PRLCAUTIONS AGAINST CHOLERA. 
87 
infected, capable (as the cholera patient himself would be capable, under the same condi¬ 
tions) of spreading the disease in places whither they are sent for washing or other pur¬ 
poses ; that, in the above described ways, even a single case of disease, perhaps of the 
slightest degree, and perhaps quite unsuspected in its neighbourhood, may, if local cir¬ 
cumstances co-operate, exert a terribly infective power on considerable masses of popula¬ 
tion. ‘ If local circumstances co-operate,’ however, is the stated condition for that pos¬ 
sibility ; and it will be observed that the essence of the sanitary precautions, which have 
been recommended to nuisance authorities and others, is to annihilate those ‘ local circum¬ 
stances,’ The choleraic infection does not seem able largely to injure any population 
unless a filthy state of things be presupposed. It is presupposed that the atmosphere or 
the drinking-water of the population is impure with the most loathsome of impurities ; 
that the infective material has had opportunities of action which decent cleanliness would 
not have afforded it; that, in inefficient drains or cesspools, or other like depositories, it 
has had time to deveiope its own infective power, and to render other stagnating filth 
equally infective with itself ; and that from such foci of infection the disgusting leaven 
of the disease has spread, in air or water, to be breathed or swallowed by the population. 
In this view of the case it will be understood that works of sewage, house drainage, and 
water supply, properly executed and properly used, give to town populations an almost 
absolute security that cholera, if introduced among them, can have no means of spread¬ 
ing its infection. And equally it will be understood that, in the absence of those per¬ 
manent safeguards, no approach to such security can be got without incessant cleansings 
and disinfections, or without extreme vigilance against every possible contamination of 
drinking water. 
“ 7. Personal precautions against cholera consist essentially in avoiding the unwhole¬ 
some circumstances which have been described; and where that avoidance can be secured 
there need not be further thought on the subject. Even where cholera seems imminent 
the danger is quite conspicuously one which ought not to give occasion to panic. In¬ 
telligence and cool decision are wanted against it. The case is no longer that of a 
mysterious pestilence coming (like the plagues of past centuries) on ignorant and but 
half-socialized populations; it is the case of a distinct and measurable attack, against 
which definite precautions can be taken with success; and power to enforce those pre¬ 
cautions is in the hands of local authorities throughout the country. But individual 
security cannot be promised apart from the security of districts; and for selfish safety, 
no less than for the general good, it is expedient that every man should do his utmost 
to promote where he dwells a vigorous sanitary administration over the largest possible 
area. Those who know that such an administration is at work around them need have 
but little apprehension as to the result. 
“ 8. As to personal precautions, in a narrower sense of the words, only one general 
rule can be laid down—a rule, however, which is most important for persons who un¬ 
fortunately find themselves in the midst of local outbreaks of cholera, and which each 
individual must apply according to his experience of his own bodily habits—the rule of 
living as strictly as possible on that system which commonly agrees best with the health ; 
to guard, as far as practicable, against all exhausting infiuences of privation, fatigue, 
exposure, and the like; and, as regards diet, especially to avoid all acts of intemperance 
and all such eating and drinking as are likely to disturb the stomach or bowels.* But 
* Precautions against causing such disturbance to oneself by errors of diet will vary some¬ 
what with different individuals. Every person of ordinary discretion knows the habits of his 
own body, and can be tolerably conficlent, within certain limits of food, that he gives himself 
no occasion of such illness. Apart from personal peculiarities (where each man must judge for 
himself), the chief dangers of diet appear to be as follows :—Firstly, in those mere excesses of 
diet which (especially under circumstances of fatigue) occasion sickness to the stomach, or an 
increased labour of digestion; secondly, in taking food, solid or fluid, which is midway in some 
process of chemical transition—half-fermented beer and wine, water containing organic impu¬ 
rities, meat and game and venison no longer fresh and not completely cooked, fish and shell¬ 
fish in any state but the most perfect freshness, fruit or vegetables long gathered or badly kept, 
and the like; thirdly, in the excessive or unseasonable use of refrigerating drinks or ice; 
fourthly, in partaking largely of those articles of diet which habitually, or by reason ot imper¬ 
fect cooking, pass unchanged through the intestinal canal ; and, litthly, in the indiscreet 
use of purgative medicines, or in taking any article of diet which is likely to produce the same 
effect. 
