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- THE INDIAN MEDICAL GAZETTE.

(Fee. 1904, The insanitary condition of the villages in Puri district haa been admirably depieted by Dr. Sen, and He hag described how cholera is disseminated ainohgst the villagers; hy also details a scheme to prevent the inroad of cholera into villages.

It is an almost universal experience that a éholera epidemic rons its own course; but the prevention of the disease in Puri town iteelf, the focta of “primary dissettination,” is quite within the domain of practical sanitation.

Previous to the advent of the majority of the pilgriins, the lodging-houses were inspecbsd and their accommodation certified, private camping grounds and atreet camping were disallowed, ail public and lodging-house wells were perman- ganated, extra staff fur conservancy work waa entertained, and all lodgittg-house keepera were warned to notify the police or health officer on the occurrence of a vase of cholera, so that disin- fection measures might be carried out, and-th patient isolated.

Arrangements wete made for the ore the bodiea of ange dying from chdlera, Jée the cleaning of the steps and banks for the ptevention of promiecuous defr hear tatks, wells, &c., arid for the washing. f elothes in, vr drinking or carrying away water ‘from, the tanks. Moat of these moenatires were in the main well carried out, except those re- ferring to the washing of clothea in tanks and ‘the drinking of and carrying away of water from tanks, which measures were almost impos- aible to property carry out,

The ehtef sourees of infection in Puri town -#re tlie sacred tanks; at all the local festivals or melue the pilgrims largely resort to the Neren- ~dew and Makanda tanks, less so to the Indra- dyumna, whilst the Swetaganga, which is the ‘sesallest and is considered sonaielly holy, iain a deplorably insanitary state anc consists mainly of the washings and liquid sewage from the latrines in elose proximity all round the tank,

1 have frequently witnessed large numbers of people bathing in these tanks, and aa the clothes of infected people were continually being wash- ed in them, the water continues to be polluted and never gets a chance of purifying itself.

It will be understood to what extent these tanks are infected, especially the Narendra, when I mention the fact that many pilgrims came and lay down on the banks to die, much of whose dejecta was washed into the tanks and sone actually washed themselves in the tank whilst pea from the disease; these cases always orcurred during the night,

Though all the wells were permanganated, yet many of them are certain to have become infected with choleraic discharges. This is specially the cace with some of the private and lodging house wells, which are all shallow aurface soil wells, aud, as they have no pucea aligninent and no protecting wall, they must be eastly con- taminated either from actual surface washings or from percolation through the surface soil, I have myself observed people washing themselvea dnd their clothes close to the unprotected mouth of a well situated in the compound of & lodgings house in which cholera had occurred.

Another source of infection is the private lattines, very few of which have receptacles, and the ground thus: becomes saturated with filth before ita removal. Some of these latrines are in close proximity to the wells, and thus percolas tion easily takes place. ;

Pools and tanks on the roadside, more eapectal- ly on the Juggernath road from Puri te Cuttack, are a fruitful source of cholera. Pilgrims be- coming affected with cholera invariably go to the nearest pool and lie down close to the water's edge; the result is that these people contam- inate the water, and this being drunk by passers- by further disseminates the disease.

Same of the cases in the Cholera Hospital raced to the eating of the sacred food gat,” but being the only food allowed their stay in the Lown, it is con- ajits state of putrefaction and thus ag Ye disease. flitions under which the piigtim: the unavoidable overs

SWading, deficient ventilation, the impure water, the bad food and the general insanitary condi+ tion of the placs, all these tend towards dimi- nishing the resistance of the individual aud increasing his susceptibility to cholers.

To ameliorate these conditions and, if pos sible, prevent further outbreaks in places similar to Purl, where there are large gatherings of feople, it neeins to me, that in addition to the above, the following preeautionsare necessary :—

1st..—The provision of a perinanent cainping ground, where the pilgrimd would be housed int large corrugated iron sheds; the ground ghould be a good distance off from the town.

Suh a camp abould be furnished with the latest sanitary arrangemenéa ; sufficient latrine accommodation should be provided, and the wator-supply obtained from deep wells, the water being pumped up to 4 cisters and from thence supplied ly means of pipea on the tap system ; in this manner the tvater-supply would _ be safe-guarded from contamination,

A pucka masonry dhuli-ghat should- be provided for the washing of clothes, and the ground itself should be thoroughly drained,

2nd—The sanitation of the town — inust, especially during the rainy season, be as good as possible ; the acavenging, the flushing of drains, the removal of sewage and refuse, and above all, the removal aud dispusal of exereta to 4 good high trenching-ground.

3rd—That in view of the fuct that the sucred tanks never geta chance to purify themselves, the templé authoriiies be asked te proclaim that ona of the tanks is sacred for a week at a tino During that period the people would be alloyed to bathe in that tank, but only sprinkle water on their heads froin thd other three, --(.

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