es 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 Mediterrane