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Meghna. It consists of the three districts of Chittagong (including the Hill Tracts), Noakhali, and Tipperah. Its area covers 12,118 square miles; the population in 1891 was 4,190,081, giving an average density of 345 persons per square mile.

Chittore, a town of British India, in the North Arcot district of Madras, situated in 13° 13′ N. lat. and 79° 8' E. long. ; station on the South Indian railway. Formerly a Population (1881), 5809; (1891), 9965. military cantonment, it is now only the civil headquarters of the district. It has an English church, mission chapel, and Roman Catholic chapel, a high school, two printingpresses, and several literary institutes.

these difficulties Colonel Kelly set out on the 23rd March, the day | Bay of Bengal, extending northward along the left bank of the after receiving his orders. Marching rapidly, the little force successfully crossed the Shandur Pass on the 28th March. On the 9th April Colonel Kelly fought and defeated the Chitralis, and on the same day relieved the garrison of Mastang. On the 13th April Colonel Kelly again fought a successful action at Nisa Gol. The enemy having now been dispersed, the road to Chitral was left clear, and on the 20th April the gallant little force relieved Chitral Fort without opposition from Sher Afzul and his followers, who had fled during the previous night. General Low's army was then at Umra Khan's stronghold, and no news arriving of the relief by Colonel Kelly, one lightly-equipped brigade under General Gatacre was pushed on towards Chitral. On 1st May they crossed the Lewarai Pass (10,000 feet high) over deep snow. Here verdue fly's force they halted, as all opposition was over. Colonel Kelly's force soon returned to Gilgit, but Sir Robert Low's troops held the line from Nowshera to Chitral for six months while the future policy was being arranged. At one time during the occupation the force had actually received orders to evacuate the whole country; but before this was commenced a change of Government occurred in England, and the new Cabinet immediately reversed the orders of their predecessors. Eventually the force was withdrawn during September and October 1895, a brigade being left at Killa Dresh. This was to be relieved every two years. The Khan of Dir (to whom were returned the lands seized by Umra Khan) and the Khan of Nawayai were subsidized to keep the road in repair and to ensure the safety of the biennial reliefs to and from Killa Dresh. Umra Khan was not permitted to return to his country. Sher Afzul, finding resistance hopeless, surrendered with his force. He and twenty of his chief men, with the assassin Amir-ul-Mulk, were sent to India to remain perpetually domiciled at Dharmsala, a hill-station in the Himalayas. (C. J. B.) Chittagong, a seaport of British India, giving its name to a district and a division of Bengal. is situated on the right bank of the Karnaphuli river, about 12 miles from its mouth. It is the terminus of the Assam-Bengal railway. The municipal area covers about 9 square miles; population (1881), 20,969; (1891), 24,069. Chittagong is the second seaport of Bengal. In 1897-98 the sea-borne exports were valued at Rs.1,12,63,036, of which more than half was jute, other items being tea, raw cotton, rice, and hides. There is also a large trade by country boats, which brought imports in 1897-98 valued at Rs.33,87,915, chiefly cotton, rice, spices, sugar, and tobacco. There is one rice-husking mill, employing 65 persons, with an out-turn valued at Rs.1,50,000. There are a Government college, a law class, a high school, and two Roman Catholic convent schools. Two of the five printing-presses issue vernacular newspapers.

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It

The district of CHITTAGONG is situated at the north-east corner of Bengal, occupying a strip of coast and hills between the sea and the mountains of Burma. Its area (excluding the Chittagong Hill Tracts) is 2563 square miles. The population in 1891 was 1,290,167, giving an average density of 503 persons per square mile. Classified according to religion, Hindus numbered 302,333; Mahommedans, 924,849; Buddhists (from Arakan), 61,615; Christians, 1191, of whom 256 were Europeans; "others," 179. In 1901 the population was 1,352,722, showing an increase of 5 per cent. The land revenue and rates are Rs. 10,16,834; the number of police is 497; the death-rate in 1897 was 49-46. This high mortality was partly due to the destructive cyclone of October. In 1896-97 the number of boys at school was 56,593, being 62 per cent. of the male population of school-going age. The northern portion of the district is traversed by the AssamBengal railway. Tea cultivation is moderately successful. 1897-98 there were 23 gardens, with 4025 acres under tea, employing permanently 3556 persons and producing more than two million Ib. The Chittagong forests yielded in 1897-98 a gross revenue of Rs.77,406.

In

The CHITTAGONG HILL TRACTS, formerly an independent district, have been reduced to the status of a subdivision. They Occupy the ranges between Chittagong proper and the south Lushai hills. The area covers 5419 square miles. In 1891 the population was 107,286, giving an average density of 20 persons per square mile. In 1901 the population was 124,851, showing an increase of 16 per cent. The inhabitants, who are either Arakanese or aboriginal tribes, are almost all Buddhists. The headquarters are at Rangamati (population, 2336), which was entirely wrecked by the cyclone of October 1897. There is one tea garden with 100 acres under tea, employing 120 persons and producing 27,000 lb.

The division of CHITTAGONG lies at the north-east corner of the

Chitty, Sir Joseph William (1828-1899), English judge, was born in London in 1828. He was the second son of Mr Thomas Chitty (himself son and brother of well-known lawyers), a celebrated special pleader and writer of legal text-books, in whose pupil-room Earl Cairns, Lord O'Hagan, Chief Justice Whiteside, Mr Justice Willes, Mr Justice Quain, Sir James Hannen, and many other distinguished lawyers began their legal education. Joseph Chitty was educated at Eton and Balliol, Oxford, gaining a first-class in 1851, in the old honour school of Litera Humaniores, and being afterwards elected to a fellowship at Exeter College. His principal distinctions during his school and college career had been earned in athletics, and he came to London as a man who had stroked the Oxford boat and captained the Oxford cricket eleven, besides bearing a well-known In legal name and being possessed of first-class abilities. these circumstances he had little difficulty in making his He became a member of Lincoln's Inn in 1851, mark. was called to the bar in 1856, and made a queen's counsel in 1874, electing to practise as such in the court in which Sir George Jessel, Master of the Rolls, presided. Chitty was highly successful in his method of dealing with a very masterful if exceedingly able judge, and soon gained the reputation of having the ear of the court to such an extent that his practice became very large, his fees being stated to have amounted at one time to £13,000 a year, a large sum for one not a law officer of the Crown. In 1880 he entered the House of Commons, being returned as Liberal member for Oxford (city) at the general election of that year.

His parliamentary career was short, for

in 1881 the Judicature Act required that the Master
of the Rolls should cease to sit regularly as a judge of
first instance, and Chitty was selected to fill the vacancy
thus created in the Chancery division. It was remarked
that two other judges during the century, Lord Hatherley
and Sir William Erle, had represented Oxford in Parlia-
ment. Sir Joseph Chitty was for sixteen years a popular
judge, in the best meaning of the phrase, being noted for
his courtesy, geniality, patience, and scrupulous fairness,
as well as for his legal attainments, and being much
respected and liked by those practising before him, in
spite of a habit of interrupting counsel, possibly acquired
through the example of Sir George Jessel-a habit which
in the case of Mr Justice Chitty did not accelerate the
despatch of business as it did with his predecessor, but
which no doubt was inspired, as a rule, by his desire to
appreciate every detail of the case before him.
His ready
ejaculation "Fiat justitia ruat cœlum," when a piece of the
ceiling of his court fell while he was on the bench, is
deserving of record.
1897, when, on the retirement of Sir Edward Kay, L.J.,
He remained a puisne judge until
he was promoted to the Court of Appeal. There he more
than sustained-in fact, he appreciably increased-his
reputation as a lawyer and a judge, proving himself to
possess considerable knowledge of the common law as well
as of equity, during the short time which elapsed before

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his death. He died in London on 15th February 1899, | obscurity. At an important discussion on the subject, held after a very short illness, originating in an attack of the prevailing epidemic of influenza.

Many legal contemporaries of Sir Joseph Chitty had been distinguished athletes while young. Lord Esher, M.R., Lord Justice A. L. Smith, Mr Justice Denman, and Lord Macnaghten may be mentioned as instances of university oars who were on the bench while he was a judge, while Sir Richard Webster (afterwards Lord Alverstone, L.C.J.) and Sir R. T. Reid, both law officers of the Crown, had been "blues" for running and cricket respectively. During four seasons Chitty kept wicket for the Eton eleven, of which he was captain in 1847 (he was afterwards held to be the best amateur wicket-keeper in England), and in those four years Eton won seven matches out of the eight played against Harrow and Winchester. At Oxford he played at cricket against Cambridge in 1848 and 1849, and won still greater fame on the river. He rowed 2 in the Oxford eight in the inter-university boat-race of March 1849, and 4 in the second of the two races rowed in that year. No inter-university race as such took place in 1850 or 1851, but in the latter year Oxford with Chitty stroke won the Grand Challenge Cup at Henley, Cambridge being a competitor; and in 1852 the inter-university race was again held, and Chitty stroked a strong Oxford crew to victory. In after life he acted as umpire in the inter-university boat-race for twenty-four years, ceasing to do so in 1881, and he was an active member of the Inns of Court Rifle Volunteers (the Devil's Own), holding a major's commission from 1869 to 1877, having been one of those who organized it in 1860, and having then been given a commission as a captain. In a profession largely filled by university men such a record was not likely to be forgotten. Sir Joseph Chitty married in 1858 Clara Jessie, daughter of Chief Baron Pollock, and left children who can thus claim descent from two of the best-known legal families of the 19th century.

AUTHORITIES.-The Times, 16th February 1899.-Law Journal, 18th February 1899. — Law Times, 18th February 1899. -Law Quarterly, vol. xv. p. 128.—Law Magazine, vol. xxv. p. 257. (E. A. AR.)

Choisy-le-Roi, a town in the arrondissement of Sceaux, department of Seine, France, 4 miles in direct line S.E. of Paris, on the left bank of the Seine and on the railway to Orleans. A monument was erected in 1882 to Rouget de l'Isle, author of the "Marseillaise," who died here 1836. It has manufactures of cloth, felt, gloves, earthenware, porcelain, and glass, and considerable river trade. Population (1881), 6700; (1901), 11,287.

Cholera. Much light has been thrown upon Asiatic cholera since 1880. Western experience has been enlarged by several epidemic outbreaks in different countries, and by one pandemic visitation of great violence; and the study of the disease by modern methods has resulted in important additions to our previous knowledge of its nature, causation, mode of dissemination, and prevention. The cause is a micro-organism identified by Koch in 1883. An account of it will be found under PATHOLOGY

(Parasitic Diseases). For some years it was Causation. called the " comma bacillus," from its supposed resemblance in shape to a comma, but it was subsequently found to be a vibrio or spirillum, not a bacillus. The discovery was received with much scepticism in some quarters, and the claim of Koch's vibrio to be the true cause of cholera was long disputed, but is now universally acknowledged. Few micro-organisms have been more elaborately investigated, but very little is known of its natural history, and its epidemiological behaviour is still surrounded by

at the International Hygienic Congress in 1894, Professor Gruber of Vienna declared that the deeper investigators went the more difficult the problem became, while M. Metschnikoff of the Pasteur Institute made a similar admission. The difficulty lies chiefly in the variable characters assumed by the organism and the variable effects produced by it. The type reached by cultivation through a few generations may differ so widely from the original in appearance and behaviour as to be hardly recognizable, while, on the other hand, of two organisms apparently indistinguishable one may be innocuous and the other give rise to the most violent cholera. This variability offers a possible explanation of the frequent failure to trace the origin of epidemic outbreaks in isolated places. It is commonly assumed that the micro-organism is of a specific character, and always introduced from without, when cholera appears in countries or places where it is not endemic. In some cases such introduction can be proved, and in others it can be inferred with a high degree of probability, but sometimes it is impossible to trace the origin to any possible channel of communication. A remarkable case of this kind occurred at the Nietleben Lunatic Asylum near Halle, in 1893, in the shape of a sudden, explosive, and isolated outbreak of true Asiatic cholera. It was entirely confined to the institution, and the peculiar circumstances enabled a very exact investigation to be made. The facts led Professor Arndt, of Greifswald, to propound a novel and interesting theory. No cholera existed in the surrounding district and no introduction could be traced, but for several months in the previous autumn diarrhoea had prevailed in the asylum. The sewage from the establishment was disposed of on a farm, and the effluent passed into the river Saale above the intake of the water-supply for the asylum. Thus a circulation of morbid material through the persons of the inmates was established. Dr Arndt's theory was that by virtue of this circulation cholera was gradually developed from previously existing intestinal disease of an allied but milder type. The outbreak occurred in winter, and coincided with the freezing of the filter-beds at the water-works. The theory is worth notice, because a similar relation between the drainage and the water - supply frequently exists in places severely attacked by cholera, and it has repeatedly been observed that the latter is preceded by the prevalence of a milder form of intestinal disease. The inference is not that cholera can be developed de novo, but that the type is unstable, and that a virulent form may be evolved under favourable conditions from another so mild as to be unrecognized, and consequently undetected in its origin or introduction. This is quite in keeping with the observed variability of the micro-organism, and with the trend of modern research with regard to the relations between other pathogenic germs and the multifarious gradations of type assumed by other zymotic diseases. The same thing has been suggested of diphtheria. Cholera is endemic in the East over a wide area, ranging from Bombay to Southern China, but its chief home is British India. It principally affects the Epidemalluvial soil near the mouths of the great rivers, icity. and more particularly the delta of the Ganges. Lower Bengal is pre-eminently the standing focus and centre of diffusion. In some years it is quiescent, though never absent; in others it becomes diffused, for reasons of which nothing is known, and its diffusive activity varies greatly from equally inscrutable causes. At irregular intervals this property becomes so heightened that the disease passes its natural boundaries and is carried east, north, and west, it may be to Europe or beyond to the American continent. We must assume

that the micro-organism, like those of other epidemic diseases, acquires greater vitality and toxic energy, or greater power of reproduction at some times than at others, but the conditions that govern this behaviour are quite unknown, though no problem has a more important bearing on public health. Bacteriology, as already intimated, has thrown no light upon it, nor has meteorology. Some results of modern research, indeed, tend to assign increasing importance to the relations between surface soil and certain micro-organisms, and suggest that changes in the level of the subsoil water, to which Pettenkofer long ago drew attention, may be a dominant factor in determining the latency or activity of pathogenic germs. But this is largely a matter of conjecture, and, so far as cholera is concerned, the conditions which turn an endemic into an epidemic diease must be admitted to be still unknown.

On the other hand, the mode of dissemination is now well understood. Diffusion takes place along the lines of human intercourse. The poison is carried chiefly by infected persons moving from place to place; but soiled clothes, rags, and other articles that have come into contact with persons suffering from the disease may be the means of conveyance to a distance. There is no reason to suppose that it is air-borne, or that atmospheric influences have anything to do with its spread, except in so far as meteorological conditions may be favourable to the growth and activity of the micro-organisms. Beyond all doubt, the great manufactory of the poison is the human body, and the discharges from it are the great source of contagion. They may infect the ground, the water, or the immediate surroundings of the patient, and so pass from hand to hand, the poison finding entrance into the bodies of the healthy by means of food and drink which have become contaminated in various ways. Flies which feed upon excreta and other foul matters may be carriers of contagion. Of all the means of local dissemination, contaminated water is by far the most important, because it affects the greatest number of people, and this is particularly the case in places which have a public watersupply. A single contaminated source may expose the entire population to danger. All severe outbreaks of an explosive character are due to this cause. It is also possible that the cholera poison multiplies rapidly in water under favourable conditions, and that a reservoir, for instance, may form a sort of forcing - bed. But it would be a mistake to regard cholera as purely a waterborne disease, even locally. It may infect the soil in localities which have a perfectly pure water-supply, but have defective drainage or no drainage at all, and then it will be found more difficult to get rid of, though less formidable in its effects, than when the water alone is the source of mischief. In all these respects it has a great affinity to enteric fever. With regard to locality, no situation can be said to be free from attack if the disease is introduced and the sanitary conditions are bad; but, speaking generally, low-lying places on alluvial soil near rivers are more liable than those standing high or on a rocky foundation. Of meteorological conditions it can only be said with certainty that a high temperature favours the development of cholera, though a low one does not prevent it. In temperate climates the summer months, and particularly August and September, are the season of its greatest activity.

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such invasions are mentioned in the article in the ninth edition of the Encyclopædia-those of 1830-39, 1847-49, 1853-54, and 1865-67-but by some writers the epidemic of 1853 is regarded as a recrudescence of that of 1847. The earlier ones followed the land route by way of Afghanistan and Persia, and took several years to reach Europe. That of 1865 travelled more rapidly, being carried from Bombay by sea to Mecca, from there to Suez and Alexandria, and then on to various Mediterranean ports. Within the year it had not only spread extensively in Europe, but had reached the West Indies. In 1866 it invaded England and the United States, but during the following year it died down in the West. The subsequent history of cholera in Europe may be stated chronologically. 1869-74. This invasion was traced to the great gathering of pilgrims at Hardwar on the Upper Ganges in the month of April 1867. From there the returning pilgrims carried it to the Punjab, Cashmere, and Afghanistan, whence it spread to Persia and the Caspian, but it did not reach Russia until 1869. During the next four years a number of outbreaks occurred in Central Europe, and notably one at Munich in the winter of 1873. The irregular character of these epidemics suggests that they were rather survivals from the pandemic wave of 1867 than fresh importations, but there is no doubt that cholera was carried overland into Russia in the manner described.

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1883-87. This visitation, again, came by the Mediterranean. In 1883 a severe outbreak occurred in Egypt, causing a mortality of above 25,000. Its origin remained unknown. During this epidemic Koch discovered the comma bacillus. The following year cholera appeared at Toulon. It was said to have been brought in a troopship from Saigon in Cochin China, but it may have been connected with the Egyptian epidemic. A severe outbreak followed and reached Italy, nearly 8000 persons dying in Naples alone. In 1885 the south of France, Italy, Sicily, and Spain all suffered, especially the last, where nearly 120,000 deaths occurred. Portugal escaped, and the authorities there attributed their good fortune to the institution of a military cordon, in which they have had implicit confidence ever since. In 1886 the same countries suffered again, and also Austria-Hungary. From Italy the disease was carried to South America, and even travelled as far as Chile, where it had previously been unknown. In 1887 it still lingered in the Mediterranean, causing great mortality in Messina especially. According to Dr Wall, this epidemic cost 250,000 lives in Europe and at least 50,000 in America. A particular interest attaches to it in the fact that a localized revival of the disease was caused in Spain in 1890 by the disturbance of the graves of some of the victims who had died of cholera four years previously.

1892-95.--This great invasion reverted again to the old overland route, but the march of the disease was of unprecedented rapidity. Within less than five months it travelled from the North-West Provinces of India to St Petersburg, and probably to Hamburg, and thence in a few days to England and the United States. This speed, in such striking contrast to the slow advance of former occasions, was attributed, and no doubt rightly, to improved steam transit, and particularly the Transcaspian railway. The progress of the disease was traced from place to place, and almost from day to day, with great precision, showing how it moves along the chief highways and is obviously carried by man. The main facts are as follows:- -Cholera was extensively and severely prevalent in India in 1891, causing 601,603 deaths, the highest mortality since 1877. In March 1892 it broke out at the Hardwar fair, a day or two before the pilgrims dispersed ; on 19th April it was at Kabul, on 1st May at Herat, and 26th May at Meshed. From Meshed it moved in S. III. -7

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or pedestrians were seen in the streets. At the cemetery, which lies about 10 miles from the town, some hundreds of men were engaged day and night digging long trenches to hold double rows of coffins, while the funerals formed an almost continuous procession along the roads; even so the victims could not be buried fast enough, and their bodies lay for days in sheds hastily run up as mortuaries. Hamburg had been attacked by cholera on fourteen previous occasions beginning with 1831, but the mortality had never approached that of 1892; in the worst year, which was 1832, there were only 3687 cases and 1765 deaths. The disease was believed to have been introduced by Jewish emigrants passing through on their way from Russia, but the importation could not be traced. The Jews were segregated and kept under careful supervision from the middle of July onwards, and no recognized case occurred among them. The total number of places in Germany in which cholera appeared in 1892 was 269, but it took no serious hold anywhere save in Hamburg. The distribution was chiefly by the waterways, which seem to affect a larger number of places than the railways as carriers of cholera. In Paris 907 persons died, and in Havre 498. Between 18th August and 21st October 38 cases were imported into England and Scotland through eleven different ports, but the disease nowhere obtained a footing. Seven vessels brought 72 cases to the United States, and 16 others occurred on shore, but there was no further dissemination.

three directions-due west to Tehran in Persia, north-east | the hotels and restaurants were deserted, and few vehicles by the Transcaspian railway to Samarkand in Central Asia, and north-west, by the same line in the opposite direction, to Uzun-ada on the Caspian Sea. It reached Uzun-ada on 6th June; crossed to Baku, 18th June; Astrakhan, 24th June; then up the Volga to Nijni Novgorod, arriving at Moscow and St Petersburg early in August. The part played by steam transit is clear from the fact that the disease took no longer to travel all the way from Meshed to St Petersburg by rail and steamboat than to traverse the short distance from Meshed to Tehran by road. On 16th August cases began to occur in Hamburg; on 19th August a fireman was taken ill at Grangemouth in Scotland, where he had arrived the day before from Hamburg; and on 31st August a vessel reached New York from the same port with cholera on board. On 8th September the disease appeared in Galicia, having moved somewhat slowly westwards across Russia into Poland, and on 26th September it was in Budapest. Holland and Servia were also attacked, while isolated cases were carried to Norway, Denmark, and Italy. Meanwhile two entirely separate epidemics were in progress elsewhere. The first was confined to Arabia and the Somali coast of Africa, and was connected with the remains of an outbreak in Syria and Arabia in 1890-91. The second arose mysteriously in France about the time when the overland invasion started from India. The first known case occurred in the prison at Nanterre, near Paris, on 31st March. Paris was affected in April, and Havre in July. The origin of this outbreak, which was of a much less violent character than that which came simultaneously by way of Russia, was never ascertained. Its activity was confined to France, particularly in the neighbourhood of Paris, together with Belgium and Holland, which was placed between two fires, but escaped with but little mortality. The number of persons killed by cholera in 1892, outside of India, was reckoned at 378,449, and the vast majority of those died within six months. The countries which suffered most severely were as follows:- European Russia, 151,626; Caucasus, 69,423; Central Asian Russia, 31,804; Siberia, 15,037-June, and owing to the presence of an exceptionally large total for Russian empire, 267,890; Persia, 63,982; Somaliland, 10,000; Afghanistan, 7000; Germany, 9563; France, 4550; Hungary, 1255; Belgium, 961. Curiously enough, the south of Europe, which had been the scene of the previous epidemic visitation, escaped. The disease was of the most virulent character. In European Russia the mortality was 45.8 per cent. of the cases, the highest rate ever known in that country; in Germany it was 51.3 per cent.; and in Austria-Hungary, 57.5 per cent. Of all the localities attacked, the case of Hamburg was the most remarkable. The presence of cholera was first suspected on 16th August, when two cases occurred, but it was not officially declared until 23rd August. By that time the daily number of victims had already risen to some hundreds, while the experts and authorities were making up their minds whether they had cholera to deal with or not. Their decision eventually came too late and was superfluous, for by 27th August the people were being stricken down at the rate of 1000 a day. This rate was maintained for four days, after which the vehemence of the pestilence began to abate. It gradually declined, and ceased on 14th November. During those three months 16,956 persons were attacked and 8605 died, the majority within the space of a few weeks. The town, ordinarily one of the gayest places of business and pleasure on the Continent, became a city of the dead. Thousands of persons fled, carrying the disease into all parts of Germany; the rest shut themselves indoors; the shops were closed, the trams ceased to run,

During the winter of 1892-93 cholera died down, but never wholly ceased in Russia, Germany, Austria-Hungary, and France. With the return of warm weather it showed renewed activity, and prevailed extensively throughout Europe. The recorded mortality for the principal countries was as follows:-Russia (chiefly western provinces), 41,047; Austria-Hungary, 4669; France, 4000; Italy, 3036; Turkey, 1500; Germany, 298; Holland, 376; Belgium, 372; England, 139. Hardly any country escaped altogether; but Europe suffered less than Arabia, Mesopotamia, and Persia. Cholera broke out at Mecca in number of pilgrims caused an appalling mortality. The chief shereef estimated the mortality at 50,000. The pilgrims carried the disease to Asia Minor and Constantinople. In Persia also a recrudescence took place and proved enormously destructive. Dr Barry estimated the mortality at 70,000. At Hamburg, where new waterworks had been installed with sand filtration, only a few sporadic cases occurred until the autumn, when a sudden but limited rush took place, which was traced to a defect in the masonry permitting unfiltered Elbe water to pass into the mains. In England cholera obtained a footing on the Humber at Grimsby, and to a lesser extent at Hull, and isolated attacks occurred in some 50 different localities. Excluding a few ship-borne cases, the registered number of attacks was 287, with 135 deaths, of which 9 took place in London. It is interesting to compare the mortality from cholera in England and Wales, and in London, for each year in which it has prevailed since registration began:

Year.

London.

Deaths.

England and Wales.
Deaths per 10,000
living.

Deaths.

Deaths per 10,000 living.

1848
1849

1,908

1.1

652

2.9

53,293

30.3

14,137

61.8

1853

4,419

2.4

883

3.5

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In 1894 no deaths from cholera were recorded in | England, but on the Continent it still prevailed over a wide area. In Russia over 30,000 persons died of it, in Germany about 500, but the most violent outbreak was in Galicia, where upwards of 8000 deaths were registered. In 1895 it still lingered, chiefly in Russia and Galicia, but with greatly diminished activity. In that year Egypt, Morocco, and Japan were attacked, the last severely. Since then cholera has been in abeyance until the severe epidemic in India in 1900.

Prevention.

The great invasion just described was fruitful in lessons for the prevention of cholera. It proved that the one real and sufficient protection lies in a standing condition of good sanitation backed by an efficient and vigilant sanitary administration. The experience of Great Britain was a remarkable piece of evidence, but that of Berlin was perhaps even more striking, for Berlin lay in the centre of four fires, in direct and frequent communication with Hamburg, Russia, France, and Austria, and without the advantage of a sea frontier. Cholera was repeatedly brought into Berlin, but never obtained a footing, and its successful repression was accomplished without any irksome interference with traffic or the ordinary business of life. The general success of Great Britain and Germany in keeping cholera in check by ordinary sanitary means completed the conversion of all enlightened nations to the policy laid down so far back as 1865 by Sir John Simon, and advocated by Great Britain at a series of international congresses the policy of abandoning quarantine, which Great Britain did in 1873, and trusting to sanitary measures with medical inspection of persons arriving from infected places. This principle was formally adopted at the international conference held at Dresden in 1893, at which a convention was signed by the delegates of Germany, Austria, Belgium, France, Great Britain, Italy, Russia, Switzerland, Luxemburg, Montenegro, and the Netherlands. Under this instrument the practice is broadly as follows, though the procedure varies a good deal in different countries :-Ships arriving from infected ports are inspected, and if healthy are not detained, but bilge-water and drinking-water are evacuated, and persons landing may be placed under medical supervision without detention; infected ships are detained only for purposes of disinfection; persons suffering from cholera are removed to hospital; other persons landing from an infected ship are placed under medical observation, which may mean detention for five days from the last case, or, as in Great Britain, supervision in their own homes, for which purpose they give their names and places of destination before landing. All goods are freed from restrictions, except rags and articles believed to be contaminated by cholera matters. By land, passengers from infected places are similarly inspected at the frontiers and their luggage disinfected". -in all cases a pious ceremony of no practical value, involving a short but often vexatious delay; only those found suffering from cholera can be detained. Each nation is pledged to notify the others of the existence within its own borders of a "foyer" of cholera, by which is meant a focus or centre of infection. The precise interpretation of the term is left to each Government, and is treated in a rather elastic fashion by some, but it is generally understood to imply the occurrence of non-imported cases in such a manner as to point to the local presence of infection. The question of guarding Europe generally from the danger of diffusion by pilgrims through the Red Sea was settled at another conference held in Paris in 1894. The provisions agreed on included the inspection of pilgrims at ports of departure, detention of infected or suspected persons, and supervision of pilgrim ships and of pilgrims proceeding overland to Mecca.

The substitution of the procedure above described for the old measures of quarantine, and other still more drastic interferences with traffic, presupposes the existence of a sanitary service and fairly good sanitary conditions if cholera is to be effectually prevented. No doubt if sanitation were perfect in any place or country, cholera, along with many other diseases, might there be ignored, but sanitation is not perfect anywhere, and therefore it requires to be supplemented by a system of notification with prompt segregation of the sick and destruction of infective material. These things imply a regular organization, and it is to the public health service of Great Britain that the complete mastery of cholera has mainly been due in recent years, and particularly in 1893. Of sanitary conditions the most important is unquestionably the watersupply. So many irrefragable proofs of this fact were given during 1892-93 that it is no longer necessary to refer to the time-honoured case of the Broad Street pump. At Samarkand three regiments were encamped side by side on a level plain close to a stream of water. The colonel of one regiment took extraordinary precautions, placing a guard over the river, and compelling his men to use boiled water even for washing. Not a single case of cholera occurred in that regiment, while the others, in which only ordinary precautions were taken, lost over 100 men. At Ashkabad the cholera had almost disappeared, when a banquet was given by the governor in honour of the Czar's name-day. Of the guests one-half died within twenty-four hours; a military band, which was present, lost 40 men out of 50; and one regiment lost half its men and 9 officers. Within forty-eight hours 1300 persons died out of a total population of about 13,000. The water-supply came from a small stream, and just before the banquet a heavy rain-storm had occurred, which swept into the stream all surface refuse from an infected village higher up and some distance from the banks. But the classical example was Hamburg. The water-supply is obtained from the Elbe, which became infected by some means not ascertained. The drainage from the town also runs into the river, and the movement of the tide was sufficient to carry the sewage matter up above the water-intake. The water itself, which is no cleaner than that of the Thames at London Bridge, underwent no purification whatever before distribution. It passed through a couple of ponds, supposed to act as settling tanks, but owing to the growth of the town and increased demand for water, it was pumped through too rapidly to permit of any subsidence. Eels and other fish constantly found their way into the houses, while the mains were lined with vegetation and crustacea. The water-pipes of Hamburg had a peculiar and abundant fauna and flora of their own, and the water they delivered was commonly called Fleischbrühe, from its resemblance to thick soup. On the other hand, at Altona, which is continuous with Hamburg, the water was filtered through sand. In all other respects the conditions were identical, yet in Altona only 328 persons died, against 8605 in Hamburg. In some streets one side lies in Hamburg, the other in Altona, and cholera stopped at the dividing line, the Hamburg side being full of cases and the Altona side untouched. In the following year, when Hamburg had the new filtered supply, it enjoyed equal immunity, save for a short period when, as we have said, raw Elbe water accidentally entered the mains.

But water, though the most important condition, is not the only one affecting the incidence of cholera. The case of Grimsby furnished a striking lesson to the contrary. Here the disease obtained a decided hold, in spite of a pure water-supply, through the fouling of the soil by cesspits and defective drainage. At Havre also its prevalence was due to a similar cause. Further, it was

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