anomalies and curiosities of medicine-第227部分

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he　cow　to　a　similar　affection　of　the　horse's　heel。〃

This　publication　produced　a　great　sensation　in　the　medical　world；　and　vaccination　spread　so　rapidly　that　in　the　following　summer　Jenner　had　the　indorsement　of　the　majority　of　the　leading　surgeons　of　London。　Vaccination　was　soon　introduced　into　France；　where　Napoleon　gave　another　proof　of　his　far…reaching　sagacity　by　his　immediate　recognition　of　the　importance　of　vaccination。　It　was　then　spread　all　over　the　continent；　and　in　1800　Dr。　Benjamin　Waterhouse　of　Boston　introduced　it　into　America；　in　1801；　with　his　sons…in…law；　President　Jefferson　vaccinated　in　their　own　families　and　those　of　their　friends　nearly　200　persons。　Quinan　has　shown　that　vaccination　was　introduced　into　Maryland　at　least　simultaneously　with　its　introduction　into　Massachusetts。　De　Curco　introduced　vaccination　into　Vienna；　where　its　beneficial　results　were　displayed　on　a　striking　scale；　previously　the　average　annual　mortality　had　been　about　835；　the　number　now　fell　to　164　in　1801；　61　in　1802；　and　27　in　1803。　After　the　introduction　of　vaccination　in　England　the　mortality　was　reduced　from　nearly　3000　per　million　inhabitants　annually　to　310　per　million　annually。　During　the　small…pox　epidemic　in　London　in　1863；　Seaton　and　Buchanan　examined　over　50；000　school　children；　and　among　every　thousand　without　evidences　of　vaccination　they　found　360　with　the　scars　of　small…pox；　while　of　every　thousand　presenting　some　evidence　of　vaccination；　only　1。78　had　any　such　traces　of　small…pox　to　exhibit。　Where　vaccination　has　been　rendered　compulsory；　the　results　are　surprising。　In　1874　a　law　was　established　in　Prussia　that　every　child　that　had　not　already　had　small…pox　must　be　vaccinated　in　the　first　year　of　its　life；　and　every　pupil　in　a　private　or　public　institution　must　be　revaccinated　during　the　year　in　which　his　or　her　twelfth　birthday　occurs。　This　law　virtually　stamped　small…pox　out　of　existence；　and　according　to　Frolich　not　a　single　death　from　small…pox　occurred　in　the　German　army　between　1874　and　1882。　Notwithstanding　the　arguments　advanced　in　this　latter　day　against　vaccination；　the　remembrance　of　a　few　important　statistic　facts　is　all　that　is　necessary　to　fully　appreciate　the　blessing　which　Jenner　conferred　upon　humanity。　In　the　last　century；　besides　the　enormous　mortality　of　small…pox　（it　was　computed　that；　in　the　middle　of　the　last　century；　2；000；000　victims　perished　in　Russia　from　small…pox）；　the　marks　of　affliction；　blindness；　deafness；　etc。；　were　plain　in　at　least　one　member　of　every　family。

Asiatic　cholera　probably　originated　centuries　ago　in　India；　where　it　is　now　endemic　and　rages　to　such　an　extent　as　to　destroy　750；000　inhabitants　in　the　space　of　five　years。　There　is　questionable　evidence　of　the　existence　of　cholera　to　be　found　in　the　writings　of　some　of　the　classic　Grecian　and　Indian　authors；　almost　as　far　back　as　the　beginning　of　the　Christian　era。　In　the　sixteenth　and　seventeenth　centuries　travelers　in　the　East　gave　accounts　of　this　disease。　Sonnerat；　a　French　traveler；　describes　a　pestilence　having　all　the　characteristics　of　Asiatic　cholera　which　prevailed　in　the　neighborhood　of　Pondicherry　and　the　Coromandel　coast　from　1768　to　1769；　and　which；　within　a　year；　carried　off　60；000　of　those　attacked。　According　to　Rohe；　Jasper　Correa；　an　officer　in　Vasco　da　Gama's　expedition　to　Calicut；　states　that　Zamorin；　the　chief　of　Calicut；　lost　20；000　troops　by　the　disease。　Although　cholera　has　frequently　extended　to　Europe　and　America；　its　ravages　have　never　been　nearly　as　extensive　as　in　the　Oriental　outbreaks。　An　excellent　short　historic　sketch　of　the　epidemics　of　the　cholera　observed　beyond　the　borders　of　India　has　been　given　by　Rohe。　In　1817　cholera　crossed　the　boundaries　of　India；　advancing　southeasterly　to　Ceylon；　and　westerly　to　Mauritius；　reaching　the　African　coast　in　1820。　In　the　following　two　years　it　devastated　the　Chinese　Empire　and　invaded　Japan；　appearing　at　the　port　of　Nagasaki　in　1822。　It　advanced　into　Asiatic　Russia；　and　appeared　as　far　east　as　St。　Petersburg　in　1830；　from　whence　it　spread　north　to　Finland。　In　1831　it　passed　through　Germany；　invading　France　and　the　western　borders　of　Europe；　entering　the　British　Isles　in　1832；　and　crossing　the　Atlantic　Ocean　for　the　first　time；　appeared　in　Canada；　having　been　carried　thence　by　some　Irish　emigrants。

From　Canada　it　directly　made　its　way　to　the　United　States　by　way　of　Detroit。　In　the　same　year　（1832）　it　appeared　in　New　York　and　rapidly　spread　along　the　Atlantic　coast。

〃During　the　winter　of　1832　it　appeared　at　New　Orleans；　and　passed　thence　up　the　Mississippi　Valley。　Extending　into　the　Indian　country；　causing　sad　havoc　among　the　aborigines；　it　advanced　westward　until　its　further　progress　was　stayed　by　the　shores　of　the　Pacific　Ocean。　In　1834　it　reappeared　on　the　east　coast　of　the　United　States；　but　did　not　gain　much　headway；　and　in　the　following　year　New　Orleans　was　again　invaded　by　way　of　Cuba。　It　was　again　imported　into　Mexico　in　1833。　In　1835　it　appeared　for　the　first　time　in　South　America；　being　restricted；　however；　to　a　mild　epidemic　on　the　Guiana　coast。

〃In　1846　the　disease　again　advanced　beyond　its　natural　confines；　reaching　Europe　by　way　of　Turkey；　in　1848。　In　the　autumn　of　this　year　it　also　appeared　in　Great　Britain；　Belgium；　the　Netherlands；　Sweden；　and　the　United　States；　entering　by　way　of　New　York　and　New　Orleans。　In　the　succeeding　two　years　the　entire　extent　of　country　east　of　the　Rocky　Mountains　was　invaded。　During　1851　and　1852　the　disease　was　frequently　imported　by　emigrants；　who　were　annually　arriving　in　great　numbers　from　the　various　infected　countries　of　Europe。　In　1853　and　1854　cholera　again　prevailed　extensively　in　this　country；　being；　however；　traceable　to　renewed　importation　of　infected　material　from　abroad。　In　the　following　two　years　it　also　broke　out　in　numerous　South　American　States；　where　it　prevailed　at　intervals　until　1863。　Hardly　had　this　third　great　pandemic　come　to　an　end　before　the　disease　again　advanced　from　the　Ganges；　spreading　throughout　India；　and　extending　to　China；　Japan；　and　the　East　Indian　Archipelago；　during　the　years　1863　to　1865。　In　the　latter　year　it　reached　Europe　by　way　of　Malta　and　Marseilles。　It　rapidly　spread　over　the　Continent；　and　in　1866　was　imported　into　this　country　by　way　of　Halifax；　New　York；　and　New　Orleans。　This　epidemic　prevailed　extensively　in　the　Western　States；　but　produced　only　slight　ravages　on　the　Atlantic　Coast；　being　kept　in　check　by　appropriate　sanitary　measures。　In　the　same　year　（1866）　the　disease　was　also　carried　to　South　America；　and　invaded　for　the　first　time　the　states　bordering　on　the　Rio　de　la　Plata　and　the　Pacific　coast　of　the　Continent。

〃Cholera　never　entirely　disappeared　in　Russia　during　the　latter　half　of　the　sixth　decade；　and　in　1870　it　again　broke　out　with　violence；　carrying　off　a　quarter　of　a　million　of　the　inhabitants　before　dying　out　in　1873。　It　spread　from　Russia　into　Germany　and　France　and　was　imported；　in　1873；　into　this　country；　entering　by　way　of　New　Orleans　and　extending　up　the　Mississippi　Valley。　None　of　the　Atlantic　coast　cities　suffered　from　this　epidemic　in　1873；　and　since　that　year　the　United　States　has　been　entirely　free　from　the　disease；　with　the　exception　of　a　few　imported　cases　in　New　York　harbor　in　1887〃　（and　in　1893）。　In　1883　an　epidemic　of　cholera　raged　in　Egypt　and　spread　to　many　of　the　Mediterranean　ports；　and　reappeared　in　1885　with　renewed　violence。　In　Spain　alone　during　this　latter　epidemic　the　total　number　of　cases　was　over　one…third　of　a　million；　with　nearly　120；000　deaths。　In　1886　cholera　caused　at　least　100；000　deaths　in　Japan。　In　the　latter　part　of　1886　cholera　was　carried　from　Genoa　to　Buenos　Ayres；　and　crossing　the　Andean　range　invaded　the　Pacific　coast　for　a　second　time。　In　Chili　alone　there　were　over　10；000　deaths　from　cholera　in　the　first　six　months　of　1887。　Since　then　the　entire　Western　hemisphere　has　been　virtually　free　from　the　disease。

In　1889　there　was　an　epidemic　of　cholera　in　the　Orient；　and　in　1892　and　1893　it　broke　out　along　the　shores　of　the　Mediterranean；　invading　all　the　lines　of　commerce　of　Europe；　Hamburg　in　the　North　and　Marseilles　in　the　South　being　especially　affected。　In　the　summer　of　1893　a　few　cases　appeared　in　New　York　Bay　and　several　in　New　York　city；　but　rigorous　quarantine　methods　prevented　any　further　spread。

Typhus　fever　is　now　a　rare　disease；　and　epidemics　are　quite　infrequent。　It　has　long　been　known　under　the　names　of　hospital…fever；　spotted…fever；　jail…fever；　camp…fever；　and　ship…fever；　and　has　been　the　regular　associate　of　such　social　disturbances　as　overcrowding；　excesses；　famine；　and　war。　For　the　past　eight　centuries　epidemics　of　typhus　have　from　time　to　time　been　noticed；　but　invariably　can　be　traced　to　some　social　derangement。

Yellow　Fever　is　a　disease　prevailing　endemically　in　the　West　Indies　and　certain　sections　of　what　was　formerly　known　as　the　Spanish　Main。　Guiteras　recognizes　three　areas　of　infection：

（1）　The　focal　zone　from　which　the　disease　is　never　absent；　including　Havana；　Vera　Cruz；　Rio；　and　the　other　various　Spanish…American　points。

（2）　The　perifocal　zone；　or　regions　of　periodic　epidemics；　including　the　ports　of　the　tropical　Atlantic　and　Africa。

（3）　The　zone　of　accidental　epidemics；　between　the　parallels　of　45　degrees　north　and　35　degrees　south　latitude。

In　the　seventeenth　century　Guadaloupe；　Dominica；　Martinique；　and　Barbadoes　suffered　from　epidemics　of　yellow　fever。　After　the　first　half　of　the　seventeenth　century　the　disease　was　prevalent　all　through　the　West　Indies。　It　first　appeared　in　the　United　States　at　the　principal　ports　of　Boston；　Philadelphia；　and　Charleston；　in　1693；　and　in　1699　it　reappeared　in　Philadelphia　and　Charleston；　and　since　that　time　many　invasions　have　occurred；　chiefly　in　the　Southern　States。

The　epidemic　of　1793　in　Philadelphia；　so　graphically　described　by　Matthew　Carey；　was；　according　to　Osler；　the　most　serious　that　has　ever　prevailed　in　any　city　of　the　Middle　States。　Although　the　population　of　the　city　was　only　40；000；　during　the　months　of　August；　September；　October；　and　November　the　mortality；　as　given　by　Carey；　was　4041；　of　whom　3435　died　in　the　months　of　September　and　October。　During　the　following　ten　years　epidemics　of　a　lesser　degree　occurred