174 CHOLERA 



where autopsies were being made on the bodies of persons dead 

 of cholera. When antiseptic precautions were observed and the 

 autopsies conducted as rapidly as possible the vibrios could no 

 longer be obtained from the flies in the room. Tsuzuki (1904) 

 succeeded in isolating the vibrios from flies captured in a cholera 

 house in Tientsin. 



Observations during cholera epidemics. 



Moore (1853) first drew attention to the necessity of guarding 

 food against flies in cholera outbreaks, adding : " flies in the East 

 have not far to pass from diseased evacuations or from articles 

 stained with such excreta, to food cooked and uncooked." 

 Nicholas (1873) describing the epidemic at Malta in 1849 writes: 

 " My first impression of the possibility of the transfer of the 

 disease by flies was derived from the observation of the manner 

 in which these voracious creatures, present in great numbers, 

 and having equal access to the dejections and food of the 

 patients, gorged themselves indiscriminately and then disgorged 

 themselves on the food and drinking utensils." Fhigge (1893), 

 Simmonds (1892), Tsuzuki (1904), Chantemesse (1905), Ganon 

 (1908) and others, from their personal experiences, have all 

 expressed the opinion that flies play an important part in the 

 spread of cholera under favourable conditions. 



The two most interesting obsen^ations are those of Macrae 

 (1894) and Buchanan (1897) in India. Macrae describes an out- 

 break in a jail at Gaya, when flies were present in great numbers. 

 " They were present in swarms when the disease broke out, and 

 it was an observation of daily occurrence to see them settling 

 on cholera stools whenever possible." At feeding time there was 

 "a struggle between them and the prisoners for the food." In 

 the female department, shut off from the male side by a high 

 wall, which apparently prevented the access of flies from the 

 other side, no cases occurred. On the male side there were 

 several cases and boiled milk exposed there and in the cow shed 

 became infected with V. cholcne. This infection could only have 

 been carried by flies. Macrae considers that the well-known 

 erratic behaviour of cholera in certain outbreaks may be explained 



