SUMMARY OF PROPHYLACTIC MEASURES 1819 



The milk, ice, and aerated waters should be taken under the 

 municipal control, and not merely must care be taken that they 

 are pure, but they must be tested bacteriologically from time to 

 time. 



Vegetables must be inspected, and the place where they are grown 

 ascertained and inspected, in order to find whether there is faecal 

 pollution. A crusade must be made against flies and dirt in general. 

 The disposal of sewage should, of course, have been dealt with 

 before the epidemic has occurred; but if it is defective, attempts 

 should be made to remedy this as far as possible, and a scheme at 

 once started for proper collection and disposal. 



Bathing-places must be carefully inspected, and bad places closed, 

 and only pure water allowed to be used. No washing must be 

 allowed near wells. Drugs must be given free, and means for 

 inoculation of the prophylactic provided on a large scale. 



When the epidemic is past, the sanitary defects found out during 

 its course should be remedied, and not forgotten until another 

 outbreak occurs. 



Summary of Prophylactic Measures. 



Public Prophylaxis: — , 



1. Protection of the frontiers by regular inspection posts and 



quarantine stations. 



2. A central Cholera Board, with full staff and apparatus for bac- 



teriological disinfection and hospital work. 



3. Instruction of the populace by means of pamphlets. 



4. House-to-house search for cases. 



5. Search for carriers and sources of infection. 



6. Distribution of medicines and disinfectants. 



7. Provision of medical aid which can be readily obtained by anyone. 



8. Crusade against house-flies. ^ 



- Private Prophylaxis : — ■ 



' I. Personal cleanliness. 



2. Avoidance of foods liable to be contaminated or to cause diarrhoea. 



3. Avoidance of pollution of foods, especially by flies. 



4. Filtration and boiling of all water used for cooking, drinking, etc. 



Filters to be kept strictly clean. 



5. Boiling of milk and protection against flies. 



6. Clean, sanitary dwelling free from flies, 



7. Anti-cholera vaccination, repeated yearly in endemic centres. 



8. Immediate application for medical aid in case of diarrhoeal 



illness of any description. 



PARACHOLERA. 

 Synonym. — N'diank (Senegal). 



Definition. — Paracholera, a term first introduced by Castellani, 

 indicates an acute attack of colic and diarrhoea, with or without 

 rice-water motions, which resembles cholera in the severity of the 

 symptoms, but differs therefrom in that its causal organism is a 

 vibrio different from Vibrio cholercB Koch. 



Remarks.- — ^The work of Castellani, Thiroux, Lamas, Greig, Orti- 

 coni, Chalmers and Waterfield, and many others, has demonstrated 



