Medical Officers of the Army of India.
sumption. These vegetables were cut up and shaken up in sterilised water and direct
microscopic examination revealed the presence of an extraordinary number of animalcules
belonging to the various groups of rhizopoda, infusoria, crustacea, arachnids, insecta and
worms; some 52 species in all, mostly innocuous, but including Amœba Coli, Balantidium
Coli and Anguillula Stercoralis; with eggs of all the common Parasitic worms. By
bacterioscopic examination microbes were found in uncountable myriads, which included
B. Coli, B. Septicus, B. Tetani and a bacillus indistinguishable from B. Typhosus.
Further particulars are given in the "Lancet" of November 24, 1900.]—
Lastly reference is made to the drinking of bazaar-made aërated waters; to the milk
supply, "precautions as to which are only mentioned in general terms."
There is a general consensus of opinion in favour of putting cantonment bazaars "out
of bounds."
Nothing more need be said in the way of pointing the moral of the facts and
opinions set forth above at, I fear, wearisome length, but the subject is of such
vast and immediate importance that it is necessary to focus the facts as a whole;
attention solely directed to one or other of the many factors leads to an erratic and
partial policy in our practical efforts of prevention, and we may sum up this part
of the subject in the words of two authorities whose eminent qualifications to
speak to the point will not be questioned. M. Haffkine says*:
—
"From the point of view of preventive measures in diseases like rabies, syphilis or
small-pox, where infection can be found in the patient alone, precautions taken as regards
the individual must affect directly the prevalence and propagation of the disease; whereas
in enteric fever or cholera or plague, where the patient is only one and proportionately
only a limited source of danger, his isolation and the destruction of hi belongings leave
unaffected the vast cultivations of infection which are going on in nature besides."
He goes on to draw the inference of the necessity of personal protection by
means of prophylactic inoculation, a measure the value of which we are
certainly not prepared to dispute; but he leaves the question of the other
factor—that of the environment—untouched. To any one who has followed the
facts set forth in the preceding pages, there is still another obligation imposed
upon responsible sanitarians, and this brings us to the opinion of one whose words
demand our highest respect. I allude to Sir John Simon, who says:—
"No community, so far as science can be trusted, can deserve immunity from epidemic
disease" (and he is discussing "filth" diseases)" except by making absolute cleanliness
the first law of its existence; such cleanliness as consists in the perfect adaptation of
drainage, water-supply, scavenage and ventilation to the purposes they should respectively
fulfil; such cleanliness as consists in carrying away by these means, inoffensively, all refuse
materials of life,—gaseous, solid or fluid—from the person, the house and the thoroughfare,
so soon as possible after their formation, and with as near an approach as their several
natures allow to one continuous current of removal."†
* B r i t i s h M e d i c a l J o u r n a l , J u l y 1 s t , 1 8 9 9 .
† " R e p o r t o n t h e C i t y o f L o n d o n . "
125
H H