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and several times the disease has 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 sea-port towns to which
such infected persons were admitted. The general history
of these epidemics, so far at least as relates to England, has
been that isolated outbreaks occurred in the autumn of
the first year, that the disease died out with the approach
of winter, and re-appeared Avith virulence in the later
spring, summer, or early autumn of the second year, lasting
for some two or three months, and then disappearing
altogether. It might seem from this that its prevalence
was largely determined by season; and, indeed, there is
strong evidence to show that on the whole high temperature
is favourable, and cold inimical, to its spread. Yet, on the
other hand, the disease has prevailed with the greatest
severity in Moscow, Sweden, and other northern regions in
the depth of winter.
To what cause or causes Epidemic Cholera is due is a
question which has been the subject of innumerable discussions
and investigations. The horror which the disease
occasions, the slowness yet certainty of its onward march,
its sudden and capricious outbreaks, and its equally
capricious subsidence and then total disappearance, all