"contagium" and the "miasm," which have given rise to much misunderstanding, would best be dispensed with altogether; and that the designation "infective material" (Infectionstoff ), which is common to both contagium and miasm, should be divided into entogen and ectogen, according as the material is obtained from the sick body or the locality (soil). According to many, cholera would belong to the entogenous section, and according to others to the ectogenous division. The supporters of the first view might be termed "contagionists"; the supporters of the second "localists." As is always the case in medicine, the conflict of views is important, inasmuch as the measures to be adopted in the healing and prevention of a disease depend on the theoretical conception of it.
All readers know that cholera originated in the East Indies, and most individuals are also aware that the epidemic spread into Europe in the present century (1830), We shall first speak of its age in India, the home of cholera. There the disease appears to have existed at all times; not only at the time of the discovery of the sea-passage to India by the Portuguese, but long before, as the oldest Sanskrit writings show. Many hundreds of years before the birth of Christ the disease was accurately described and its epidemics spoken of as attended with mahá mâri (magna mors, great death). In these writings the disease appears under widely different names, which are taken from the chief symptoms: 1. Vishû dschikâ, vomiting and sweating; 2. Alasikâ, cramps which bring on exhaustion and stiffness; 3. Rilambikâ, which is perhaps best translated by the term "collapse." Another word which is often used in India is taken from the Mahratta, mordeshin or mordschi, which has been translated into French as mort de chien, but which also means "collapse."
In the seventeenth and eighteenth centuries a. d. there are abundant proofs and descriptions of epidemics of this disease. The disease is best known in Europe under the names of cholera, cholera morbus, Asiatic cholera, since the epidemic of 1817 to 1819, in which the English army, under the command of the Marquis of Hastings during a war against the natives, was rendered unfit for fighting and almost annihilated. But cholera had never visited Europe till the present century, when in 1830 it appeared in Russia and spread to Poland, where war was prevailing. Since that time, sometimes at longer and sometimes at shorter intervals, cholera has appeared in Europe. The question why cholera remained a thousand years in India before it first began to migrate is one of great interest, but one which can not be satisfactorily answered. The principal consideration appears to me to be that the event happened at the time when intercommunication in all directions, both by water and land, had become more rapid. The first steamship appeared in the Indian waters at the beginning of the second decade of the present century. By land also intercourse was greatly accelerated. The Russians possibly
