SUPPRESSION OF A CHOLERA OUTBREAK. 109 



4. GENERAL DISINFECTION OF LARGE AREAS. 



General disinfection of large areas is necessary at times when scattered 

 cases occur over a large area and the source of infection can not be 

 definitely located. Such disinfection should include that of all closets or 

 any substitute therefor, or any place suspected of being soiled or infected 

 by faecal matter. It may include also disinfection of the hands of the 

 people in the suspected area, and an effort should be made to induce 

 them to wash their hands before eating. 



5. CAMPAIGN OF EDUCATION. 



The inculcation of cleanly habits among the people, and instruction as 

 to how they should protect themselves from infection are very valuable 

 general measures in the prophylaxis of cholera. The campaign is most 

 effectively carried on in the schoolroom and from the pulpit. The 

 medical officer who is able to secure in this work the cooperation of the 

 local padre and school-teacher will be indeed forttinate. The Director of 

 Education and the Archbishop of Manila have done everything in their 

 power to secure the cooperation of their representatives in the provinces 

 with the Bureau of Health. The cholera circular of the Bureau of 

 Health is concise and explicit and contains all the necessary rules for 

 protection against infection. The circular is printed in Spanish, English, 

 and the principal native dialects. 



6. THE PROHIBITION OF CERTAIN FOOD STUFFS. 



The prohibition of certain native foods, fruits, and vegetables seems to 

 be a useful measure, although there is some doubt as to the reason why 

 such prohibition is beneficial. Some of these foods are very irritating 

 and indigestible and may be only predisposing factors. All these pro- 

 hibited foods may cause infection, as they are either eaten raw or long 

 after cooking, and are handled by a people many of whom in epidemic 

 times may be bacilli carriers and whose habits of personal hygiene are 

 those of a semi-savage people who have not yet arrived at the refinement 

 of using a knife, fork, or spoon at their meals, or the washing of their 

 hands before eating. 



7. ENACTMENT OF SANITARY ORDINANCES. 



It will be necessary to induce the municipal board to pass necessary 

 ordinances in order to place these general measures in force, if such 

 ordinances do not already exist, and the accomplishment of this is an 

 art in itself. I think the past grand master in the art of inducing 

 municipal councils to pass and enforce sanitary ordinances in the Phil- 

 ippines is Medical Inspector Paul Clements of the Bureau of Health. 

 An efficient and fearless justice of the peace is essential to see that the 

 enforcement of the ordinances is real and to apply substantial fines to 

 the offenders. 



