CHOLERA. 



157 



of anti-bacterial agents, and the hopes that had 

 been born of the ether-treatment, and its ef- 

 fectiveness, have also been shattered. A new 

 method of treating the disease has been em- 



Sloyed by French physicians, during the epi- 

 emic of 1886, with considerable success, but 

 there have not been a sufficient number of 

 cases reported to enable us to express any 

 opinion as to its real value. This treatment 

 consists in painting the abdomen and loins 

 thoroughly with collodion. It is claimed for 

 this that heat is retained, and the abdomen is, 

 as it were, placed in a perfect-fitting splint, and 

 rest thereby secured. The collodion applica- 

 tion is also said to prevent the rapid and great 

 loss of the watery elements of the blood. 



Treatment by means of ice to the spine, as 

 recommended by Dr. Chapman, of England, 

 has been tried to a considerable extent by phy- 

 sicians in India, no more success following this 

 line of treatment than was observed in the op- 

 posite plan. Dr. Chapman recently expressed 

 the opinion that cholera depended to some ex- 

 tent upon a severe nervous disturbance, and 

 that treatment from this standpoint would 

 yield a much more satisfactory result. India 

 physicians, during the past epidemic, have 

 given this treatment a trial, and have reported 

 no increase in the ratio of cures under it. 



No sooner had the year 1886 made its ap- 

 pearance, than cholera was announced in the 

 provinces of Girona and Cadiz in Spain. That 

 the disease should appear in these two locali- 

 ties, in opposite portions of the Spanish king- 

 dom, at the same period, is regarded as evi- 

 dence of the latency of the germ through the 

 cold months. Notwithstanding the terrible 

 lesson these people had received from the rav- 

 ages of the epidemic in the past, they had 

 failed to profit by it, and the sanitary condition 

 of the country was not in the slightest re- 

 spect improved ; indeed, the condition of ma- 

 ny of the towns was worse than in 1885. 

 Quarantine regulations were very deficient, 

 and sanitary cordons were not at all observed. 

 No attention was given to purifying or pro- 

 tecting the water-supplies, the people still 

 drinking water drawn from canals that had 

 been made for the purpose of irrigation. Into 

 these canals the drainage of small towns found 

 its way, and, as they pursued their course 

 through the country, instances of their being 

 used for the purpose of washing soiled linen 

 and clothes were quite numerous. These ca- 

 nals scarely or never found their way into the 

 larger cities, but traversed the rural districts 

 mainly, and an evidence that they were the 

 means of spreading the disease is shown in the 

 fact, that cholera was more severe in the rural 

 districts. The increased rate of mortality in 

 rural districts has also been noticed in the 

 other countries of Europe and in India. This 

 relatively high rate of mortality in villages is 

 also to be explained by absence of organized 

 hygienic supervision, the miserable construc- 

 tion of the dwellings, in which the people are 



crowded together with the domestic animals, 

 and the impossibility of providing extensive 

 and costly water-supplies. 



In an official report of the epidemic in Spain, 

 published May 22, 1886, it is said that the 

 epidemic ended in the province of Malaga 

 Jan. 19, in the province of Oviedo Jan. 31, 

 in the province of Salamanca Jan. 17, and in 

 the province of Cadiz March 22. Not a single 

 case has appeared in the whole Spanish Pe- 

 ninsula up to the publication of this report. 

 During this period of 1886, there were 2,000 

 cases and about 750 deaths from cholera in 

 Spain. 



Concerning the value of Ferran's anti-chol- 

 eric inoculations, the opinions of Spanish phy- 

 sicians are still divided. That they are at 

 least harmless, is beginning to be admitted. 

 The' last official commission, appointed by the 

 Spanish Government, to examine the official 

 statistics in their possession, have finally ad- 

 vised the resumption of the inoculations in the 

 event of a recurrence of the disease. 



An analysis of the recently published official 

 statistics, collected by the officers of the Gov- 

 ernment, in the localities where the inocula- 

 tions were practiced, comprising upward of 

 30,000 inoculations in 22 villages, having a 

 population of 135,000, proved that only 387 of 

 the inoculated were attacked, and 104 died of 

 cholera ; showing that 12 per 1,000 were at- 

 tacked, and 3 per 1,000 died of the disease. On 

 the other hand, of the population not inocu- 

 lated, 77 per 1,000 were attacked, and 33 per 

 1,000 died of cholera. It would appear, there- 

 fore, that the inoculations conferred a protec- 

 tion from attack six times greater than that 

 conferred by the measures of hygiene and pre- 

 vention enforced in the villages, and that the 

 inoculation conferred a protection from death 

 by cholera ten times greater. It should be re- 

 marked that in many of these villages two 

 thirds of the whole population were subject- 

 ed to the inoculation, comprising the poorest 

 class of the inhabitants, and, therefore, those 

 most liable to attack. In such villages the 

 epidemic suddenly came to an end, which ap- 

 peared to be the result of the inoculation ex- 

 periments. This sudden termination of the 

 epidemic is in marked contrast with that in 

 other afflicted villages ; for an analysis of Dr. 

 Shakespeare's investigations of 361 towns, 

 mainly in this part of Spain, shows that the 

 average duration of the epidemic was 44 days, 

 of which the period of rise was 14 days, that its 

 stationary period was 11 days, while the pe- 

 riod of decline lasted 19 days. 



Cholera in Italy, as in Spain, was found to be 

 present during the winter months. Later in 

 the year it occurred, more or less extensively, 

 in the provinces bordering the Adriatic from 

 Venice to Brindisi, and penetrated to some ex- 

 tent into the interior, mainly among the north- 

 eastern provinces. It is reported that there 

 were upward of 45,000 cases and 14,000 deaths 

 from cholera in Italy during 1886. The Ital- 



