Page:Tropical Diseases.djvu/498

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Section III.— ABDOMINAL DISEASES

CHAPTER XXVIII

CHOLERA

Definition.— An acute, infectious, epidemic disease, characterized by profuse purging and vomiting of a colourless serous material, muscular cramps, suppression of urine, algidity and collapse, the presence of a special bacterium in the intestine and intestinal discharges, and a high mortality.

History and geographical distribution.— It is probable that from remotest antiquity cholera has been endemic in Lower Bengal,*[1] and that thence, from time to time, it has spread as an epidemic over the rest of India. European physicians observed it there in the sixteenth, seventeenth, and eighteenth centuries, but it was not until the great epidemic extension of 1817 that the disease seriously attracted the attention of the profession in Europe. In that year cholera began to spread all over Asia, extending eastwards as far as Pekin and Japan, southwards to Mauritius, and westwards to Syria and the eastern shores of the Caspian. Stopping short at Astrakhan in 1825, it did not on that occasion invade Europe.

European epidemics.— In 1830 cholera visited Europe for the first time. Advancing through Afghanistan and Persia, it entered by way of Russia, and swept as an epidemic over nearly the entire continent, reaching Britain at the beginning

  1. * Though it is customary to speak of Lower Bengal as the home of cholera, it is by no means certain that other Eastern localities have not some claim to a similar distinction— Bangkok, Canton, and Shanghai, for example. Dr. Henderson, in his health reports, indicates that the disease is rarely absent during the summer months from the last-named city; the same may be said of Bangkok and of Canton.