126 



THE POPULAR SCIENCE MONTHLY. 



ago so little was known of the causes 

 which produced the disease, or of the 

 means of hindering its distribution, that 

 the doctors themselves not rarely be- 

 came the innocent carriers of its poison. 

 With its cause a mystery, and resistless 

 apparently in its advance, it is no won- 

 der that the frightful mortality attend- 

 ing it struck terror to the hearts of the 

 people among whom it appeared. But, 

 thanks to experience and the scientific 

 investigation of many observers, all this 

 has gradually been changed. It has 

 been abundantly shown both here and 

 in England that, with suitable sanitary 

 precautions, such as are within the 

 reach of every enlightened community, 

 not only cholera but other diseases 

 which tend to become epidemic can, if 

 taken in time, be arrested in their prog- 

 ress and ultimately stamped out alto- 

 gether by the prompt and energetic 

 application of ordinary hygienic rules. 

 This is now so well understood float 

 epidemics of any kind, particularly in 

 centers of population under municipal 

 control, are justly regarded as evidence 

 of official neglect or mismanagement. 



In the case of cholera the work of 

 the sanitary authorities is really very 

 simple. It lias long been attempted to 

 exclude the disease from cities and 

 towns by means of quarantine, the pro- 

 hibition of immigration, and of the im- 

 portation of certain classes of merchan- 

 dise. These measures, however, seri- 

 ously conflicting as they do with the 

 self-interest of individuals and corpora- 

 tions, have always proved more or less 

 ineffective, until it has become very 

 plain that they can not be relied upon 

 to keep out the scourge. In England 

 this is now generally admitted in prac- 

 tice, as the authorities interfere far less 

 with commerce than formerly, but give 

 strict attention to the immigrant and the 

 cargo after they are landed. 



The real concern of the sanitarian, 

 then, is with the conditions of living 

 among the masses of the people in the 

 district under his charge, and, if past 



experience is any guide, his chief duty 

 will be to promote, and, if need be, 

 enforce the virtue of cleanliness, inter- 

 preting that word in its widest mean- 

 ing. Filth is a necessity to the very ex- 

 istence of cholera. It has been the one 

 uniform condition present in all the epi- 

 demics of which we have any record, 

 and is the usual vehicle for the trans- 

 mission of the disease. On the other 

 hand, purity and wholesomeness are 

 its deadly enemies, and in proportion 

 as these are secured will the danger of 

 epidemics decrease. Medical authori- 

 ties are generally agreed that cholera is 

 propagated by a specific poison. It 

 matters not whether we call this a virus, 

 a germ, or a bacillus, the important 

 point to observe is that whatever its 

 nature it must gain a lodgment in the 

 system before the disease can develop. 

 So far as known this poison or germ is 

 only produced by the disease. It is 

 thrown off from the bodies of the sick 

 in the discharges from the digestive 

 tract, and, if not destroyed at once, 

 is ready for its career of destruction. 

 Through defective drains or other chan- 

 nels it may pass into a well or stream 

 which furnishes the drinking-water to 

 many families. This is one of the most 

 common ways for the poison to gain an 

 entrance into the bodies of the healthy. 

 Dirty food and the use of articles soiled 

 with choleraic discharges may also con- 

 vey it, but most authorities assert that it 

 is never carried through the medium of 

 the air — that is, the disease is contagious, 

 but, unlike scarlet fever and measles, is 

 not infectious. Physicians and nurses 

 work among it with impunity, even in 

 its most virulent form, so long as rigid 

 cleanliness of person and clothing is ob- 

 served. 



The only recorded death from the 

 disease among the attendants in Russian 

 hospitals during the present outbreak is 

 that of a nurse who heedlessly swal- 

 lowed the remains of a cholera patient's 

 dinner. Drinking-water, however, is 

 by far the most frequent vehicle of the 



