho disease ccaaed, as il tho
cause OF 1t Ind been loft on tho spot wLero it
foil.
All tho factn, however, with very rare oxcep-
tionB Of tho kind Just mentioned. indicate that
tho cholera ia carried around the Garth from man
to man that the poison of the disease in The
discharges Of one patient afroct otlors exposed
to 1t under certain circumstances; and that thus
the disorder by sort otleaven-
!''G pu"o'' "o'e" eonsu4as' ~ 'eub 40 '.o '."'-
lty OF tRo poison anu The cifcum6tances 1aToftnE
its action endure.
gYs1p1oMs.
o+4oo,, ~ oho1a,o INV, l., oo.i,,, ~oo,,-r;,,7
M "s'A ~ ..3;a, .ssy - !
by these symptoms, mentioned ID the genoral
order OF their occurrence: Purging, vomiting,
and cramps. Tho discharges aro free and pain
Iene consiating at first Of tue ordinary contents
Of tho stomach and bowoH,-sopn however,
assuming tho worry characteristic appearance Of
rice-wator. Tho cramps occur most frequently
in tho cxtrernitioB. To these symptoms succeed,
in the worst ca6es, yyllat is termed collapse,
accompanied by q peculiar shrinking OF tho
body, cotdnoBs and liyidity Of the surface Bod-
den appearance OF tho hands, huskincas Of the
voice. ind intenne thirat. Tho state Of collapse
An ordinary tnrrhea almost invariably procodcH
MI attack Of cholora it may colltinua soyeral
hours Or days before the incirsion Of tho moro
violent symptoms. So gonornl is this Eromoni-
tory cIoleraic iarrnoa, that in one aores Of 600
cases it was present in MI.
Tho duration Of tho disease yaries groatIy with
lilo character Ut the epidemic cud tho gl,acepti-
biity Of the individual. In India pcrsous ar
it's duration may bo stated as from three hours
to three daya.
Tho Asiatic cho!orA cannot long 10 confounded
with cholera morbuH. The latter iB seldom fatn1
hna is incapable Of bcgetting its like. The chol-
Gro ia often fatal, and, under cortaiu conditions
ono case may produce others.
NOT CONTAGIOUS.
1t ia q question Of tho f,reateRt importance
whether cholera ID contagious. It is not con-
tagouH aB ia smallpox or Bcarlet-fevor. It's Inv
OF transmission is cortninly different from that
Of Hucl1 diHoaBes. 4 fow facts will Boryo to catab
liHh this position, though III thoso Ia not embod-
led all tic considerations which have led tho
great majority Of the profession to tho opluion
ahovo expressed.
Eight hundred and Blxty patiC1tH sick with
other dlBcagob Uero in Aospital at Moscow,
during tho time in which 680 persons were sick
with cholera tloro. Tho hospital consisted OF
three stories, communicating By stairs plnced
81 ~