The next visitation of cholera to England was met by the simple remedy of domestic and civic cleanliness; and so manifestly effectual was this measure that the pestilence lost its former terrors. But the great and lasting gain to the people, which grew out of the original proclamation of the Prime Minister that cleanliness of the home and its surroundings was the best preventive of cholera, was the discovery of the fact that nearly all diseases which afflict the individual family, and in a larger sense the whole community, have their origin in or are intensified by decomposing waste matter, the “filth” of the sanitarian, in and around their homes. So profoundly impressed with this fact were the laboring classes, and so earnest did they become in their zeal for sanitation, that sanitary measures entered into the political campaign. On one occasion a prominent candidate was so disturbed by the numerous inquiries which the audience made as to his views in relation to current questions of local sanitation, that he cried out in despair, “_Sanitas sanitatum, et omnia sanitas!_” III THE AWAKENING IN AMERICA [Sidenote: Apathy in the United States] During the score of years that the great awakening of the people of England to the value of cleanliness of the individual, the home, and the municipality, as the true remedial measure against foreign as well as domestic pestilences was in progress, extending from 1846 to 1866, the people of the United States remained profoundly apathetic in relation to all questions of improvement of the public health and the prevention of epidemics. Cholera ravaged their cities in 1849, and again in 1854, without meeting other obstruction than the occasional fumes of sulphur. Days of fasting and prayer were religiously observed; but, for the most part, the terror-stricken people fled to the country to escape what they believed to be inevitable death if they remained in their town homes. The object lesson which the people of England had learned from the experience of one town, and had so successfully applied in several visitations of epidemics, was known to a few students of sanitary science and administration in different parts of this country and efforts had been made by them, from time to time, to awaken public interest in sanitation of the home and the municipality, but very little progress was made. A few cities had health organizations which, for the most part, were devoted to political schemes and purposes, with no pretense to knowledge of the objects or methods of sanitation. [Sidenote: An Incident That Counted]