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CHAPTER IV.

ON THE ORIGIN AND SPREAD OF THE ASIATIC CHOLERA WHICH REACHED THE UNITED STATES IN 1873.

BY JOHN C. PETERS, M. D., of New York City.

The late outbreak of Asiatic cholera in this country, which commenced in New Orleans in February, 1873, was preceded by a great prevalence of the disease in North Germany, Poland, Hungary, and Austria for at least three years, viz: in 1870, 1871, and 1872; and by extended outbreaks in Russia in 1869, 1870, 1871, and 1872; while it had also been present in Persia every year since 1865; and notably so in 1867, 1868, 1869, and 1870.

It is well known to be in operation in India, especially in the province of Bengal, every year; more particularly every third, sixth, ninth, and twelfth years, in connection with the great pilgrimages to Juggernaut, Hurdwar, and their affiliated shrines. The influence of the Juggernaut pilgrimages, or of the worshipers of Shiva, the Destroyer, can be traced from 1781 through the great twelve-year epidemics of 1817, 1829, 1841, 1853, and 1865 in India, stretching north to Calcutta and south to Madras, on the east coast of Hindostan; while the pressure of the adorers of Vishnu, the Preserver, to Hurdwar, in the north of India, and to numberless other sanctuaries, may be seen in the great outbreaks of 1819, 1831, 1843, 1855, and 1869, in India and adjacent places.

The great epidemic of 1865 issued from India, by way of Bombay, to Makallah, and from there up to Mecca by steamships; and was forwarded by Suez, Cairo, and Alexandria to the Mediterranean Sea, aud from thence by steamships to Beyroot and back to Damascus in Syria, towards Persia; also to Smyrna, and through Asia Minor again towards Persia. Also, from Alexandria to Constantinople, and from there east through the Black Sea to Trebizond, and down through Armenia, also toward Persia, from the northwest.

It was also forwarded from Bombay, up the Persian Gulf, to Bushire, and from there into Persia, by way of the south. And, finally, returning Persian pilgrims from Mecca carried it back to the Persian Gulf, to Bushire, and Bassorah, from the southwest. (See maps 1, 2, and 3.)

The presence, persistence, and recurring activity of cholera in Persia for so many years, viz, from 1865 to 1872, although paralleled by previ ous periods of equal continuance, led some observers, especially Dr. Tholozan, principal physician to the Shah, and director of the sanitary administration of Persia since 1813, to conclude that the disease had become naturalized there; and to hint that Persia, rather than India, was the source of the late epidemic in Europe and this country. The entire subsidence of cholera in Persia, however, since 1872, has now finally disproved that supposition; while all the best epidemiologists have again returned to their former conclusions, that the central position of Persia, between India and Europe, exposes it to frequent importation and invasion of cholera, which scarcely allows one outbreak to subside before another is introduced.