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 the Wisconsin State board of Health, a space in your valuable paper.
The specific directions for the prevention of cholera (or any 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 the Public:
It is beyond question that cholera of genuine Asiatic type exists in several places on the western shore of Europe, and, in the opinion of those best informed concerning it, there is great danger that it will spread from these centers of infection, and following the course of previous cholera epidemics, will reach this country within the next few months while there is a possibility of its doing so at any time.
Very recent experience has given us proof that disease may develop itself in inland towns in Wisconsin, in persons who bring with them the germs of sickness of which their were no recognized manifestations during the brief 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, and there is no reason why cholera may not be brought to us in the same way. Thus it will be seen that there is no place in the State that can be reckoned safe from the visitation of Cholera, while places on lines of railroad travel are especially exposed.
In view of these facts the State Board of Health desires to urge upon all local boards, communities and individuals the duty of making such preparation as will enable them in the first instance to resist the approaches of Cholera, and in the second, to prevent it from gaining a foothold should it unfortunately be brought to them in ways suggested. To be forewarned in this matter should be to be forewarned also.
The worst and most violent out -breaks of cholera occur where sanitary conditions are bad; where accumulations of filth and stagnant pools of water are found; where the drinking water is polluted, where ventilation is neglected, and where the people are neglected, and where the people are over-crowded. it is true that such conditions always exist in many places, and it is not here claimed that they produce cholera. Nevertheless, it is not only certain that they furnish a fit soil for the reception of the special of the disease, but it is also a well established fact that the specific cholera infection cannot find lodgment to any great extent, or seriously injure any community in which the sanitary conditions are such as do not invite its presence or favor its development.
Koch's investigations show the presence of minute bacilli, or microbes, in the intestines and intestinal discharges of patients suffering from Cholera, and that microbes are capable of reproduction under favorable circumstances. Whether they be the cause of Cholera or not, whether we can or cannot clearly define the character of the specific Cholera poison, we do know its chosen habitations and can do much to resist and prevent it. The means of prevention remain substantially unchanged by Koch's discoveries, which indeed only emphasize more strongly than ever the necessity of general cleanliness, and for the dryness of soil.
The State Board of Health therefore, earnestly warns the people of Wisconsin to :
PREPARE NOW TO RESIST AND PREVENT CHOLERA
To any given place or to any number of places it may not come, but since no place is exempt from the danger of its coming, it will be unwise 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 that secure these to the greatest extent will have the least fear from Cholera, or indeed, from any disease; but the cleanliness that is necessary can be secured only by vigorous, intelligent and concerted action, and can be maintained only by unceasing vigilance. All measures of preparation should be adopted before Cholera comes. for in the presence of the disease they cannot be effectively taken, possibly not even safely.
Cess-pools, privy vaults, and accumulations of filth generally, may and should be now emptied or removed, whereas when Cholera is actually with us, it may not be wise to stir them up, but better and safer to cover them temporarily with earth and disinfectants.
On the part of the local Health Boards and sanitary authorities in all parts of the state, the following essential precautions are earnestly advised:
1. Thorough sanitary inspection of every city, town and village.
2. The drainage of all stagnant ponds and low, wet grounds.
3. The careful cleansing and disinfecting of all sewers and public drains.
4. The cleansing and disinfecting of all private vaults, and
5. The destruction, entire and complete, of all accumulations of filth that may be discovered.
On the part of private citizens and householders, the State Board of Health recommends a careful investigation and thorough cleansing of cellars, barns, and out houses frequently; of house-drains, sinks, cesspools, privy vaults, together with a frequent and plentiful use of lime whitewash wherever it may be appropriate; attention to the ventilation of all parts of the dwelling; avoidance of anything like overcrowding in living rooms or bed rooms; in short the most scrupulous cleanliness in all respects, both in-doors and out of doors.
A very efficient way of disposing of much refuse, both of household and communities, and one to be highly recommended, is to destroy it by 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 especial care to the character of their supply of drinking water, and the adoption of such precautions as will insure its purity. It is by the water used for drinking purposes that the germs of cholera most often enter the system, and since this is a source of danger that frequently needs times for its removal, and which cannot be remedied in the face of a cholera epidemic, examination of wells and similar sources of supply should be made now. The leakage of privy vaults and cesspools into wells, the water of which is highly esteemed, is a matter of much more 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 they be neglected and the disease should come to us, its malignity in any given community will probably be in direct proportion to the degree of negligence existing there.
As already stated, the object of this article is to secure such 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, another circular will be published, giving more specific directions for dealing with its actual presence. It is hoped, however, that by the action of this and other State Boards, and by the general observance of the precautions recommended herein, that the necessity for so doing will be avoided.
Physicians are again reminded of the law which requires prompt reports of all cases of this (and other) contagious diseases, and Health Officers and Health Boards are likewise reminded of the obligation to make reports such cases to the office of the State Board of Health. Such towns as have not fully organized Boards of health with efficient Health Officers, are also reminded of the requirements of the law that such Boards be organized and such Officers appointed.
As suggested already in this circular, Cholera patients, in the early stages of the disease, may travel from place to place suffering from Diarrhoea, the true nature of which is unsuspected, and may use a number of different privies. Should this occur, it has been wisely suggested that inquiry be made concerning the privies used by any such patient, and that an officer be sent at once to disinfect them. For this purpose it is recommended that for each vault, two or three pailfuls of a strong solution of copperas be used; this solution may be made by dissolving fifteen pounds of copperas in ten gallons of water, and since it is said that the cholera germ is destroyed by acids, a pound of strong, commercial Sulphuric Acid may be added to each gallon of the solution with great advantage.
What has been said concerning the duty of securing and maintaining the cleanliness of towns and private premises will apply with even greater force to railway stations, hotels, and all similar places, and the special attention of managers and and proprietors herein contained.
Everyone who is responsible for the sanitary condition of any building or apartment for the accommodation of the traveling public is urged to see that his charge is kept in the most cleanly possible condition, and to have especial care that all privies, water-closets and urinals used by employees or travelers are regularly and systemically cleansed and disinfected. Railroad managers and hotel proprietors would subserve their own interests and render good service to the public by giving orders at once for the adoption of such measures.
Finally, all work done in the line suggested in this circular will be conducive to health and of benefit to all, even though cholera should not come.
By order of the State Board of Health,
J. T. Reeve, M. D.
Copies of this circular may be had by addressing the secretary at Appleton, Wis.