a word, we should charge the Majesty of
Heaven with the cure of our own idleness,
and call that a visitation from God, which is
the result of human uncleanliness and
carelessness. Yet, in the face of all science and
of all fact, it is still asserted that disease is a
sign of Divine wrath, and not the consequence
of certain fixed physical laws. An easier
way of getting rid of responsibility and
trouble than even the castigation of saints.
What the fixed physical laws are, and how
they are to be dealt with, Dr. Southwood
Smith's Lectures on Epidemics will help us to
understand.

One unvarying character of epidemics is,
that they are all fevers. The Black Death
of the fourteenth century, an aggravated
form of the Oriental or Bubo plague, was a
fever, deriving its name from effusions of
black blood forming spots on the arms,
face, and neck. The Oriental Plague,
still in existence in Egypt and Eastern
Europe, and the Sweating Sickness of the
fifteenth and sixteenth centuries, were both
fevers; and even the cholera of the present
day, in the last or perfect stages of its development,
is a fever. All the ordinary
epidemics, such as typhus, scarlet fever,
measles, and small-pox, are recognised fevers.

A second likeness of epidemics with each
other is the extent of their rage. The Black
Death extended from China to Greenland,
desolating Asia, Europe, and Africa. The
Bubo Plague often left its own region to
spread westward and northward. In the
fifteenth century it spread seventeen times
over Europe to the most northerly countries.
The Sweating Sickness burst out simultaneously
in England, France, Germany, Prussia,
Poland, Russia, Norway, and Sweden. It
extended like a violent conflagration which
spread in all directions; yet the flames did
not issue from the focus, but rose up everywhere
as if self-ignited. The influenza of the
middle ages had a universal range; and, in
our own day, we have seen it in almost every
family of every city, then rush over the
whole of Europe and leap the Atlantic to
America. Alike in essential character, and
in the extent of their range, epidemics are
also alike in the rapidity of their course.
The cholera of eighteen hundred and thirty-
one extended in five days from Cairo, where
it first appeared, over the whole of Lower
Egypt; in eighteen hundred and thirty-
two it made a bound from London to Paris,
and in five days spread over four-fifths of the
city. The influenza of eighteen hundred and
forty-one flashed over London in one day, and
upwards of five hundred thousand were
struck. We have already seen that the
earlier epidemics were as rapid as they were
extensive.

Epidemics are generally preceded by two
signs. One is the influenza. The plague,
cholera, &c., have all been heralded by this
disease. The first attack of cholera in
England was preceded by an outbreak of
influenza, which resembled in the minutest
particular that which ushered in the mortal
Sweating Sickness of fifteen hundred and
seventeen; and the cholera of eighteen hundred
and forty-eight was preceded by the influenza
of eighteen hundred and forty-seven.
The other sign, Dr. Smith says, is " the general
transformation of the type of ordinary diseases
into the characteristic type of the approaching
pestilence."

Epidemics are periodical. The first appearance
of the Sweating Sickness was in fourteen
hundred and eighty-five. It spread over
England for a year, then disappeared. After
a lapse of twenty years it broke out again,
went over all its former haunts and after six
months died away. In eleven years it came
again, and again died away in six months;
a fourth time it returned after a sleep of
eleven years, continued six months, then
disappeared. Its fifth and last visitation was
after a period of twenty-three years. It raged
—as it had raged before—in six months,
as usual, disappeared; and, since then,—
this was in fifteen hundred and fifty-one,
—it has never been known in any country
whatsoever. The Oriental plague breaks out
in the East about every ten years; the
fever epidemics of London occur every ten or
twelve years; the Irish typhus epidemics
have been decennial visitations for the last
hundred and fifty years. Epidemic cholera
remained with us fifteen months, on its first
visitation. After sixteen years it broke out
again, for exactly fifteen months, as before.
Again— this time after only five years'
absence—it came for seventeen months;
coming earlier and staying longer than it
had done before. According to this rule we
may expect it again, after even a shorter
absence.

Epidemics are rapid in their effects. Death
generally occurs after a few hours: seldom,
if the disease can be protracted. The great
object of all modern treatment for cholera,
for instance, is to gain time; for, if the disease
does not kill at once, the patient will oftener
recover than die, after a prolonged attack.
It is the shock, rather than exhaustion, that
destroys.

Lastly, epidemics are alike in cause. What
may have produced one epidemic at one
period, will produce another at another
period: the difference consisting in the form
and name, not in the cause. Over-crowding,
filth, exhalations from foul sewers, rivers,
ditches, canals, &c., putrescent animal or
vegetable matter, impure drinking-water,
unwholesome meat, decayed vegetables, unsound
grain,—these are some of the predisposing
personal causes of epidemics, which make all
those living under such conditions more
likely to be attacked than those in healthier
circumstances. Of all predisposing causes
foul air ranks as chief. We have several
striking proofs of this in the late cholera.