Cholera and Its Prevention
Transcribed and edited by Michael R. Reilly
December 19, 2005 Updated 12/20/2005
Waukesha Freeman, Thursday, August 21, 1884
Prevention of Cholera
Mr. Editor: Please give the annexed circular issued by theWisconsin State board of Health, a space in your valuable paper.
The specific directions for the prevention of cholera (orany other filth disease) are laid down in the following five points:
1st. The condition of the water supply.
2nd. The disposition of night soil, garbage and sewage.
3d. The cleansing of streets, alleys and other public places.
4th. The supervision of food suppliers, and of market-places,slaughter-houses and similar establishments.
5th. The general sanitation of every house and its surroundings.
Dr. Hugo Philler
To local Boards of Health, Health Officers and thePublic:
It is beyond question that cholera of genuine Asiatic typeexists in several places on the western shore of Europe, and, in the opinion ofthose best informed concerning it, there is great danger that it will spreadfrom these centers of infection, and following the course of previous choleraepidemics, will reach this country within the next few months while there is apossibility of its doing so at any time.
Very recent experience has given us proof that disease maydevelop itself in inland towns in Wisconsin, in persons who bring with them thegerms of sickness of which their were no recognized manifestations during thebrief time needed for transit from seaboard. Small pox was thus lately conveyed,in one instance in the bedding of immigrants, in another in their persons, andthere is no reason why cholera may not be brought to us in the same way. Thus itwill be seen that there is no place in the State that can be reckoned safe fromthe visitation of Cholera, while places on lines of railroad travel areespecially exposed.
In view of these facts the State Board of Health desiresto urge upon all local boards, communities and individuals the duty of makingsuch preparation as will enable them in the first instance to resist theapproaches of Cholera, and in the second, to prevent it from gaining a footholdshould it unfortunately be brought to them in ways suggested. To be forewarnedin this matter should be to be forewarned also.
The worst and most violent out -breaks of cholera occurwhere sanitary conditions are bad; where accumulations of filth and stagnantpools of water are found; where the drinking water is polluted, whereventilation is neglected, and where the people are neglected, and where thepeople are over-crowded. it is true that such conditions always exist in manyplaces, and it is not here claimed that they produce cholera. Nevertheless, itis not only certain that they furnish a fit soil for the reception of thespecial of the disease, but it is also a well established fact that the specificcholera infection cannot find lodgment to any great extent, or seriously injureany community in which the sanitary conditions are such as do not invite itspresence or favor its development.
Koch’s investigations show the presence of minute bacilli,or microbes, in the intestines and intestinal discharges of patients sufferingfrom Cholera, and that microbes are capable of reproduction under favorablecircumstances. Whether they be the cause of Cholera or not, whether we can orcannot clearly define the character of the specific Cholera poison, we do knowits chosen habitations and can do much to resist and prevent it. The means ofprevention remain substantially unchanged by Koch’s discoveries, which indeedonly emphasize more strongly than ever the necessity of general cleanliness, andfor the dryness of soil.
The State Board of Health therefore, earnestly warns thepeople of Wisconsin to :
PREPARE NOW TO RESIST AND PREVENT CHOLERA
To any given place or to any number of places it may notcome, but since no place is exempt from the danger of its coming, it will beunwise for any to neglect timely precautions to prevent it.
The essential measure of preparation is cleanliness,including purity of water supply and dryness of soil and the communities thatsecure these to the greatest extent will have the least fear from Cholera, orindeed, from any disease; but the cleanliness that is necessary can be securedonly by vigorous, intelligent and concerted action, and can be maintained onlyby unceasing vigilance. All measures of preparation should be adopted beforeCholera comes. for in the presence of the disease they cannot be effectivelytaken, possibly not even safely.
Cess-pools, privy vaults, and accumulations of filthgenerally, may and should be now emptied or removed, whereas when Cholera isactually with us, it may not be wise to stir them up, but better and safer tocover them temporarily with earth and disinfectants.
On the part of the local Health Boards and sanitaryauthorities in all parts of the state, the following essential precautions areearnestly advised:
1. Thorough sanitary inspection of every city, town andvillage.
2. The drainage of all stagnant ponds and low, wetgrounds.
3. The careful cleansing and disinfecting of all sewersand public drains.
4. The cleansing and disinfecting of all private vaults,and
5. The destruction, entire and complete, of allaccumulations of filth that may be discovered.
On the part of private citizens and householders, theState Board of Health recommends a careful investigation and thorough cleansingof cellars, barns, and out houses frequently; of house-drains, sinks, cesspools,privy vaults, together with a frequent and plentiful use of lime whitewashwherever it may be appropriate; attention to the ventilation of all parts of thedwelling; avoidance of anything like overcrowding in living rooms or bed rooms;in short the most scrupulous cleanliness in all respects, both in-doors and outof doors.
A very efficient way of disposing of much refuse, both ofhousehold and communities, and one to be highly recommended, is to destroy itby burning, thus rendering it absolutely harmless.
The board desires to call the attention of all,individuals and communities, to the great importance of looking with especialcare to the character of their supply of drinking water, and the adoption ofsuch precautions as will insure its purity. It is by the water used for drinkingpurposes that the germs of cholera most often enter the system, and since thisis a source of danger that frequently needs times for its removal, and whichcannot be remedied in the face of a cholera epidemic, examination of wells andsimilar sources of supply should be made now. The leakage of privy vaults andcesspools into wells, the water of which is highly esteemed, is a matter of muchmore frequent occurrence than the owners of wells deem possible.
With the above precaution above suggested, duly observed,it is believed that we shall have little reason to fear Cholera; while if theybe neglected and the disease should come to us, its malignity in any givencommunity will probably be in direct proportion to the degree of negligence existingthere.
As already stated, the object of this article is to securesuch preparation as will prevent danger should Cholera be brought to our shores,and such as will put the State in the best position to resist its attacks.Should the disease appear in Wisconsin, or in any adjoining States, anothercircular will be published, giving more specific directions for dealing with itsactual presence. It is hoped, however, that by the action of this and otherState Boards, and by the general observance of the precautions recommendedherein, that the necessity for so doing will be avoided.
Physicians are again reminded of the law which requiresprompt reports of all cases of this (and other) contagious diseases, and HealthOfficers and Health Boards are likewise reminded of the obligation to makereports such cases to the office of the State Board of Health. Such towns ashave not fully organized Boards of health with efficient Health Officers, arealso reminded of the requirements of the law that such Boards be organized andsuch Officers appointed.
As suggested already in this circular, Cholera patients,in the early stages of the disease, may travel from place to place sufferingfrom Diarrhoea, the true nature of which is unsuspected, and may use a number ofdifferent privies. Should this occur, it has been wisely suggested that inquirybe made concerning the privies used by any such patient, and that an officer besent at once to disinfect them. For this purpose it is recommended that for eachvault, two or three pailfuls of a strong solution of copperas be used; thissolution may be made by dissolving fifteen pounds of copperas in ten gallons ofwater, and since it is said that the cholera germ is destroyed by acids, a poundof strong, commercial Sulphuric Acid may be added to each gallon of the solutionwith great advantage.
What has been said concerning the duty of securing andmaintaining the cleanliness of towns and private premises will apply with evengreater force to railway stations, hotels, and all similar places, and thespecial attention of managers and and proprietors herein contained.
Everyone who is responsible for the sanitary condition ofany building or apartment for the accommodation of the traveling public is urgedto see that his charge is kept in the most cleanly possible condition, and tohave especial care that all privies, water-closets and urinals used by employeesor travelers are regularly and systemically cleansed and disinfected. Railroadmanagers and hotel proprietors would subserve their own interests and rendergood service to the public by giving orders at once for the adoption of suchmeasures.
Finally, all work done in the line suggested in thiscircular will be conducive to health and of benefit to all, even though cholerashould not come.
By order of the State Board of Health,
J. T. Reeve, M. D.
Copies of this circular may be had by addressing thesecretary at Appleton, Wis.