Page:Popular Science Monthly Volume 27.djvu/42

30 have failed because they simply treat the individual, the possible case of cholera. But the germs of cholera may be transmitted in the absence of the disease as manifested by illness. Even perfect sanitary cordons and quarantine would be also valueless, for the reason that they are commenced too late. It is true that quarantine and cordons may prevent a certain quantity of the germs of cholera from entering a country, so that it will serve as much purpose as a good custom-house against smuggling. But there is a great difference between articles of commerce and germs of cholera. The germs of disease are capable of multiplication, and so the smuggling through of a few may, under suitable circumstances, be the means for the development of millions and billions. The epidemics at Toulon and Marseilles afford excellent illustrations of my argument. Paris has not yet been attacked, while all the regulations have failed to prevent the appearance of cholera at Naples. No doubt inspection of ships is a good regulation as tending to discover unhygienic conditions, but it is useless as preventing the transmission of cholera. Inspection of places where cholera prevails, the disinfection of articles coming from localities where cholera is, as well also as the places where the dead are laid, are important matters, but too much is not to be expected from these measures. The prevalence of contagious diseases like small-pox can not be much diminished by attempts to limit intercommunication. Protection from small-pox by vaccination, which leaves human intercourse free, has been followed by success. But we have not at our command a simple and sovereign remedy by means of which the individual predisposition to cholera may be done away with, and yet we can do something in this direction. Everything which tends to lower the general health and cause depression, but especially those conditions which induce diarrhœa, predisposes to cholera. To these matters every one must look for himself, and his own efforts may be aided by the advice of doctors. The organs of public health may also effect much. Medical treatment should be obtained for the earliest cases of cholera and of diarrhœa. Care must be taken by the authorities and by the community to take measures for the treatment of the sick. But the difficult point in the prevention of cholera is the predisposition in time and place. It is no use urging, as the contagionists do, that we can not change the nature of the soil. One of the established facts concerning epidemics of cholera is the tendency of the disease to rage in those quarters where the greatest filth prevails. All towns which have been provided with good drainage and water-supply have lost their susceptibility to cholera. England affords the best example of this fact. In 1849 there were recorded 53,237 deaths from cholera, in 1854 the numbers were 20,097, and in 1866 only 14,378, while from 1872 to 1874, when several epidemics prevailed on the Continent, cholera did not reach England. I do not imagine that this immunity was due to the want of predisposition to cholera as regards conditions of time. The case of Fort