( 8 5 ) 



Thorough disinfection of all clothing (if it be not possible to burn 

 it) is imperative. 



An anti-rat crusade is advisable early in the epidemic. 



Quarantine should extend to ten days unless the medical officer 

 relaxes this rule for good reasons. 



Cyllin is said to be the best disinfectant. 



Haftkines plague serum has been variously reported upon. 

 Cholera. 



Frequently commences as a simple painless diarrhoea, but may 

 start very suddenly during the night, the diagnosis— in the event of 

 cholera existing in the vicinity — of all cases of diarrhoea, must be 

 guarded, and when under such circumstances, such cases occur, 

 isolation, prompt and efficient is strongly to be recommended. 



The next stage is one of collapse from which many cases never 

 recover, the motions at this period become like rice-water, cramps 

 occur, and no doubt about the diagnosis usually remains, more 

 especially if the disease has been reported from the nearest town or 



The vehicles of infection are, water, milk, and contaminated food, 

 and clothing. 



I found, however, when dealing with the disease in Pahang in the 

 year 1901, that a grave suspicion fell upon the river fish, and whether 

 "post hoc" or "propter hoc" the disease certainly abated rapidly 

 when I got the "kathis" to place the river fish under a "pantang," 

 thus preventing their use as food. 



During the stage of collapse stimulants are indicated by the mouth 

 (« retained) and by hypodermic medication, the application of heat, 

 mustard plasters and such like remedies also. 



Contact with the discharges must be avoided, and disinfection 

 carried out thoroughly if such contact occur. 



The vomited material, the urine, and saliva are infective, and of 

 course the motions. 



The most prompt isolation of all diarrhoea cases in the event of 

 cholera being present in the district is necessary. 



If possible, change the water supply at once, examine the food 

 *"Pply and milk supply, and destroy all articles of doubtful virtue 

 ,ex cept human beings) on the estate or works at once. 



Vomiting is usually severe in cholera cases and is usually a pale 

 eatery fluid. The appearance of a cholera patient is most typical, the 

 hollows round the eyes, the dazed or hunted appearance, taken 

 together with loss of voice, coldness of the extremities, a feeble pulse, 

 ae ep collapse, and the macerated appearance of the hands all lead one 

 r *Pidly to the correct diagnosis. 



