CHOLERA. 25 



small part of its value, for the facts which he has brought together 

 prove that man can be modified by selection as readily as any of 

 our domesticated animals or plants, and that increased knowledge 

 will ultimately enable us to bring about rapid improvements in 

 our race. 



CHOLEEA. 



By Dr. MAX VON PETTENKOFER.* 

 IV. PREVENTION. 



THE last sheet-anchor of the contagionists is always the linen of 

 cholera-patients. But this view rests on such debatable ground 

 that in the end it may prove to be fallacious. If cholera is really 

 spread through human intercourse, then it is clear that the unknown 

 specific something must accompany other vehicles, which may be man 

 himself ; and if this something can cause illness in man, then it must 

 reside in the system of the patient, and ought to be found there. There 

 can be no doubt of this ; and I am prepared to admit as much. Thirty 

 years ago I began my investigations on cholera in the belief that the 

 germs of cholera were contained in the stools ; but afterward, having 

 made sure that cholera was dependent on locality as well as human 

 intercourse, I endeavored to see how this relationship obtained by ask- 

 ing myself what was brought to the soil by man in his journeyings. 

 The reply was, urine and stools his excrements and nothing else. 

 This view ripened into the belief that disinfection of the excreta and 

 their receptacles ought to be a prophylactic measure against the spread 

 of cholera, and excreta which had not been disinfected constituted a 

 source of danger. These thoughts occupied me up to April, 18G6, 

 when I published with my lamented friends, Griesinger and Wunder- 

 lich, some regulations on cholera ; and I first relinquished these views 

 when further study showed the uselessness of measures of disinfection 

 as well as the harmlessness of the undisinfected excreta of cholera- 

 patients. If the poison of cholera be contained in the excreta, then, 

 individual predisposition aside, those who mostly come in contact with 

 the excreta ought to be most frequently affected. And these should be 

 the various physicians and nurses in hospitals devoted to the care of 

 cholera-patients. But experience has clearly shown that the medical 

 attendants in cases of cholera are not more prone to take the disease 

 than others. The like holds good of nurses. Let us first of all consider 

 how the facts stand in the home of cholera, in India. During 1867, 

 in which the epidemic at Hurdwar prevailed, James Cuningham in- 

 vestigated the relationship of cholera to nurses in forty garrison towns 

 containing sixty-seven hospitals ; of the sixty-seven hospitals only eight 



* Reprint of a special translation made for the London " Lancet." 



