212 DISEASES DUE TO BACTERIA 



pints; the temperature of the saHne in the cistern should be loAvered 

 and the infusion continued. 



That the reaction induced by the saline infusion may, to some 

 extent, be due to a toxaemia induced by the endotoxins of water-borne 

 bacilli used in the infusion is possible; that it entirely accounts for the 

 reaction rigor I do not believe. In any case, it will be interesting to 

 see to what extent the phenomena of the infusion reaction will be 

 modified by filtration previous to boiling. 



PROPHYLAXIS (Castellani). 



(7) Public. 



(i) Protection of the frontiers, regular inspection, quarantine 

 stations. 



(2) A central Cholera Board, with a full staff and apparatus for 

 bacteriological work, disinfection, &c. 



(3) Instruction of the populace by pamphlets. 



(4) House-to-house search for cases. 



(5) Search for carriers and sources of infection. 



(6) Distribution of medicines and disinfectants. 



(7) Provision of medical aid to be readily obtained by all. 



(8) Crusade against house-flies. 

 (77) Private. 



(i) Personal cleanliness. 



(2) Avoidance of foods liable to be contaminated. 



(3) Avoidance of foods liable to cause diarrhoea. 



(4) Filtration and boiling of all water for drinking and cooking. 

 The regular cleansing of all filters and water receptacles. 



(5) Boiling of milk and protection against flies. 



(6) Clean sanitary dwellings. 



(7) Anti-cholera vaccination. Hafifkine's protects for six to four- 

 teen months. 



(8) Immediate application for medical aid in the event of any 

 diarrhoeal illness. 



Professor Simpson, working at Calcutta, was inoculating some 

 civilians with Hafifkine's vaccine of living cultures, when an epidemic 

 broke out four days afterwards with the following interesting 

 results : — 



The 654 uninoculated had 71 deaths, or io"86 per cent. 



The 412 inoculated had 12 deaths, or 2*99 per cent. 



Not only so, but for the ensuing twelve months the inoculated were 

 almost free from the disease, while cases were cropping up all the time 

 among the uninoculated, the ratio of the mortality being as 3 is to 1 1 . 



Kitasato in Japan, and Castellani in Ceylon, used devitalized 

 vaccines, but Simpson used living cultures. 



