small part of its value, for the facts which he has brought together prove that man can be modified by selection as readily as any of our domesticated animals or plants, and that increased knowledge will ultimately enable us to bring about rapid improvements in our race.
| CHOLERA. |
By Dr. MAX VON PETTENKOFER.[1]
IV.—PREVENTION.
THE last sheet-anchor of the contagionists is always the linen of cholera-patients. But this view rests on such debatable ground that in the end it may prove to be fallacious. If cholera is really spread through human intercourse, then it is clear that the unknown specific something must accompany other vehicles, which may be man himself; and if this something can cause illness in man, then it must reside in the system of the patient, and ought to be found there. There can be no doubt of this; and I am prepared to admit as much. Thirty years ago I began my investigations on cholera in the belief that the germs of cholera were contained in the stools; but afterward, having made sure that cholera was dependent on locality as well as human intercourse, I endeavored to see how this relationship obtained by asking myself what was brought to the soil by man in his journeyings. The reply was, urine and stools—his excrements and nothing else. This view ripened into the belief that disinfection of the excreta and their receptacles ought to be a prophylactic measure against the spread of cholera, and excreta which had not been disinfected constituted a source of danger. These thoughts occupied me up to April, 1866, when I published with my lamented friends, Griesinger and Wunderlich, some regulations on cholera; and I first relinquished these views when further study showed the uselessness of measures of disinfection as well as the harmlessness of the undisinfected excreta of cholera-patients. If the poison of cholera be contained in the excreta, then, individual predisposition aside, those who mostly come in contact with the excreta ought to be most frequently affected. And these should be the various physicians and nurses in hospitals devoted to the care of cholera-patients. But experience has clearly shown that the medical attendants in cases of cholera are not more prone to take the disease than others. The like holds good of nurses. Let us first of all consider how the facts stand in the home of cholera, in India. During 1867, in which the epidemic at Hurdwar prevailed, James Cuningham investigated the relationship of cholera to nurses in forty garrison towns containing sixty-seven hospitals; of the sixty-seven hospitals only eight
- ↑ Reprint of a special translation made for the London "Lancet."
