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October 31, 1908


JAMA. 1908;LI(18):1499-1505. doi:10.1001/jama.1908.25410180023001g

Winter epidemics of bowel disturbances, characterized by an intestinal flux, have become a problem in some of our large cities during the past few months. Simulating, in some respects, in their toxemia and collapse, the symptoms engendered by the vibrio of Koch, these endemic and epidemic bowel disturbances are popularly known as "winter cholera."

It is the purpose of this paper to detail observations on recurrent epidemics of so-called "winter cholera" at Escanaba, Mich., a city of approximately 10,000 inhabitants. Escanaba is situated on Little Bay de Noc, an inlet of Green Bay. The principles evolved from the study of such epidemics will serve to explain the cause of bowel disturbances that have become in some cities a very momentous problem, taxing the ingenuity of sanitarians.

In the Sixth Annual Report of Mortality Statistics, published in 1905 by the Department of Commerce and Labor, Washington, D. C., the editor says

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