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192
were imported into Sunderland, and the disease
remained endemic in this country for fourteen
months. Having thus reached the north-western
angle of Europe, the epidemic divided into two
branches, one of which crossed the Atlantic and
appeared in Quebec in 1832, thence diffusing itself
over the North American continent; the other
turned southwards, attacking successively France,
Spain, Italy, and the Northern coast of Africa.
The disease did not finally leave Europe until the
year 1837. Since the epidemic of 1817, numerous
other epidemics have occurred in India, and several
times the disease has slowly spread thence to
Europe and to this country: not, however, always
taking the same route as on the first occasion.
The first British epidemic was that above
referred to, of 1831-32, the second occurred in
1848-49, the third in 1853-54, and the last in
1865-66. On each of these occasions the disease
was distinctly imported into this country by passengers
or sailors coming direct from infected places,
and its general prevalence was always preceded by
local outbreaks in the seaport towns to which
such infected visitors were admitted. The general
history ot these epidemics, so far at least as relates
to England, has been that isolated outbreaks