"The disease was not known in this country (England) till the autumn of the year 1831. There are persons, I am aware, who hold that it has always existed among us; only not in such numerous instances as at that period; and they appeal to Morton and other early writers on the diseases of this country, in the support of their opinion. But the malady was too striking to be overlooked or ever forgotten, by any one who had once seen it. Certainly, till that year, I never saw anything like it. The late Br. William Babington told me that it was quite new to him. He had, for a very long period, been in extensive practice in those parts of the metropolis and its vicinity where the epidemic Cholera raged most; and when it first came among us he had the curiosity to ask every medical man he met whether he had seen any case of the Cholera; and, if the answer were ' yes,' he went on to inquire whether before that year, the person had ever met with the same complaint; and the reply was always, without a single exception,' no.'

"But we have evidence of a different kind of the newness of the epidemic Cholera to these kingdoms. Its approach was discerned afar off, as distinctly as a storm is foreseen by the rising of the clouds from the horizon in the direction of the wind. The disorder began to rage with terrible severity, in the Delta of the Granges, in the year 1817. I do not mean that it then broke out there for the first time. It had again and again desolated those regions before. But from its irruption in the year I have mentioned, when it committed frightful devastation in our armies in the north-eastern districts of India, its course can be distinctly traced to our own shores; towards which it approached with slow and halting, but with sure steps, in a north-western direction. From India it spread to Persia; from thence to Russia; and across through Poland to Germany; and at length it was found at Hamburg. It was predicted before that time that the distemper would at length reach Great Britain. Our Government had even sent two physicians (Drs. Barry and Russell) into Russia to meet it, and to investigate its nature, in the fearful anticipation that its march across the earth would continue progressive; and accordingly, at the expiration of fourteen years, it made its appearance on the eastern coast of this country, in Sunderland, and in due time extended over every part of these islands. I say its arrival had been foreseen and foretold; and it is absurd to suppose that a vast number of persons would fall sick and die, with symptoms quite strange to the great mass of practitioners here, merely to fulfil this prediction.

"The progress of the disorder did not end here. Crossing the Atlantic, it invaded America; turning at the same time, in a south-easternly direction, it ravaged Prance and Spain, and the north coast of Africa, and Italy.

"Moving thus onward,as it did, in defiance of all natural and artificial barriers, under opposite extremes of season, temperature and climate, in the teeth of adverse winds, over lofty mountain chains, across wide seas, though ' hot, cold, moist and dry,' in what manner was this wasting pestilence propagated?

" Upon this question various and discordant opinions are entertained. Many persons believe that the complaint spread by contagion; more, however, that it was not contagious at all, but arose from some deleterious cause with which the general atmosphere of the place was pregnant.

"Dr. Condie says:' During the prevalence of the Cholera in Philadelphia, in 1832, we closely investigated every fact calculated to throw light upon the question of its contagious or non-contagious character, and for this investigation, our position in the Hoard of Health and as chief of a large Hospital, afforded us ample opportunities, but we were unable to discover the slightest evidence of the disease having been, in any one instance, communicated from the sick to the well. And yet there are many curious facts upon record which would seem to give countenance to the idea suggested by Dr. Watson, that the aerial poison productive of epidemic Cholera may be conveyed from one spot to another, by persons who are themselves proof against its effects, or who, at any rate, were unaffected by it.'

"Whatever obscurity may overhang the exciting causes of the epidemic Cholera, we are quite sure that certain circumstances exercised a strong predisposing influence upon the human body, to render it more than usually susceptible of the disease. The predisposing causes, as might well be imagined, were such as tended to debilitate the system; and therefore poverty, which implies scanty nourishment, and frequently also the confinement of several persons to a narrow space, and the want of fresh air,-poverty, which includes these and other evils, was found to predispose the body to a ready reception of the malady. But to intemperance, more than to any other single cause, may the liability to become affected by this species of Cholera be ascribed; and especially to the intemperate and habitual use of distilled spirits. This fact was peculiarly manifested in the selection by the disease of its victims in this country; and it has been remarked almost everywhere else. Nevertheless, men the most sound and vigorous were liable to take, and to succumb to the disorder.

"The epidemic Cholera made its attack in two different modes. In one, it seized upon the patient suddenly, and without warning. This was comparatively rare. Much more commonly the specific symptoms were preceded, for some little time, even for some days, perhaps, by painless diarrhoea. And this I take to have been the most important practical fact that was ascertained during its first prevalence among us. When the disease was once fairly formed, medicine had very little power over it, but in the preliminary stage of diarrhoea, it was more easily manageable. Unfortunately people are inclined, especially those classes of the community among whom the Cholera most raged, to regard a loose state of the bowels as salutary; and to make no complaint of it, and to do nothing for it. The proper plan of proceeding, I am convinced, was to arrest the diarrhoea as soon as possible after its commencement."