392 



NA TURE 



[February 22, 1894 



AX INCIDENT IN THE CHOLERA EPIDEMIC 

 AT ALTONA. 



THE third contribution by Dr. Koch last year to 

 the subject of cholera appears in the Zeitsclirift 

 fiir Hygiene, vol. xv. part i. It covers no less than 

 seventy-six pages, and is entitled " Die Cholera in 

 Deutschland wahrend des Winters 1892 bis 1893." As 

 :he title implies, it is an elaborate essay giving a most 

 lucid and remarkably interesting exposition of the rise 

 and course pursued by the several epidemics of cholera 

 which visited Hamburg, Altona, and Nietleben near 

 Halle, respectively. Several figures serve to illustrate 

 the descriptions of sites, buildings, &c., referred to in 

 the text. 



From a bacteriological point of view, perhaps the most 

 interesting part of the paper is that which relates to the 

 disease in Altona, and in which an account is given of ! 

 the successful elucidation of a remarkable outburst of 

 cholera which occurred in a restricted area of that town, 

 and which in many respects recalls the incidents of the 

 now classical cholera explosion which took place in 1854 

 in connection with the Broad-street pump in London. 



In a district of Altona, rejoicing in the suggestive name 

 of " der lange Jammer," and inhabited by about 270 

 persons, cholera made its appearance onj January 21, 

 1893, and in a week nine cases had occurred, of 

 which seven ended fatally. Strange to say, in the neigh- 

 bourhood and, indeed, for some distance around this 

 centre, no other cases of cholera were recorded at all, 

 thus pointing very clearly to some local cause as respon- 

 sible for the outbreak. A searching investigation was at 

 once instituted, resulting in the discovery that the in- 

 fected houses were not connected with the Altona water- 

 supply, but dependent for their water upon a well in their 

 midst. The ordinary town water-supply was in fact 

 regarded as an article of luxury and an extravagance 

 which the humble inhabitants of "der lange Jammer" were 

 too poor to indulge in. In May, 1892, a systematic inves- 

 tigation had, it appears, been made of all the wells in 

 Altona, and ninety-two out of 366 had been condemned 

 as unfit for use. This particular well was, however, 

 amongst those which had been passed, as its construction 

 appeared to be satisfactory, and its surroundings suf- 

 ficiently protected to remove all fear of contammation. 

 During the severe frost, however, there can be no doubt 

 that surface water, unable to get away by the usual 

 channels, gained access to the well, for when the courts 

 of the surrounding houses were washed down with strong 

 carbolic it was noticed that the well-water acquired a 

 smell of this material. Thus the possibility of its con- 

 tamination with choleraic matters was established, and 

 on January 26 the well was closed. After this date 

 only four more cases of cholera occurred, the last one 

 recorded being on February i, and all of these might 

 have been contracted prior to the closing of the well, and 

 are therefore still attributable to the use of this water. 



The bacteriological examination of the water was taken 

 in hand on January 31, and on this day large 

 numbers of cholera bacilli were revealed by the usual 

 special methods employed. A sample of the water 

 collected on January 31 was preserved for further in- 

 vestigation, and was kept in a room having a tempera- 

 ture of 3— 5" C. ; in this sample cholera bacilli were 

 found on the 2nd, 3rd, and 17th February respectively, 

 showing that under the particular circumstances the 

 bacilli were able to maintain their vitality for eighteen 

 days in the water ; on the other hand, in samples of 

 water collected later directly froffz the well itself no 

 cholera bacteria could be detected. It is to be presumed, 

 therefore, that as no further cases of cholera occurred in 

 the adjacent houses after February i, no fresh bacilli 

 found their way into the well, and those cholera bacilli 

 which were proved to be present on January 31, must 



NO. 1269. VOL. 49] 



have either become altogether extinct or have been so 

 much reduced in number as to defy detection. 



The incident is instructive, if only in demonstrating 

 the folly of presuming that a well with flagrantly 

 unsanitary environment may be regarded as safe for 

 drinking purposes, just because its past history happens 

 to be untarnished by any observed connection with an 

 outbreak of zymotic disease. But another point which 

 I consider is very clearly brought out by the case in 

 question, is the uncertainty which attaches to the actual 

 discovery of the cholera or, indeed, of other pathogenic 

 bacteria in water, even under such peculiarly favourable 

 conditions as were present in the case of the Altona 

 well. Had the examination of this water been delayed 

 only for a few days, the search for cholera bacilli would 

 have been absolutely fruitless, and the direct bacterio- 

 logical evidence entirely wanting. Chance, in this 

 particular instance, decided otherwise, and a very 

 satisfactory confirmation of a most probable hypothesis 

 was obtained. 



Nevertheless, it is very apparent that however im- 

 portant bacteriological evidence may be in determining 

 the hygienic value of water purification processes, and 

 as I have so often pointed out, it is in this matter the only 

 competent referee ; on the other hand, in the matter 

 of the actual detection of disease organisms in any 

 given water, its usefulness is of a much more restricted 

 character. 



There is undoubtedly a tendency at the present time 

 to regard the detection of pathogenic bacteria as the 

 most important object of bacteriological water examina- 

 tion. It is, however, surely a matter of far greater 

 moment to anticipate and be forearmed against evil by 

 ascertaining whether the principal conditions, such as 

 purity of source, efficiency of subsidence, filtration, &c. 

 attaching to a given water-supply are such as to reduce 

 to a minimum the danger of its disseminating zymotic 

 disease, than to wait for the actual discovery of patho- 

 genic bacteria, and only then to be led to see the necessity 

 of, as it were, locking the stable-door after the horse has 

 been stolen ! 



The failure to discover the typhoid bacillus in the 

 Worthing water-supply is another instance in point, and 

 in the majority of cases the task of tracing the connec- 

 tion between an outbreak of disease and an infected 

 water-supply must obviously still be performed without 

 the direct support of the bacteriological detection of the 

 zymotic poison. Percy Frankland. 



NOTES. 

 The foundation of the Bakerian Lecture, to be delivered to-day 

 at the Royal Society by Prof. Thorpe, F.R.S., and Mr. J. W. 

 Rodger, although not so ancient as that of the Croonian, is yet 

 of respectable antiquity. Established during the presidency of 

 Sir John Pringle, the predecessor of Sir Joseph Banks, it has its 

 origin in the bequest, in 1774, by Henry Baker, antiquary, 

 naturalist, and Fellow of the Society, of the sum of one 

 hundred pounds, the interest of which is directed to be applied 

 for an oration, or discourse, to be spoken or read yearly by a Fellow 

 on some subject in natural history or experimental philosophy. 

 The forfeiture of the bequest is contingent on the lecture failing 

 to be delivered in any one year. The founder of this lecture was 

 himself a man of considerable parts, and, besides being the 

 author of numerous memoirs in the Philosophical Transactions 

 published two treatises on the microscope, and some poetical 

 works. He was elected into the Royal Society in 1740, and in 

 1744 was awarded the Copley medal. He married the youngest 

 daughter of Daniel De Foe. The first lecture under the bequest 

 was given in 1775 by Mr. Peter Woulfe, the subject being 

 " Experiments made in order to ascertain the nature of some 



