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This disease, so sudden in its appearance, so uniform in its symptomatology, and so early pandemic, is commanding universal attention, and will enlist a critical study on the part of the medical profession at large. In the rapidity of its development and world-wide diffusion as compared with other epidemics, its progress is simply phenomenal. So far as we know it is uninfluenced by temperatures, climates, or seasons. It is regardless of geographical limits, and obeys no known laws of transmission.
With reference to its etiology, we have as yet no positive knowledge; rather, we have everything yet to learn. Bacteriological studies have all had their birth since a like epidemic was known, and until now no such opportunities for study were possible. If its methods of propagation are specific they are essentially different from any others, of contagions or of epidemics, with which we are familiar. It would seem most
THE EPIDEMIC.. JAMA. 1890;XIV(2):60–61. doi:10.1001/jama.1890.02410020024005