450 SPIKILLUM CHOLEIUE ASIATICS. 



avoided the most dangerous cause of predisposition on 

 the part of the patient is avoided. In correspondence 

 with these facts we learn from experience that those in- 

 dividuals who are in a hetter position of life, who are the 

 most cleanly and moderate in their habits, are attacked 

 by cholera in much smaller numbers than those who 

 pay no attention to cleanliness, moderation, or the 

 digestibility of their nutriment. Hence the English who 

 are resident in India, and who are able to bestow great 

 attention on the selection and preparation of their food, 

 are almost entirely protected against cholera even in the 

 regions where it is endemic. 



The immunity I n harmony with this we have also the fact that 

 nurses. doctors and nurses are very seldom attacked by cholera ; 



they are accustomed, by having to deal with other con- 

 tagious diseases, to habits of precaution and cleanliness 

 in handling the patients on the one hand, and in their 

 mode of feeding on the other. Here and there, it is 

 true, there are incautious or dirty nurses, or the arrange- 

 ments of the hospital in question are such that the 

 number of sources of infection is multiplied, and con- 

 tagion rendered more easy ; and as a result we have in 

 some epidemics a greater number of cases of the disease 

 among the attendants. Experience has also shown that 

 it is on the whole a rare occurrence for other patients 

 and convalescent persons to be attacked in the same 

 hospital ; and this is easily intelligible, because these 

 individuals are usually kept clean, and their food is pre- 

 pared with a care such as they do not usually employ in 

 Cholera on their own homes. In like manner in the case of ships, 

 ships. where as a matter of experience it is relatively seldom 



that severe cholera epidemics occur, there is decidedly 

 less opportunity for the transmission of the contagium 

 than in private houses ; on board ship the passengers 

 between decks are compelled to be cleanly, at least to a 

 certain extent, and as they do not take part in the pre- 

 paration of the food there is never such a close relation 

 between the sources of infection, the modes of contagion, 

 and the predisposed individuals, as is seen in the houses 

 of the poor. Nevertheless, there are naturally certain 



