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the smaller towns and is spreading in the districts surroundingTultcha, Bacan and Kustendje.As regards Germany, it is noteworthy that, after a long

period of immunity, there has been a recrudescence of thedisease at Hamburg. From 6 to 10 cases occur daily, withthe amount of fatality usual in cholera. This is what mighthave been expected after the large outbreak of last year, butit is extremely unlikely that there will be any repetition ofthe disease on a similar scale this year. The new cases are

scattered over the suburbs, and do not occur in the city andin the vicinity of the harbour. Some cases have also appearedat Altona. A few cases of cholera have been reported to theImperial Office of Health at Berlin during the week. Theyhave mainly occurred on the Rhine at Papiermilhle nearSolingen, and 1 at Duisburg in Rhenish Prussia.From Vienna we learn that cases of cholera are still

making their appearance in Galicia and Hungary, where thedisease showed a slight increase during the few days on whichan increased temperature prevailed. According to the latestaccounts 17 cases and 9 deaths were reported in Galicia and16 cases and 9 deaths in Hungary between the 15th and 16thinst. Two fatal cases occurred quite recently in the Hungariancapital. Some experiments are reported as having beencarried out at the Vienna Institute of Experimental Patho-logy under the direction of Professor Stricker and his col-leagues. Six persons swallowed fluids containing largenumbers of comma bacilli with complete immunity as regardsany attack of cholera.

Reports from the Hague show that cholera still prevails tosome extent in the Netherlands; at Rotterdam, Ysselmonde,Overschie, Gorkum, Leerdam, Gonda, Zwyndrecht, Delft,and other places sporadic cases have occurred. A case is

reported at Amsterdam on the monitor Tiger.Cholera still prevails to some extent at Constantinople.

The recent severe outbreak at the lunatic asylum, Scutari, israpidly declining. It is stated that the origin of the out-break has been traced to the introduction of the disease bysome pilgrims from Mecca, who were admitted into the asylumfor insanity following sunstroke. It is alleged that there isno authenticated case of Asiatic cholera on the Europeanside of the Bosphorus. The disease at Smyrna is fast dis-appearing.As regards Italy, we learn by intelligence from Rome (up to

the 20th inst.) that cholera still prevails at Palermo, Leghornand Naples, but not to any great extent.Accounts from Madrid show that the disease prevails at

Bilbao and in villages in the province of Biscay. Nine casesof cholera were reported at Belchite, in Arragon, on the 19thinst.From Paris a violent outbreak is reported as having occurred

at Barreme, Basses Alpes, a village of 800 inhabitants. Onthe 13th inst. 13 deaths occurred and 30 persons were sufferingfrom the disease. Cholera also exists at Brest, where therehave been 188 fatal cases since the beginning of Septemberand 68 fatal cases in the neighbouring villages. Paris isstated to be healthy.As regards the latest cholera intelligence in this country

we have to record that no fatal case has occurred in Hull,Grimsby, Rotherham or Cleethorpes since the 20th inst., andthat no fatal case has taken place in Rotherham or Cleethorpesfor nearly a week. With respect to the case of cholera whichoccurred on board the Jennie, a Norwegian barque lying inthe Tyne, a bacteriological investigation has caused it to be

regarded as one of Asiatic cholera. It is worthy of notethat the barque has been lying in the Tyne since early in themonth of August. It is rumoured that suspicions are enter-tained in regard to some sickness that has arisen at Ilkestoneand at Appleton-le-street, in the Maldon rural district, andthat medical inspectors from the Local Government Boardhave been despatched to those places. At Liverpool a fatalcase occurred on the 20th inst. in an adult, who died after

eleven hours, which is regarded as a case of Asiatic cho](;[2>but the results of the bacteriological examination have noayet transpired. Some very suspicious occurrences have alsotaken place at Manchester, but it is certain that all the.

necessary precautions will be taken by the health ûffiC2L

Dr. Tatham.

CHOLERA AT LEGHORN.(FROM OUR OWN CORRESPONDENT IN ITALY.)

- Sept. 16th."CERCANO DI NASCONDERLO " (they try to hide it), sai<3

a Neapolitan Commendatore to me the other day-"they’being the authorities and I I it " the cholera. Your readerscannot have forgotten what was duly reported in THE.

LANCET shortly after the last explosion of the disease atNaples-namely, the solemn meeting of the town council whichwas convened to vote special thanks to the syndic for his." patriotism "-the patriotism consisting in his having keptthe outside world in the dark as to the death-rate and sc,saved the prosperity of the town by not scaring away thejorestieri. One is hardly surprised even now at such ostrich.like policy in Southern Italy; but that Leghorn, the advancedTuscan seaport, should be adopting it is, to say the least,disappointing.

There is no doubt that a very formidable outbreak ofcholera has within the last week declared itself at Leghorn,and yet the authorities think it opportune and wise to with.hold from the Press and even from the local Comando de’Carabinieri (the police, in fact) the sanitary bulletins otwhich they are in daily possession. "Cosi," writes the-correspondent of one of the leading Italian journals, "sonc.,forzatamente nel caso di non potervi dare notizie precise sulF’epidemia sviluppatasi a Livorno " (so I am perforce in theposition of being unable to give you precise details as to theepidemic which has developed in Leghorn). What, however,does the outside world see? The precipitate stampede from thetown of all who can afford to leave it and the crowding ofPisa, of Siena, of the Bagni di Lucca and of other Tuscanresorts by the refugees and their families. Omne i,gaaotmpro 7nagit-ifico. When will Italian municipalities learn thatthere is no corrective to panic like the truth, the whole truth.and nothing but the truth, and that there is no provocative ofexaggeration and the terror that springs from it so powerful’as the uncertainty of ignorance ’?The truth is that, like most Mediterranean seaports,

Leghorn is in an exceedingly insanitary condition, and theauthorities are in no hurry to court inquiry into the remiss-ness by which the visitation of cholera has been incurred.Let me state a few facts for which I can vouch. Fcia considerable time, to be measured not by months butby years, the scavenging of Leghorn has been performed ica most perfunctory manner : the streets have been s’Mptin niodo p1’imitit,o - that is, not at all, according to ourBritish notions ; the drains have never been flushed or dis-infected ; and the contents of the water-closets have beer.allowed to accumulate till anyone who passes through the YjRicasoli, for example-one of the most fashionable (saiorili;7streets,-has to quicken his steps and to hold his handkerchiefto his nose. And the water-supply ? For years and years(it is a local authority who speaks) no one has had thecourage to adopt the" innovations " which have beelintroduced into all civilised towns in North - WesternEurope-to substitute, that is to say, for the old leahieeaqueduct which supplies the town a series of soundly constructed pipes to bring in pure water in the proportion whichis lequired by the increasing population.

I will now tell you what was done when the disease begaLto project its ominous shadow over the Mediterraneanlittoral.A lazaretto was prepared and kept in readiness during thesummer in a palazzina outside the Porta delle Colline. I-nr:the 9th of the present month, however, no case occurred whichnecessitated admission. There were patients suffering fromthe usual "bowel complaints " and from the acuter forms oigastro-enteritis, but though some of these terminated fatallyin their own homes there was not one case that bacteriologiestests could ascribe to the Asiatic disease. At the ceinhospital cases began to be admitted in which the symptom;were violent enough to justify a consultation on the part orthe medical staff, the result of which was that the .Municip.Office of Hygiene was warned of the suspicious characterof the cases in question, and, following this admonition, they

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telegraphed to the Minister of the Interior, who at once sentthe President of the Board of Health, Professor Pagliani,to the town. An inquiry was immediately instituted asto the origin of the suspicious cases, and it was found that aman who had returned from Marseilles had had his soiled linenwashed by a laundress in the Venezia quarter, that the cholerahad first established itself there, and that significantly enoughits earliest victims had belonged to the sesso debole (theweaker sex). The quarter was at once isolated, and theenergy of the authorities, under the inspiration of ProfessorPa-,Ilini’-z presence, became well-nigh feverish-insomuchthat the population, realising for the first time the gravity ofthe visitation, began to leave the town. In little more than

forty-eight hours 35 cases were acknowledged and of these10 died. The later figures show a sensible decrease both inpatients and mortality, and from the noon of the 14th inst.to the noon of the 15th only 7 cases occurred, none of thembeing fatal. The panic has now subsided, though the refugeesin the Tuscan interior are still disinclined to return to the town.Meanwhile the energy of the local authorities is displayed,often in the most vexatious fashion-a fashion, indeed, whichwould hardly be tolerated out of Southern Europe. A

passenger train travelling from Leghorn to Pisa includedan individual who suffered so severely from colicky tenesmusthat his case became known to the other inmates ofthe carriages and an alarm was raised. The sanitaryinspector at Pisa, having been made cognisant of the fact,stopped the further progress of the train, drew a cordon roundit outside the Pisa station and there it remained and

(so far as my information goes) still remains in quarantine,amidst discomfort and inconvenience of every kind, which ofthemselves explain the horror with which Italians regard"cholera time." They dread the precautionary or isolatingmeasures as much as the disease itself.

Liter, Sept. 18th.In spite of official bulletins of a reassuring character the

stampede from the cholera-smitten seaport of all who canafford it proceeds pleno rivo. Lucca, and still more the

neighbouring Bagni di Lucca, are now so thronged withrefugee Livornesi that the local authorities-dreading anoutbreak of the disease-have placed an interdict on any morearrivals from that quarter by train. " Shut out from thedoor, they are now coming in by the window," to quote anItalian saying ; in other words, debarred by rail, they areentering the Bagni di Lucca by omnibus, which literally setsdown loads" of panic-stricken Livornesi on the outskirts,and, there being as yet no "sanitary cordon " round theplace, admission is gained at every available opening.Traffic -passenger traffic particularly --on the Leghorn-Pisa-Florence railway lines is daily becoming more diffi-cult, all trains with third-class carriages undergoingrigorous inspection, all trunks and boxes and "hold-alls"being thoroughly overhauled in the search for soiled under-clothing. In Leghorn itself the recrudescence of thedisease admitted by the authorities as having declareditself on the 16th inst. is still on the ascending curve of theparabola, though the cases are described as being all assai-M (rather mild). All Saturday’s cases having occurredin the immediate neighbourhood of the hospital in the ViaMagnani&mdash;that is to say, the zone to which the outbreakhas hitherto, with but a slight indication of diffusion, seemedto confine itself-it has been decded to close for the timebeing the dispensaries and ambulance reception rooms inthat quarter. The lazaretto above described receives the

properly authenticated cases ; seven out of the ten caseswhich were reported to the Office of Hygiene between themorning of the 16th and the morning of yesterday were un-doubtedly cases of cholera. Of the cases announced in pre-vious bulletins four were registered as dead last evening.These figures, as I have indicated, must be taken for whatthey are worth ; they seem to have a special interpretationplaced upon them by the well-to-do Livornesi.

CHOLERA IN RUSSIA.(FROM OUR OWN CORRESPONDENT.)

THE number of cases of cholera in the capital continuestc increase. At the moment of writing there are in all 136under treatment, distributed in eleven different hos-pi’&ls. Since the publication of daily bulletins has beenrecommenced the daily numbers of admissions and deathswe been as follows. Between Aug. 12th and noon on

Aug. 19th there were 40 cases, 15 deaths, 1 recovery and24 remained in hospital.

Cases. Deaths.From noon on Aug. 19th to noon on Aug. 20th.. 9 3

" 20th " 21st ... 6 ..... 3

" 21st " 22nd.. lt .... 7" 22nd "

23rd 12 .... 4

" 23rd " 24th.. 11 .... 4r

" 24th " 25th.. 12 .... 2:

" 25th " 26th.. 7 .... 2

" 26th " 27th.. 13 .... 5.

" 27th " 28th.. 21 ..... 6

" 28th " 29th .. 33 ..... 11

" 29th " 30th 27 .... 14

" 30th " 31st .. 39 .... 16

" 31st Sept. 1st .. 46 .... 13

" Sept. lst " 2nd.. 37 .... 14

There have thus been in all 324 cases and 119 deaths fromcholera in St. Petersburg in this year’s epidemic. By far thelarger number of cases continue to be drawn from the-

Vassiliefsky Ostrof, one of the largest of the islands at the-mouth of the Neva.The latest bulletins upon the course of the epidemic of

cholera in the provinces indicate a still further spread of thedisease. The returns are as follow :

Cases. Deaths.Bessarabia (government) from Aug. 8th to 14th 34 .... 17

" ’’ ’’ 15th to 21st .. 41 .... 19Viatka " " 8th to 14th 148 .... 80

" " 15th to 21st 91 .... 41Grodno " ’’ 8th to 14th .. 187 .... 59

" " 15th to 21st 247 .... . 70Kalicz " 8th to 14th 114 .... 61

" " 15th to 2lst .. 78 .... 44

Kaluga " " 8th to 14th .. 20 .... &,. " 15th to 21st . 18 .... 7

Kief " 8th to l4th .. 740 .... 281" " 15th to 21st 789 .... 297’

Kostroma " " 8th to l4th .. 58 .... 28

" " 16th to 21st .. 125 .... 5&ucirc;-

Minsk ’’ " 8th to 14th 232 .... 101

11 " 15th to 21st 329 .... 102.’Moscow " " 8th to l4th .. 174 ... 53 53

" " 15th to 21st 248 .... 98’

" (town) " l6th to l8th .. 108 .... 6 57

.. " ,, 19th to 22nd .. 82 .... 38.

" " 23rd to 27th .. 75 .... 35

Orel (government) ’’ 8th to l4th .. 689 .... 243

Podolia " " 1st to 14th .. 1229 .... 601

.. " " 8th to 21st(sic) 1722 .... 653

Poltava " ’’ 8th to l4th .. 283 .... 127

" " ,, 15th to 21st .. 193 .... 85.Riazail " " lst to 7th .. 14 .... 10

Samara " " 8th to l4th .. 64 .... 25.

" " ., 15th to 21st .. 146 .... 74-Saratov " " 8th to 14th 47 .... 21

Simbirsk " " ,, .. 57 ... 32Kertch (town) " 18"h to 22nd .. 29 .... 15.

,, , 24thto30th . 7 .... 3

Sevastopol " " 8th to l4th .. 22 .... 12

" " , 15thto23rd . .. 34 ..... 23.

" " 24th to 25th ... 5.... 3.

Tambof (government) , 8th to 14th .. 6 .. . 4

" " , 15thto21st . 18 .... it

Ufa " " 8th to l4th .. 6 .... 3..

Kharkof " " " ’’ . 182 .... 87

" " 15th to 21st . 274 .... 118-Tchernigof ’’ " 8th to l4th .. 85 .... 39

, ’’ ’’ 15thto21st . 161 .... 47" " ,, 15th to 21st .. 161 .... 47

Yaroslavl " " 8thw14th.. 125 .... 64-Don Cossack (province) " l5th to l7th .. 132 .... 6d

" " 18th to 2lst .. 164 .... 91

" " " 22nd to 24th .. 113 .... 60

Kuban " 15th to 17th . 62 .... 44-

" " " l8th to 2lst .. 58 .... 35

" " " 22nd to 24th .. 26 ..... 15.

Astrakhan (government) " 8th to l4th .. 60 .... 22

Warsaw ’’ ’’ ,, ., .. 1 -" 1

Wa;saw " 15th to 21st 1 ... 1 1

Volhynia " " 8th to l4th .. 120 .... 39.

" " " 15th to 21st .. 228 .... 72Voronezh " " 8th to l4th ... 205 .... 86.

" " " 15th to 21st .. 431 ... 186Ekaterinoslav ’’ " " ’’ .. 215 .... 103.Kazan " " 8th to l4th .. 317 .. 146Kursk " " " " .. 778 .... 310Kutais " " "".. 19 .... 16.

Mogild " " ,. to 21st .. 316 .... 122

" " 15th to 21st .. 642 .... 224Per ,, ;, 8th to l4th .. 21 .... 15

Radom " 15th to 21st ... 21 .... 16.

Smolensk " " Rth to 2lst .. 6 .. . 6

Taurida ’’ " 8th to 14th.. 58 .... 3GTiflis ,, , 8th to 14th .. 21 .... 14,.

Tobolsk ’’ , 8th to 14th.. 19 .... 10

Tomsk " from July 25th to 31st .. 19 .... 11

,, . " fromAug.lstto7th .. 14 .... 7Vladimir " ,, 15th to 21st.. 385 .... 14&

Nijni-Novgorod " " 1st to 7th 692 .... 337" " " 8th to 14th .. 326 .... 214

" " , 15t.hto21st .. 229 ... 117" " 22nd to 28th.. 118 .... 60

Novgorod " , l5th to 21st 1 ... 1Cronstadt (town) , 22nd to 28th.. 2 ... 1

The dates in the above list are all according to the Old StyleSt. Petersburg, Sept. 3rd (15th).