8G 
PRECAUTIONS AGAINST CHOLERA. 
affect the public health in ordinary times, and as to the extreme degree of importance 
which attaches to them at times when any diarrhoeal disease is epidemic, has now for 
so many years been set before the public by this department and otherwise that the 
larger works of drainage and water-supply by which the dangers are permanently obvi¬ 
ated for large populations, and also the minor structural improvements by which sepa¬ 
rate households are secured against the dangers, ought long ago to have come into uni¬ 
versal use. It is to be feared that on a very large scale this wiser course has not been 
adopted, and that even yet, in very many instances, temporary security has to be found 
in measures of a palliative kind. So far as such is the case, attention is most earnestly 
called to those parts of the general memorandum which relate to the matters in hand. 
All chief sources of the one danger may be held in check, as follows—by immediate 
thorough removal of every sort of house-refuse and other filth which is now accumulated, 
by preventing future accumulations of the same sort, by attention to all defects of house- 
drains and sinks by which offensive smells are let into houses, by thorough washing and 
lime-whiting of uncleanly premises, especially of such as are densely occupied, and by 
disinfection, very freely and very frequently employed, in and round about houses, 
wherever there are receptacles or conduits of filth, wherever there is filth-sodden porous 
earth, wherever anything else in or under or about the house tends to make the atmo¬ 
sphere foul. As provision against the other danger, it is essential that immediate and 
searching examination of sources of water-supply should be made in all cases where the 
source is in any degree open to the suspicion of impurity ; examination both of private 
and of public supplies ; and where pollution is discovered everything practicable should 
be done to prevent the pollution from continuing, or, if this object cannot be attained, 
to prevent the water from being drunk.* The examination of sources of water-supply 
should of course extend to all receptacles of water storage, such as the tanks and reser¬ 
voirs of public supply, and the butts and cisterns of private houses. 
“ 5. That such precautions as the above (never unimportant where human health is to 
be preserved) are supremely important when the spread of cholera is to be prevented, is a 
truth which will best be understood when the manner in which cholera spreads is con¬ 
sidered. Happily for mankind, cholera is so little contagious, in the sense in which 
small-pox and typhus are commonly called contagious, that if proper precautions are 
taken where it is present there is scarcely any risk that the disease will spread to per¬ 
sons who nurse and otherwise closely attend upon the sick. But cholera has a certain 
peculiar contagiousness of its own, now to be explained, which, where sanitary circum¬ 
stances are bad, can operate with terrible force, and at considerable distances from the 
sick. It appears to be characteristic of cholera—not only of the disease in its developed 
and alarming form, but equally of the slightest diarrhoea which the epidemic influence 
can produce, that all matters which the patient discharges from the stomach and bowels 
are infective ; that the patient’s power of infecting other persons is represented almost or 
quite exclusively by those discharges ; that they, however, are comparatively non-infec- 
tive at the moment when they are discharged, but afterwards, while undergoing decom¬ 
position, acquire their maximum of infective power; that, if they be cast away without 
previous disinfection, they impart their own infective quality to the excremental matters 
with which they mingle, in filth-sodden earth or in depositories and conduits of filth, and 
to the effluvia which those excremental matters evolve; that, if the infective material, 
by leakage or soakage from drains or cesspools, or otherwise, gets access, even in the 
smallest quantity, directly or through porous soil, to wells or other sources of drinking 
water, it can infect, in the most dangerous manner, very large volumes of the water; 
that the infective influence of choleraic discharges attaches to whatever bedding, clothing, 
towels, and like things have been imbued with them, and renders these things, if not dis- 
* If, unfortunatelj% the onl}' water which for a time can be got should be open to suspicion 
of dangerous organic impurity, it ought at least to be boiled before it is used for drinking, but 
then not to be drunk later than twenty-four hours after it has been boiled. Or, under medical 
or other skilled direction, water in quantities sufficient for one day’s drinking in the house may 
be disinfected by a very careful use of Condy’s red disinfectant fluid. This should be added to 
the water (with stirring or shaking) in such number of drops that the water an hour after¬ 
wards shall have the faintest pink colour which the eye can distinctly perceive. Filtering of 
the ordinary kind cannot by itself be trusted to purify water, but is a good addition to either 
of the above processes. It cannot be too distinctlj'’ understood that dangerous qualities of 
water are not obviated by the addition of wine or spirits. 
