510 CHOLERA sons, commencing with the first heats of sum- mer, affecting almost exclusively infants and children in large towns and cities, prevailing in the parts most densely populated, and being most virulent in crowded courts and alleys, where the ventilation is very imperfect and the inhabitants most unclean. In fact it arises from a combination of hot weather and the im- pure air of cities, aided largely by bad food and poor milk. It somewhat approaches septic cholera in its nature. 6. Septic cholera, arising from the inhalation of air charged with organic impurities springing from decomposing vege- table and animal matter, sewer gases, and night soil. 7. True Asiatic cholera, a virulent form of septic cholera, always originating in Hindostan, and which, like the contagious forms of influenza, dysentery, or erysipelas, has become portable, communicable, and capable of reproducing itself in every body in which it gets lodgment. Hippocrates, 400 B. C., makes remarks about cholera which scarcely allow us to doubt of the conveyance of the Asiatic disease to Greece in that early period. Are- tseus of Cappadocia, A. D. 50, gives a correct description of it, even describing the spasms, coldness of the body, loss of voice, and suppres- sion of urine. Galen in A. D. 131, and G- lius Aurelianus in 151, did the same ; also Ora- basius of Pergamus (230) ; while Alexander of Tralles (525) speaks of the watery evacuations, suppression of pulse and urine, followed in some cases by secondary typhoid fever, or death in a few hours. When the French and English struggled for the Coromandel coast of India, repeated epidemics were noticed near Madras and Pondicherry, in connection with the great Hindoo pilgrimages. The year 1756 marks the recognition of periodically returning 12-yearly epidemics, connected with the great 12-yearly Hindoo festivals at the great temples. The great 12-yearly epidemics of 1756, 1768, and 1781 have been well described by Paisley, Girdlestone, Curtis, Sonnerat, Fra Bartolom- meo, Papin, Davis, and others. On March 22, 1781, 5,000 English troops under Col. Pearse, marching near Ganjam, not far from the great temple of Juggernaut, and very shortly after the huge 12-yearly festival had taken place, were attacked by the disease very suddenly and with inconceivable fury, after camping on foul pilgrim grounds and drinking polluted water. Men previously healthy dropped down by dozens, and those less severely affected were generally past re- covery in 24 hours. Besides those who had died there were 500 on the sick list on the first day, and in two days more nearly 3,000 were affected. This epidemic was carried by re- turning pilgrims up to Calcutta and down to Madras. Three times 12 or 36 years subse- quently the great historical epidemic of 1817 occurred ; this proceeded up the Ganges as far as Allahabad, when it was deflected southward to the province of Bundelcund, in which the marquis of Hastings was carrying on war against the Mahrattas with 90,000 men. Of the natives 10,000 had.already died in Allah- abad, and many others had joined the army as camp followers, among whom the disease crept about in its usual insidious manner for several days, until a sufficient number of foci of the disease had been developed for it to burst forth with irresistible fury in every di- rection. The natives deserted in great num- bers, and the highways and fields for many miles around were strewed with the bodies of those who had fled with the disease upon them. The encampments and lines of march of the army presented most deplorable spec- tacles ; hundreds of soldiers dropped down in every day's advance, and on every night's halt ; so that the whole presented the appear- ance of successive battle fields and the track of an army retreating under every circum- stance of defeat and discomfiture. In two weeks 9,000 men succumbed to the pestilence. A subsidiary force coming up from the south under Col. Adams to cooperate with the mar- quis of Hastings afforded the second striking instance of a large body of men in high health coming into the pestilential region and falling at once into a wretched state of sickness ; 70 cases and 20 deaths occurred on the first day, and many were attacked while loitering for water at contaminated springs and rivulets. Other reinforcements were advancing from Bombay in the southwest, and the course of the disease had long been so regular along the line of much travelled roads and the marches of troops that the Bombay authori- ties prepared for it when it was many hundreds of miles off. Step by step the disease could be traced marching from town to town and creeping from village to village, by the arrival of persons affected with the disease from places where it was known to prevail. From Bombay it was carried up the Persian gulf to Bushire, the only port of southern Persia, from which it was transported by travellers to Shiraz ; was excluded from Ispahan by a rigid quarantine, and deflected east to Yezd ; from there north to Teheran, and from thence to Reshd, the principal Persian port on the Caspian sea; and from there both by land and water up to As- trakhan, at the mouth of the Volga, where the disease died out. From Bombay it was also carried up to Bassorah at the head of the Per- sian gulf, where 18,000 persons died in 18 days; and from there along the rivers Euphrates and Tigris to Bagdad, Damascus, Aleppo, and the Mediterranean coast, where it also faded away in 1821. Every successive epidemic of cholera has always been carried up the Persian gulf from Bombay, Surat, Kurrachee, and other ports on the western coast of India, and thus reached the Mediterranean, Black, and Caspian seas, and neighboring countries, by the so-called Persian gulf route. In the Bombay presidency there are 94 shrines to which large pilgrimages are made, and from which the disease is brought to the seacoast. In India the epidemic of 1817
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