PROPHYLAXIS 



prepared an endotoxic serum, and Violle has prepared a serum by inoculating 

 the cholera vibrio in the gall-bladder of rabbits. Several authors recommend 

 treatment by repeated hypodermic injections of morphia, and others adrenalin 

 and pituitary extract. Kuhne recommends massive doses of bolus alba (kaolin) . 



With regard to diet, no food should be given during the acute 

 attack, but merely liquids, which should consist of water, iced 

 water, iced soda-water. Stimulants should only be given with 

 great moderation, and carefully by the mouth, as at times they are 

 apt to do more harm than good. In the algide state the liquids 

 given should be warmed, and hot black coffee may be used as a 

 cardiac stimulant. 



When reaction sets in, only the mildest foods must be allowed, 

 and then only with care. Begin with thin arrowroot, and continue 

 with milk mixed with soda-water, and then with milk, barley- 

 water, rice-water, etc. Sanatogen, plasmon, and somatose are also 

 recommended. Meat-extracts should be avoided. As improve* 

 ment continues, the diet may be slowly and carefully increased, but 

 the greatest care must be taken for a long time. 



Prophylaxis. — The prophylaxis must be based upon the know- 

 ledge that the disease is carried by man, and is spread from one 

 man to another by water, milk, contaminated food, especially green 

 vegetables, and insects, especially flies and perhaps ants. 



The methods which may be adopted are classifiable into private 

 and public. 



Private Methods. — 'At the beginning of an epidemic it is as well 

 to circulate a printed notice in English and in the vernacular telhng 

 the householder what he should do to prevent the disease attacking 

 his household. It is the duty of the head of every household to 

 personally inspect twice a week at least his kitchen and go-downs, 

 and especially his servants' latrines, and to see that the house and 

 compound are kept in a clean, sanitary condition. He must also 

 see that the filters are properly cleaned, and should flies abound 

 in the house, their source should be diligently sought for, or, if it 

 cannot be found and dealt with, the Sanitary Authority should be 

 informed. He should also see that the whole household keep them- 

 selves strictly clean, especially the cooks. 



With regard to food and drink, care should be taken that all 

 cooking and serving vessels are thoroughly cleansed with boiling 

 water, and that kitchen cloths are washed in a solution of cylhn 

 or carbolic acid. Especial care should be taken with regard to the 

 ice-safe, which is apt to become coated internally with green shme, 

 which may cause diarrhoea. This ice-safe must be thoroughly 

 cleaned with hot soda and water, and exposed to the sun at least 

 once a week. Food must not be stored near latrines, and must be 

 protected from flies and ants, and the rooms and cupboards in 

 which it is placed must be thoroughly cleansed with soda and hot 

 water at least once a week. 



All water must be boiled and filtered, and stored in covered 

 vessels, and all milk must be boiled and carefully protected fj om 



