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these difficulties Colonel Kelly set out on the 23rd March, the day Bay of Bengal, extending north ward along the left bank of the after receiving his orders. Marching rapidly, the little force Meghna. It consists of the three districts of Chittagong (insuccessfully crossed the Shandur Pass on the 28th March. On cluding the Hill Tracts), Noakhali, and Tippera h. Its arou covers the 9th April Colonel Kelly fought and defeated the Chitralis, and 12,118 square miles; the population in 1891 was 4,190,081, giving on the same day relieved the garrison of Mastang. On the 13th an average density of 345 persons per square mile. April Colonel Kelly again fought a successful action at Nisa Gol. The enemy having now been dispersed, the road to Chitral was left Chittore, a town of British India, in the North clear, and on the 20th April the gallant little force relieved Chitral Arcot district of Madras, situated in 13° 13' N. lat. and Fort without opposition from Sher Afzul and his followers, who 79° 8' E. long. ; station on the South Indian railway. had fled during the previous night. then at Umra Khan's stronghold, and no news arriving of the Population (1881), 5809 ; (1891), 9965.

Formerly a relief by Colonel Kelly, one lightly-equipped brigade under General military cantonment, it is now only the civil headquarters Gatacre was pushed on towards Chitral. On 1st May they crossed

of the district. It has an English church, mission chapel, the Lewarai Pass (10,000 feet high) over deep snow. Here they and Roman Catholic chapel, a high school, two printinghalted, as all opposition was over. Colonel Kelly's force soon returned to Gilgit, but Sir Robert Low's troops held the line from presses, and several literary institutes. Nowshera to Chitral for six months while the future policy was Chitty, Sir Joseph William (1828-1899), being arranged. At one time during the occupation the force had actually received orders to evacuate the whole country ; but English judge, was born in London in 1828. before this was commenced a change of Government occurred in the second son of Mr Thomas Chitty (himself son and England, and the new Cabinet immediately reversed the orders of brother of well-known lawyers), a celebrated special pleader their predecessors. Eventually the force was withdrawn during and writer of legal text-books, in whose pupil-room Earl September and October 1895, a brigade being left at Killa Dresh. Cairns, Lord O'Hagan, Chief Justice Whiteside, Mr Justice This was to be relieved every two years. The Khan of Dir (to whom were returned the lands seized by Umra Khan) and the Willes, Mr Justice Quain, Sir James Hannen, and many Khan of Nawayai were subsidized to keep the road in repair and other distinguished lawyers began their legal education. to ensure the safety of the biennial reliefs to and from Killa Dresh. Joseph Chitty was educated at Eton and Balliol, Oxford, Umra Khan was not permitted to return to his country. Sher gaining a first-class in 1851, in the old honour school Afzul, finding resistance hopeless, surrendered with his force. He and twenty of his chief men, with the assassin Amir-ul-Mulk,

of Literæ Humaniores, and being afterwards elected were sent to India to remain perpetually domiciled at Dharmsala,

to a fellowship at Exeter College. His principal disa hill-station in the Himalayas.

(C. J. B.) tinctions during his school and college career had been Chittagong, a seaport of British India, giving earned in athletics, and he came to London as a man its name to a district and a division of Bengal. It

who had stroked the Oxford boat and captained the is situated on the right bank of the Karnaphuli river, Oxford cricket eleven, besides bearing a well-known about 12 miles from its mouth. It is the terminus of the legal name and being possessed of first-class abilities. In Assam-Bengal railway. The municipal area covers about 9

these circumstances he had little difficulty in making his square miles ; population (1881), 20,969; (1891), 24,069. mark. He became a member of Lincoln's Inn in 1851,

a Chittagong is the second seaport of Bengal. In 1897-98

was called to the bar in 1856, and made a queen's counsel the sea-borne exports were valued at Rs.1,12,63,036, of in 1874, electing to practise as such in the court in which which more than half was jute, other items being tea,

Sir George Jessel, Master of the Rolls, presided. raw cotton, rice, and hides. There is also a large trade Chitty was highly successful in his method of dealing by country boats, which brought imports in 1897-98 with a very masterful if exceedingly able judge, and soon valued at Rs.33,87,915, chiefly cotton, rice, spices, sugar, gained the reputation of having the ear of the court to and tobacco. There is one rice-husking mill

, employing such an extent that his practice became very large, his 65 persons, with an out-turn valued at Rs.1,50,000. There fees being stated to have amounted at one time to £13,000 are a Government college, a law class, a high school, and

a year, a large sum for one not a law officer of the Crown. two Roman Catholic convent schools. Two of the five

In 1880 he entered the House of Commons, being returned printing-presses issue vernacular newspapers.

as Liberal member for Oxford (city) at the general election The district of CHITTAGONG is situated at the north-east

of that year. His parliamentary career was short, for corner of Bengal, occupying a strip of coast and hills between in 1881 the Judicature Act required that the Master the sea and the mountains of Burma. Its area (excluding the of the Rolls should cease to sit regularly as a judge of Chittagong Hill Tracts) is 2563 square miles. The population in first instance, and Chitty was selected to fill the vacancy 1891 was 1,290,167, giving an average density of 503 persons per square mile. Classified according to religion, Hindus numbered

thus created in the Chancery division. It was remarked 302,333 ; Mahommedans, 924,849 ; Buddhists (from Arakan), that two other judges during the century, Lord Hatherley 61,615; Christians, 1191, of whom 256 were Europeans; "others, and Sir William Erle, had represented Oxford in Parlia179. In 1901 the population was 1,352,722, showing an increase ment. Sir Joseph Chitty was for sixteen years a popular 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 judge, in the best meaning of the phrase, being noted for high mortality was partly due to the destructive cyclone of his courtesy, geniality, patience, and scrupulous fairness, October. In 1896-97 the number of boys at school was 56,593, as well as for his legal attainments, and being much being 62 per cent. of the male population of school-going age. respected and liked by those practising before him, in The northern portion of the district is traversed by the Assam: spite of a habit of interrupting counsel

, possibly acquired Bengal railway. Tea cultivation is moderately successful. In 1897-98 there were 23 gardens, with 4025 acres under tea, through the example of Sir George Jessel—a habit which employing permanently 3556 persons and producing more than in the case of Mr Justice Chitty did not accelerate the two million tb.

The Chittagong forests yielded in 1897-98 a despatch of business as it did with his predecessor, but gross revenue of Rs. 77,406. The CHITTAGONG HILL Tracts, formerly an independent

which no doubt was inspired, as a rule, by his desire to district, have been reduced to the status of a subdivision. They appreciate every detail of the case before him. His ready occupy the ranges between Chittagong proper and the south ejaculation “Fiat justitia ruat cælum,” when a piece of the Lushai hills. The area covers 5419 square miles. In 1891 ceiling of his court fell while he was on the bench, is the population was 107,286, giving an average density. 08.30 deserving of record. He remained a puisne judge until persons per square mile. In 1901 the population was 124,851.: 1897, when, on the retirement of Sir Edward Kay, L.J., showing an increase of 16 per cent. The inhabitants, who are either Arakanese or aboriginal tribes, are almost all Buddhists. he was promoted to the Court of Appeal. There he more The headquarters are at Rangamati (population, 2336), which was than sustained—in fact, he appreciably increased—his entirely wrecked by the cyclone of October 1897. There is one tea garden with 100 acres

under tea, employing 120 persons and reputation as a lawyer and a judge, proving himself to producing 27,000 lb.

possess considerable knowledge of the common law as well The division of CHITTAGONG lies at the north-east corner of the 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 at the International Hygienic Congress in 1894, Professor prevailing epidemic of influenza.

Gruber of Vienna declared that thedeeper investigators went Many legal contemporaries of Sir Joseph Chitty had the more difficult the problem became, while M. Metschnibeen distinguished athletes while young. Lord Esher, koff of the Pasteur Institute made a similar admission. M.R., Lord Justice A. L. Smith, Mr Justice Denman, The difficulty lies chiefly in the variable characters assumed and Lord Macnaghten may be mentioned as instances of by the organism and the variable effects produced by it. university oars who were on the bench while he was a The type reached by cultivation through a few generations judge, while Sir Richard Webster (afterwards Lord Alver- may differ so widely from the original in appearance and stone, L.C.J.) and Sir R. T. Reid, both law officers of the behaviour as to be hardly recognizable, while, on the other Crown, had been “blues” for running and cricket re- hand, of two organisms apparently indistinguishable one spectively. During four seasons Chitty kept wicket for may be innocuous and the other give rise to the most the Eton eleven, of which he was captain in 1847 (he was violent cholera. This variability offers a possible explanaafterwards held to be the best amateur wicket-keeper in tion of the frequent failure to trace the origin of epidemic England), and in those four years Eton won seven matches outbreaks in isolated places. It is commonly assumed out of the eight played against Harrow and Winchester. that the micro-organism is of a specific character, and At Oxford he played at cricket against Cambridge in always introduced from without, when cholera appears in 1848 and 1849, and won still greater fame on the river. countries or places where it is not endemic. In some He rowed 2 in the Oxford eight in the inter-university cases such introduction can be proved, and in others it boat-race of March 1849, and 4 in the second of the two can be inferred with a high degree of probability, but races rowed in that year. No inter-university race as sometimes it is impossible to trace the origin to any such took place in 1850 or 1851, but in the latter year possible channel of communication. A remarkable case of Oxford with Chitty stroke won the Grand Challenge Cup this kind occurred at the Nietleben Lunatic Asylum near at Henley, Cambridge being a competitor; and in 1852 Halle, in 1893, in the shape of a sudden, explosive, and the inter-university race was again held, and Chitty isolated outbreak of true Asiatic cholera. It was entirely stroked a strong Oxford crew to victory. In after life confined to the institution, and the peculiar circumstances he acted as umpire in the inter-university boat-race for enabled a very exact investigation to be made. The facts twenty-four years, ceasing to do so in 1881, and he was led Professor Arndt, of Greifswald, to propound a novel an active member of the Inns of Court Rifle Volunteers and interesting theory. No cholera existed in the sur(the Devil's Own), holding a major's commission from rounding district and no introduction could be traced, but 1869 to 1877, having been one of those who organized it for several months in the previous autumn diarrhea had in 1860, and having then been given a commission as a prevailed in the asylum. The sewage from the establishcaptain. In a profession largely filled by university men ment was disposed of on a farm, and the effluent passed such a record was not likely to be forgotten. Sir Joseph into the river Saale above the intake of the water-supply Chitty married in 1858 Clara Jessie, daughter of Chief for the asylum. Thus a circulation of morbid material Baron Pollock, and left children who can thus claim through the persons of the inmates was established. Dr descent from two of the best-known legal families of the Arndt's theory was that by virtue of this circulation 19th century.

cholera was gradually developed from previously existing AUTHORITIES.— The Times, 16th February 1899.- Law Jour- intestinal disease of an allied but milder type. The outnal, 18th February 1899. — Law Times, 18th February 1899. break occurred in winter, and coincided with the freezing of -Law Quarterly, vol. xv. p. 128.Law Magazine, vol. xxv. the filter-beds at the water-works. The theory is worth

(E. A. AR.) notice, because a similar relation between the drainage and Choisy-le-Roi, a town in the arrondissement of the water - supply frequently exists in places severely Sceaux, department of Seine, France, 4 miles in direct attacked by cholera, and it has repeatedly been observed line S.E. of Paris, on the left bank of the Seine and on that the latter is preceded by the prevalence of a milder the railway to Orleans. A monument was erected in form of intestinal disease. The inference is not that 1882 to Rouget de l'Isle, author of the “Marseillaise,” who cholera can be developed de novo, but that the type is died here 1836. It has manufactures of cloth, felt, gloves, unstable, and that a virulent form may be evolved under earthenware, porcelain, and glass, and considerable river favourable conditions from another so mild as to be untrade. Population (1881), 6700; (1901), 11,287.

recognized, and consequently undetected in its origin or

introduction. This is quite in keeping with the observed Cholera.-Much light has been thrown upon Asiatic variability of the micro-organism, and with the trend of cholera since 1880. Western experience has been enlarged modern research with regard to the relations between by several epidemic outbreaks in different countries, and other pathogenic germs and the multifarious gradations of by one pandemic visitation of great violence; and the type assumed by other zymotic diseases. The same thing study of the disease by modern methods has resulted in has been suggested of diphtheria. important additions to our previous knowledge of its Cholera is endemic in the East over

a wide area, nature, causation, mode of dissemination, and prevention. ranging from Bombay to Southern China, but its chief The cause is a micro-organism identified by Koch in home is British India. It principally affects the

Epidem1883. An account of it will be found under PATHOLOGY alluvial soil near the mouths of the great rivers, icity.

(Parasitic Diseases). For some years it was and more particularly the delta of the Ganges. Causation.

called the "comma bacillus,” from its supposed Lower Bengal is pre-eminently the standing focus and resemblance in shape to a comma, but it was subsequently centre of diffusion. In some years it is quiescent, found to be a vibrio or spirillum, not a bacillus. The dis- though never absent; in others it becomes diffused, for covery was received with much scepticism in some quarters, reasons of which nothing is known, and its diffusive and the claim of Koch’s vibrio to be the true cause of cholera activity varies greatly from equally inscrutable causes. was long disputed, but is now universally acknowledged. At irregular intervals this property becomes so heightened Few micro-organisms have been more elaborately in- that the disease passes its natural boundaries and is vestigated, but very little is known of its natural history, carried east, north, and west, it may be to Europe or and its epidemiological behaviour is still surrounded by beyond to the American continent. We must assume

p. 257.

that the micro-organism, like those of other epidemic | such invasions are mentioned in the article in the ninth diseases, acquires greater vitality and toxic energy, or edition of the Encyclopædia—those of 1830-39, 1847-49, greater power of reproduction at some times than at 1853-54, and 1865-67—but by some writers the epidemic others, but the conditions that govern this behaviour are of 1853 is regarded as a recrudescence of that of 1817. quite unknown, though no problem has a more important The earlier ones followed the land route by way of bearing on public health. Bacteriology, as already in Afghanistan and Persia, and took several years to reach timated, has thrown no light upon it, nor has meteorology. Europe. That of 1865 travelled more rapidly, being Some results of modern research, indeed, tend to assign carried from Bombay by sea to Mecca, from there to Suez increasing importance to the relations between surface soil and Alexandria, and then on to various Mediterranean and certain micro-organisms, and suggest that changes in ports. Within the year it had not only spread extensively the level of the subsoil water, to which Pettenkofer long in Europe, but had reached the West Indies. In 1866 it ago drew attention, may be a dominant factor in determin- invaded England and the United States, but during the ing the latency or activity of pathogenic germs. But this following year it died down in the West. The subsequent is largely a matter of conjecture, and, so far as cholera is history of cholera in Europe may be stated chronologically. concerned, the conditions which turn an endemic into an 1869 - 74.—This invasion was traced to the great epidemic diease must be admitted to be still unknown. gathering of pilgrims at Hardwar on the Upper Ganges

On the other hand, the mode of dissemination is now in the month of April 1867. From there the returning well understood. Diffusion takes place along the lines of pilgrims carried it to the Punjab, Cashmere, and Afghanhuman intercourse. The poison is carried chiefly by in- istan, whence it spread to Persia and the Caspian, but it fected persons moving from place to place; but soiled did not reach Russia until 1869. During the next four clothes, rags, and other articles that have come into con- years a number of outbreaks occurred in Central Europe, tact with persons suffering from the disease may be the and notably one at Munich in the winter of 1873. The means of conveyance to a distance. There is no reason to irregular character of these epidemics suggests that they suppose that it is air-borne, or that atmospheric influences were rather survivals from the pandemic wave of 1867 have anything to do with its spread, except in so far as than fresh importations, but there is no doubt that cholera meteorological conditions may be favourable to the growth was carried overland into Russia in the manner described. and activity of the micro-organisms. Beyond all doubt, 1883-87.—This visitation, again, came by the Mediterthe great manufactory of the poison is the human body, ranean. In 1883 a severe outbreak occurred in Egypt, and the discharges from it are the great source of con- causing a mortality of above 25,000. Its origin remained tagion. They may infect the ground, the water, or the unknown. During this epidemic Koch discovered the immediate surroundings of the patient, and so pass from comma bacillus. The following year

cholera appeared at hand to hand, the poison finding entrance into the bodies Toulon. It was said to have been brought in a troopship of the healthy by means of food and drink which have from Saigon in Cochin China, but it may have been conbecome contaminated in various ways. Flies which feed nected with the Egyptian epidemic. A severe outbreak upon excreta and other foul matters may be carriers of followed and reached Italy, nearly 8000 persons dying in contagion. Of all the means of local dissemination, con- Naples alone. In 1885 the south of France, Italy, Sicily, taminated water is by far the most important, because it and Spain all suffered, especially the last, where nearly affects the greatest number of people, and this is par- 120,000 deaths occurred. Portugal escaped, and the ticularly the case in places which have a public water- authorities there attributed their good fortune to the instisupply. A single contaminated source may expose the tution of a military cordon, in which they have had implicit entire population to danger. All severe outbreaks of an confidence ever since. In 1886 the same countries suffered explosive character are due to this cause. It is also again, and also Austria-Hungary. From Italy the disease possible that the cholera poison multiplies rapidly in was carried to South America, and even travelled as far as water under favourable conditions, and that a reservoir, Chile, where it had previously been unknown. In 1887 it for instance, may form a sort of forcing - bed. But it still lingered in the Mediterranean, causing great mortality would be a mistake to regard cholera as purely a water- in Messina especially. According to Dr Wall

, this epidemic borne disease, even locally. It may infect the soil in cost 250,000 lives in Europe and at least 50,000 in localities which have a perfectly pure water supply, but America. A particular interest attaches to it in the fact

have defective drainage or no drainage at all, and then it that a localized revival of the disease was caused in Spain will be found more difficult to get rid of, though less for- in 1890 by the disturbance of the graves of some of the midable in its effects, than when the water alone is the victims who had died of cholera four years previously. source of mischief. In all these respects it has a great 1892-95.—This great invasion reverted again to the old affinity to enteric fever. With regard to locality, no overland route, but the march of the disease was of situation can be said to be free from attack if the unprecedented rapidity. Within less than five months it disease is introduced and the sanitary conditions are travelled from the North-West Provinces of India to St bad; but, speaking generally, low-lying places on alluvial Petersburg, and probably to Hamburg, and thence in a few soil near rivers are more liable than those standing high days to England and the United States. This speed, in or on a rocky foundation. Of meteorological conditions it such striking contrast to the slow advance of former can only be said with certainty that a high temperature occasions, was attributed, and no doubt rightly, to imfavours the development of cholera, though a low one does proved steam transit, and particularly the Transcaspian not prevent it. In temperate climates the summer months, railway. The progress of the disease was traced from and particularly August and September, are the season of place to place, and almost from day to day, with great its greatest activity.

precision, showing how it moves along the chief highways Cholera spreads westwards from India by two routes- and is obviously carried by man. The main facts are as (1) by sea to the shores of the Red Sea, Egypt, and the follows :—Cholera was extensively and severely prevalent

Mediterranean; and (2) by land to Northern in India in 1891, causing 601,603 deaths, the highest Western diffusion.

India and Afghanistan, thence to Persia and mortality since 1877. In March 1892 it broke out at the

Central Asia, and so to Russia. In the great Hardwar fair, a day or two before the pilgrims dispersed; invasions of Europe during the 19th century it some- on 19th April it was at Kabul, on 1st Vay at Herat, times followed one route and sometimes the other. Four | and 26th May at Meshed. From Meshed it moved in

S. III. 7


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 or pedestrians were seen in the streets. At the cemetery, Asia, and north-west, by the same line in the opposite which lies about 10 miles from the town, some hundreds direction, to Uzun-ada on the Caspian Sea. It reached of men were engaged day and night digging long trenches Uzun-ada on 6th June; crossed to Baku, 18th June; to hold double rows of coffins, while the funerals formed Astrakhan, 24th June; then up the Volga to Nijni an almost continuous procession along the roads; even so Novgorod, arriving at Moscow and St Petersburg early in the victims could not be buried fast enough, and their August. The part played by steam transit is clear from bodies lay for days in sheds hastily run up as mortuaries. the fact that the disease took no longer to travel all the Hamburg had been attacked by cholera on fourteen way from Meshed to St Petersburg by rail and steamboat previous occasions beginning with 1831, but the mortality than to traverse the short distance from Meshed to had never approached that of 1892; in the worst year, Tehran by road. On 16th August cases began to occur which was 1832, there were only 3687 cases and 1765 in Hamburg ; on 19th August a fireman was taken ill at deaths. The disease was believed to have been introduced Grangemouth in Scotland, where he had arrived the day by Jewish emigrants passing through on their way from before from Hamburg; and on 31st August a vessel Russia, but the importation could not be traced. The reached New York from the same port with cholera on Jews were segregated and kept under careful supervision board. On 8th September the disease appeared in from the middle of July onwards, and no recognized case Galicia, having moved somewhat slowly westwards across occurred among them. The total number of places in Russia into Poland, and on 26th September it was in Germany in which cholera appeared in 1892 was 269, Budapest. Holland and Servia were also attacked, while but it took no serious hold anywhere save in Hamburg. isolated cases were carried to Norway, Denmark, and The distribution was chiefly by the waterways, which seem Italy. Meanwhile two entirely separate epidemics were in to affect a larger number of places than the railways as progress elsewhere. The first was confined to Arabia and carriers of cholera. In Paris 907 persons died, and in the Somali coast of Africa, and was connected with the Havre 498. Between 18th August and 21st October remains of an outbreak in Syria and Arabia in 1890-91. 38 cases were imported into England and Scotland through The second arose mysteriously in France about the time eleven different ports, but the disease nowhere obtained a when the overland invasion started from India. The footing. Seven vessels brought 72 cases to the United first known case occurred in the prison at Nanterre, near States, and 16 others occurred on shore, but there was no Paris, on 31st March. Paris was affected in April, and further dissemination. Havre in July. The origin of this outbreak, which was of During the winter of 1892-93 cholera died down, but a much less violent character than that which came never wholly ceased in Russia, Germany, Austria-Hungary, simultaneously by way of Russia, was never ascertained. and France. With the return of warm weather it showed Its activity was confined to France, particularly in the renewed activity, and prevailed extensively throughout neighbourhood of Paris, together with Belgium and Europe. The recorded mortality for the principal Holland, which was placed between two fires, but escaped countries was as follows :-Russia (chiefly western prowith but little mortality. The number of persons killed vinces), 41,047; Austria-Hungary, 4669; France, 4000; by cholera in 1892, outside of India, was reckoned at Italy, 3036; Turkey, 1500; Germany, 298; Holland, 378,449, and the vast majority of those died within six 376; Belgium, 372, England, 139. Hardly any country months. The countries which suffered most severely were escaped altogether; but Europe suffered less than Arabia, as follows:— European Russia, 151,626; Caucasus, Mesopotamia, and Persia. Cholera broke out at Mecca in

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 ; number of pilgrims caused an appalling mortality. The chief Somaliland, 10,000; Afghanistan, 7000; Germany, shereef estimated the mortality at 50,000. The pilgrims 9563; France, 4550; Hungary, 1255; Belgium, 961. carried the disease to Asia Minor and Constantinople. In Curiously enough, the south of Europe, which had been Persia also a recrudescence took place and provedenormously the scene of the previous epidemic visitation, escaped. destructive. Dr Barry estimated the mortality at 70,000. The disease was of the most virulent character. In At Hamburg, where new waterworks had been installed European Russia the mortality was 45.8 per cent. of the with sand filtration, only a few sporadic cases occurred cases, the highest rate ever known in that country; in until the autumn, when a sudden but limited rush took Germany it was 51.3 per cent.; and in Austria-Hungary, place, which was traced to a defect in the masonry per57:5 per cent. Of all the localities attacked, the case of mitting unfiltered Elbe water to pass into the mains. In Hamburg was the most remarkable. The presence of England cholera obtained a footing on the Humber at cholera was first suspected on 16th August, when two Grimsby, and to a lesser extent at Hull, and isolated attacks cases occurred, but it was not officially declared until 23rd occurred in some 50 different localities. Excluding a few August. By that time the daily number of victims had ship-borne cases, the registered number of attacks was already risen to some hundreds, while the experts and 287, with 135 deaths, of which 9 took place in London. authorities were making up their minds whether they had It is interesting to compare the mortality from cholera in cholera to deal with or not. Their decision eventually England and Wales, and in London, for each year in which came too late and was superfluous, for by 27th August it has prevailed since registration began : the people were being stricken down at the rate of 1000

England and Wales. a day. This rate was maintained for four days, after

Deaths per 10,000

Deaths per 10,000 which the vehemence of the pestilence began to abate.

living. It gradually declined, and ceased on 14th November.

| 1848 1,908


652 During those three months 16,956 persons were attacked

2.9 53,293 30-3

14,137 61.8 and 8605 died, the majority within the space of a few



3.5 weeks. The town, ordinarily one of the gayest places of 71854 20,097


10,738 business and pleasure on the Continent, became a city of

| 1865 1,297



0.6 the dead. Thousands of persons fled, carrying the disease

| 1866 14,378


| 1893

0.05 into all parts of Germany; the rest shut themselves

7 1894

nil indoors; the shops were closed, the trams ceased to run,













In 1894 no deaths from cholera were recorded in The substitution of the procedure above described for England, but on the Continent it still prevailed over a the old measures of quarantine, and other still more drastic wide area.

In Russia over 30,000 persons died of it, in interferences with traffic, presupposes the existence of a Germany about 500, but the most violent outbreak was in sanitary service and fairly good sanitary conditions if Galicia, where upwards of 8000 deaths were registered. cholera is to be effectually prevented. No doubt if In 1895 it still lingered, chiefly in Russia and Galicia, sanitation were perfect in any place or country, cholera, but with greatly diminished activity. In that year along with many other diseases, might there be ignored, Egypt, Morocco, and Japan were attacked, the last but sanitation is not perfect anywhere, and therefore it severely. Since then cholera has been in abeyance until requires to be supplemented by a system of notification the severe epidemic in India in 1900.

with prompt segregation of the sick and destruction of The great invasion just described was fruitful in lessons infective material. These things imply a regular organizafor the prevention of cholera. It proved that the one tion, and it is to the public health service of Great Britain

real and sufficient protection lies in a standing that the complete mastery of cholera has mainly been due Preven

condition of good sanitation backed by an in recent years, and particularly in 1893. Of sanitary

efficient and vigilant sanitary administration. conditions the most important is unquestionably the waterThe experience of Great Britain was a remarkable piece supply. So many irrefragable proofs of this fact were of evidence, but that of Berlin was perhaps even more given during 1892-93 that it is no longer necessary to striking, for Berlin lay in the centre of four fires, in direct refer to the time-honoured case of the Broad Street pump. and frequent communication with Hamburg, Russia, At Samarkand three regiments were encamped side by France, and Austria, and without the advantage of a side on a level plain close to a stream of water. The sea frontier. Cholera was repeatedly brought into Berlin, colonel of one regiment took extraordinary precautions, but never obtained a footing, and its successful repression placing a guard over the river, and compelling his men to was accomplished without any irksome interference with use boiled water even for washing. Not a single case of traffic or the ordinary business of life. The general cholera occurred in that regiment, while the others, in success of Great Britain and Germany in keeping cholera in which only ordinary precautions were taken, lost over check by ordinary sanitary means completed the conver- 100 men. At Ashkabad the cholera had almost disappeared, sion of all enlightened nations to the policy laid down so when a banquet was given by the governor in honour of far back as 1865 by Sir John Simon, and advocated by the Czar's name-day. Of the guests one-half died within Great Britain at a series of international congresses—the twenty-four hours ; a military band, which was present, lost policy of abandoning quarantine, which Great Britain did 40 men out of 50; and one regiment lost half its men and in 1873, and trusting to sanitary measures with medical | 9 officers. Within forty-eight hours 1300 persons died out of inspection of persons arriving from infected places. This a total population of about 13,000. The water supply came

principle was formally adopted at the international con- from a small stream, and just before the banquet a heavy ference held at Dresden in 1893, at which a convention rain-storm had occurred, which swept into the stream all was signed by the delegates of Germany, Austria, Belgium, surface refuse from an infected village higher up and some France, Great Britain, Italy, Russia, Switzerland, Luxem- distance from the banks. But the classical example was burg, Montenegro, and the Netherlands. Under this Hamburg. The water-supply is obtained from the Elbe, instrument the practice is broadly as follows, though the which became infected by some means not ascertained. procedure varies a good deal in different countries :—Ships The drainage from the town also runs into the river, and arriving from infected ports are inspected, and if healthy the movement of the tide was sufficient to carry the are not detained, but bilge-water and drinking-water are sewage matter up above the water-intake.

The water evacuated, and persons landing may be placed under itself, which is no cleaner than that of the Thames at medical supervision without detention; infected ships are London Bridge, underwent no purification whatever before detained only for purposes of disinfection; persons suffer- distribution. It passed through a couple of ponds, ing from cholera are removed to hospital ; other persons supposed to act as settling tanks, but owing to the landing from an infected ship are placed under medical growth of the town and increased demand for water, it observation, which may mean detention for five days from was pumped through too rapidly to permit of any the last case, or, as in. Great Britain, supervision in their subsidence. Eels and other fish constantly found their own homes, for which purpose they give their names and way into the houses, while the mains were lined with places of destination before landing. All goods are freed vegetation and crustacea. The water-pipes of Hamburg from restrictions, except rags and articles believed to be had a peculiar and abundant fauna and flora of their own, contaminated by cholera matters. By land, passengers and the water they delivered was commonly called Fleischfrom infected places are similarly inspected at the frontiers brühe, from its resemblance to thick soup. On the other and their luggage “disinfected ”—in all cases a pious hand, at Altona, which is continuous with Hamburg, the ceremony of no practical value, involving a short but often water was filtered through sand. In all other respects the vexatious delay; only those found suffering from cholera conditions were identical, yet in Altona only 328 persons can be detained. Each nation is pledged to notify the died, against 8605 in Hamburg. In some streets one side others of the existence within its own borders of a “foyer” lies in Hamburg, the other in Altona, and cholera stopped of cholera, by which is meant a focus or centre of at the dividing line, the Hamburg side being full of cases infection. The precise interpretation of the term is left and the Altona side untouched. In the following year, to each Government, and is treated in a rather elastic when Hamburg had the new filtered supply, it enjoyed fashion by some, but it is generally understood to imply equal immunity, save for a short period when, as we have the occurrence of non-imported cases in such a manner as said, raw Elbe water accidentally entered the mains. to point to the local presence of infection. The question But water, though the most important condition, is not of guarding Europe generally from the danger of diffusion the only one affecting the incidence of cholera. The case by pilgrims through the Red Sea was settled at another of Grimsby furnished a striking lesson to the contrary. conference held in Paris in 1894. The provisions agreed Here the disease obtained a decided hold, in spite of a on included the inspection of pilgrims at ports of departure, pure water-supply, through the fouling of the soil by detention of infected or suspected persons, and supervision of cesspits and defective drainage. At Havre also its pilgrim ships and of pilgrims proceeding overland to Mecca. prevalence was due to a similar cause. Further, it was

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