The Sun.
London, England, 1831-11-17 00:00:00

The. Central Board of Health have drawn up,
and ordered to be issued, the following important
paper to au various Boards of Health :
COUNCIL OFFICE, NOV. 14, 1931.
SIR,--The Central Board of -Health having ma-
turely weighed all the information which has been
transmitted to them relative to the progress of ;hp
Asiatic spasmodic cholera in various parts of Eu-
rope, but more particularly guided by the conclusions
on this head to which Drs. Russ.ll and Barry have
arrived, after a few months' careful and laborious
observations of the character of that disease in those
parts of Russia which they have visited, beg leave
to suggest for your consideration the following sana-
tory- hints :
I. AS TO PRECAUTIONARY MEASURES.
In order to insure the adoption and realise tile
benefit of any system of sanatory arrangements in a
large community, the first essential point is to divide
that community into subordinate sections, and to
form distinct Boards of Health, each to consist, if
possible, of a resident clergyman and a number of sub-
stantial householders, and of one medical wan at least.
These Boards should be charged with the fol-
lowing duties in their respective districts, viz.:-
1. To appoint inspectors. Each inspector to visit
daily, and to inquire carefully after the health, means of
.Ithsistence, cleanliness, and comforts of the initiates of,
say 100 houses, more or less according to local circuni.
stances. - -

2. To receive and examine the reports of those inspect
ters, which should be made up to a given hour on each day.
3. To endeavour to remedy by every means which as-
tlividual and public charitable exertion can supply such
deficiency as may be found to exist in their respective
districts in the following primary elements of public health,
v:z. the food of the poor, clothing, bedding, ventilation, ••
•, elesuliness, outlets for domestic filch, habits of tem—
perance, prevention of panic.
4. To report to their principal 131mila respectively on
the above heads, as well as on the actual state of the Li alth
of their districts.

The subordina►e divisions of each district ought
to be numbered or lettered, and each district named;
the names of each Board often had not been attach, d
to them, and that of the visiting inspectors employed
should be placarded in conspicuous places.
Principal Boards of cities, towns, or parishes, to
report directly to the Central Board in London-
1. On the actual state of health of the who'e popul .tion.
2. On the precautionary measures already carried into
effect.

3. On the measures contemplated.
4. On suspected sources, if ens there be, from whence
this particular disease might possibly sprine.
With regard to precautions as to intercourse with
suspected or really infected persons or places, the
Board are confident that good sense and good feel-
ing will not only point out, but morally establish, as
'nay be practicable, the necessity of avoiding such com-
munications as may endanger the lives of thousands.
But they strongly deprecate all tneesures of co-
ercion for this purpose, which, when tried upon the
continent, invariably have been found productive of
evil. The best inducements to a prompt acknow-
ledgment of the disease having entered a family, as
well as to an early and voluntary separation of the
sick from the healthy, will edweys be found in the
r.-afinesss and efficiency with which public chari able
institutions attend to the object in S.
It is with much satisfaction that the Board feel
themselves authorised 'o declare, anti it will, no
doubt, be highly consolatory to the pubis to learn,
that wider the proper observances of eleetilitie,s and
ventilation this disease eehioto spree& in families,
and rarely passes to those about the sick under such
favourable circumstances, unlees they happen to he
particularly predisposed.
It will riot, therefore, be necessary when there is
space, and when due attention is paid to cleanliness
and purity of air, to separate members of ramifies
actually affected by the disease, nor no insulate
indi-
vidual houses, unless in eases of crowded, tilthy,liadiv
ventilated hubitations,and other contingencies which
involve the health of all.
It having been proved, by ample experience, in
more than one city in Europe, that the fitting up
and flunishing of hospitals for the reception of the
poorer classes supposed likely to be attached by the
disease, at a period too long before its actual break-
ing out, has been productive of great waste of
means, by the •poiling of various articles, and the
consequent want of wholesome accommodation when
most required, the Central Board would recommend
that proper and sufficient house-room only be se-
cured and prepared in the first instenee, and that the
charitable be called upon only to pledge themselves
to furnish, at a given notice, such articles of bedding,
furniture, &c., or the value of them, as they ‘1 ould at
once have contributed.
By this means the deterioration of perishable ar-
ticles will be avoided; and should the district en-
tirely escape, the contributions will be saved.
The situations which the Board would recom-
mend for temporary cholera hospitals would be
those most detached, insulated, and thoroughly ex-
posed to free and open air; the description of hotse
such as would admit of the most perfect ventilation
and cleanliness, and the largest space around the sick.
The Board would recommend, where a family is
reported to be in an unhealthy stare by the sub-
inspector, and the disease confirmed to be cholera
by a medical member of the District Board, that
the head of such family, if unable to afford accom-
modation at home, be advised to send the sick per-
son forthwith to the temporary hospital, and that
the other members of the family be supplied with
such additional means and comforts as their state
may require, to enable them to resist the influence
of the infected atmosphere.
11. MEDICAL AND DIETETIC: PRECAUTIONS.

These will be found of considerable importance,
from their contributing to prevent or diminish the
susceptibility to infection which individuals may
possess at the moment the disease breaks out. No
sudden nor extensive alterations should be made in
the usual modes of living. All changes (if food to he
useful, indeed not to be absolutely pr. judicial, should
tend to render it drier, tnure nutritive, and c,ncen-
trative ; moderately costive bowels, the almost in-
variable cone., quence of a dry, inviguniting diet, will
be found more conducive to exemption from cholera
than an opposite habit.
Whenever aperients may become indispensable,
hose of a %vrpn aromatic kind, in moderate doses,
or domestic means, should be alone resorted to.
What is generally understood by salts, viz.
Cilaubet's salts and Epsom salts, as vvell as other
cold purgatives, should not be taken in any quans
,ities, nor on any account, without the express pre-
..cription of a medical man.
Tne medical members of the Board beg to state
ti tlis most decided manner, that no specific pre-
ventive against cholera is known to exist, and that
the drugs hitherto offered with this pretension, in
countries where the greatest ravages have been
caused by this disease, not only did not possess the
negative virtue of doing no harm, but are found to
be absolutely injurious.
The two preventives are a healthy body and a
cheerful unruffled mind. Looseness of bowels
should be immediately checked, and any thing like
periodical chills or cold perspirations should be met
by quinine in suitable doses, but habitual drugging,
t all times anproper, :is to be depreca ed in tho
the above precautionary
s
strongein terms when epidemic disease is appreh tided.
The Board have been anxious to lay before the
public, as early as passible,
outlines, which they trust will tend, together w-ith
he suggestions emanating from the wisdom of
your
and other local Boards, if not to exempt the whole
popula.ion of these realms from the scourge of spas-
cholera, at least to enable them to meet 1., in
the event of its appearing amongst them, with phy-
cal and moral constitutions the least likely to suffer
min its virulence.
The Central Board will avail themselves of the
e aliest opportunity to trans,ait to you 4,1 further
atiatory suggestions which in..y oecur ;0 them oft
ire subject of precautionary massuies, %%ell as
'labile of instructions now ail piepar,i ton tut com-
Aiunities supposed to be actually a iricked.--I have
the honour to be 6,r, your most ob-dieto servant,
E. STEWAR Cluirulan;