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nd 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 along the coast of the United States； and in 1853 the disease raged throughout the Southern States； there being a mortality in New Orleans alone of nearly 8000。 In the epidemic of 1878 in the Southern States the mortality was nearly 16；000。 South America was invaded for the first time in 1740； and since 1849 the disease has been endemic in Brazil。 Peru and the Argentine Republic have also received severe visitations of yellow fever since 1854。 In Cuba the disease is epidemic during June； July； and August； and it appears with such certainty that the Revolutionists at the present time count more on the agency of yellow fever in the destruction of the unacclimated Spanish soldiers than on their own efforts。
Leprosy is distinctly a malady of Oriental origin； and existed in prehistoric times in Egypt and Judea。 It was supposed to have been brought into Europe by a Roman army commanded by Pompey； after an expedition into Palestine。 Leprosy was mentioned by several authors in the Christian era。 France was invaded about the second century； and from that time on to the Crusades the disease gradually increased。 At this epoch； the number of lepers or ladres becoming so large； they were obliged to confine themselves to certain portions of the country； and they took for their patron St。 Lazare； and small hospitals were built and dedicated to this saint。 Under Louis VIII 2000 of these hospitals were counted； and later； according to Dupony； there were 19；000 in the French kingdom。 Various laws and regulations were made to prevent the spread of the contagion。 In 1540 it was said that there were as many as 660 lepers in one hospital in Paris。
No mention is made in the Hippocratic writings of elephantiasis graecorum； which was really a type of leprosy； and is now considered synonymous with it。 According to Rayer； some writers insist that the affection then existed under the name of the Phoenician disease。 Before the time of Celsus； the poet Lucretius first speaks of elephantiasis graecorum； and assigns Egypt as the country where it occurs。 Celsus gives the principal characteristics； and adds that the disease is scarcely known in Italy； but is very common in certain other countries。 Galen supplies us with several particular but imperfect caseshistories of elephantiasis graecorum； with a view to demonstrate the value of the flesh of the viper； and in another review he adds that the disease is common in Alexandria。 Aretaeus has left a very accurate picture of the symptoms of elephantiasis graecorum； and Pliny recapitulates the principal features and tells us that the disease is indigenous in Egypt。 The opinion of the contagiousness of elephantiasis graecorum which we find announced in Herodotus and Galen is more strongly insisted upon by Caelius Aurelianus who recommends isolation of those affected。 Paulus aegenita discusses the disease。 The Arabian writers have described elephantiasis graecorum under the name of juzam； which their translators have rendered by the word lepra。 Later； Hensler； Fernel Pare； Vesalius； Horstius； Forestus； and others have discussed it。
The statistics of leprosy in Europe pale before the numbers affected in the East。 The extent of its former ravages is unknown； but it is estimated that at the present day there are over 250；000 lepers in India； and the number in China is possibly beyond computation。 According to Morrow； in 1889 in the Sandwich Islands there were 1100 lepers in the settlement at Molokai。 Berger states that there were 100 cases at Key West； and Blanc found 40 cases at New Orleans。 Cases of leprosy are not infrequently found among the Chinese on the Pacific coast； and an occasional case is seen in the large cities of this country。 At the present day in Europe； where leprosy was once so well known； it is never found except in Norway and the far East。
Possibly few diseases have caused so much misery and suffering as leprosy。 The banishment from all friends and relatives； the confiscation of property and seclusion from the world； coupled with poverty and brutality of treatment；all emphasize its physical horror a thousandfold。 As to the leper himself； no more graphic description can be given than that printed in The Ninteenth Century； August； 1884： 〃But leprosy！ Were I to describe it no one would follow me。 More cruel than the clumsy torturing weapons of old； it distorts； and scars； and hacks； and maims； and destroys its victim inch by inch； feature by feature； member by member； joint by joint； sense by sense； leaving him to cumber the earth and tell the horrid tale of a living death； till there is nothing left of him。 Eyes； voice； nose； toes； fingers； feet； hands； one after the other are slowly deformed and rot away； until at the end of ten； fifteen； twenty years； it may be； the wretched leper； afflicted in every sense himself； and hateful to the sight； smell； hearing； and touch of others； dies； despised and the most abject of men。〃
Syphilis。Heretofore the best evidence has seemed to prove that syphilis had its origin in 1494； during the siege of Naples by Charles VIII of France； but in later d