Page:Tropical Diseases.djvu/526

484 Had the incidence of cholera been the same in both classes, the inoculated would have had 174 instead of 27 cases, and 109 instead of 14 deaths. In 1912, 8,000 Europeans were inoculated in Batavia, and among these there was only one death from cholera as against 15 deaths amongst 2,700 uninoculated.

Subsequent experience, particularly that obtained during the Balkan War of 1913 and the European War, has gone far to confirm these earlier impressions of the value of Haffkine's vaccinations. Recently Castellani has advocated, and practised with promising results, the use of a " tetra vaccine " of combined cholera, typhoid, and paratyphoid A and B strains.

Personal prophylaxis.— During cholera epidemics great care should be exercised to preserve the general health; at the same time, anything like panic or apprehension must be sedulously discouraged. Fatigue, chill, excess— particularly dietetic or alcoholic excess— are to be carefully avoided. Visits to cholera districts should be postponed if possible, seeing that the new-corner is specially liable to contract the disease. Unripe fruit, over-ripe fruit, shell-fish, food in a state of decomposition, and everything tending to upset the digestive organs and to cause intestinal catarrh are dangerous. Melons, cucumbers, and the like deserve the evil reputation they have acquired. Purgatives— particularly saline purgatives— unless very specially indicated, should never be taken at these times. All drinking-water, and all water in which dishes and everything used in the preparation and serving of food are washed, should be boiled. Filters— except perhaps the Pasteur-Chamberland filter— are not for the most part to be relied on; in many instances they are more likely to contaminate the water passed through them than to purify it. A good plan in a household, or in public institutions, is to provide for drinking purposes an abundant supply of weak tea or lemon decoction, the supply being renewed daily; such a plan ensures that the water used in the preparation of the drink has been boiled. All food should be protected from flies.