The Indianapolis journal. [volume] (Indianapolis [Ind.]) 1867-1904, 1892-09-05
FACTS ABOUT Til CHOLERA
Latest Discoveries and Conclusions Of
Medical Science About the Disease.
Character of the Bacillus Mo,t Danger Of In
lection LIS in Water-SymptOms. Pre-
ventive Measures and Treatment.

strong possibility OF Its getting even 10 THIS
city, as il has lone in the past, makes all
data regarding the disease interesting, ii
not valuable. so tar as it instructs people
in the preparation for and cure of the terri
BILE malady. Fortunately il is not neces-
sary in the United states to suppress news
regarding the spread of the disease in order
to prevent half the population dying of
fright. DIR. William Osler, physician-in-
chief to the Johns Hopkins Hospital and
Medical School, the highest American ex-
ponent of modern medical views. recently
issued a work on the principles and prac-
tice of medicine. in which he gives q very
succInct history of the disease. it's course.
modes of infection. symptoms. post mortem
changes, diagnosis from common cholera.
method of prevention and medical treat
ment. DR.. Osler defines cholera as o specific
infection, caused by the bacillus of Koch.
and characterized clinically by violent
purging and rapid collapse.
In 1884 Koch, the great German physi-
cian. announced the discovery of the spe-
citic organism of the disease. Subsequent
observations have confirmed his statement
that the comma bacillus, as it is termed.
occurs constantly in the true cholera. and
in no other disease. 1t has the form of q
more than about onc-half the length of the
tubercle bacillus. and sometimes occurs in
an s form.
THE MNIPREsEN BACILLUS.
1t is not q true bacillus, but really o
sperochaete. The organism grows upon a
great variety of media and displays dis
~tinctive and characteristic appearances.
The bacilli are found in the intestines, in
the stools from the earliest period of the
disease. and very abundantly in the charac-
teristio rice water excavations. in which
they may be seen as an almost pnre
culture. They very rarely occur In the
vOinit. Post norton they are found In
enormous numbers in the intestine. In
acutely fatal cases they do not seem 10 IN
wade the intestinal wall, but in GASES with
q more protracted course they are found
in the folllcles. and even in the deeper
tissues. 1t appears that cholera is not
highly contagious In the same sense as
smallpox and scarlet fever. but in this re-
spect Is very similar to typhoid fever.
Physicians, nurses and others in close con-
tact with the patients are not often af-
fected. On the other hand. such persons
as washer women who ore brought into
and the linen of the cholera patients. are
particularly prone to the disease.
MOSTLY THROUGH WATER.
The leading authorities now agree that
the disease is ~propagated chiefly by the
contamination of water used for drinking,
washing and cooking. 1t is quite possible
that articles Of food may be contaminated.
particularly vegetables. such as lettuces
and dresses, and Others, which have been
washed in infected water; but this is prob
ably q minor danger in comparison with
impure drinking water. The bacilli, under
suitable circumstance, that 10, when much
impurity is present, may develop TO some
extent In the water. Koch, as 10 we'll
known. found the baoillI in n tank in India.
from which the inhabitants were supplied
with water for drinking and washing.
Strongly in favor of this view Is the fact
that the viruienoe of an epidemic IN any
region is generally in direct proportion TO
the imperfectIon of the water supply. On
and perfections in the water.
works of q place. the epidemics are
reduced in intensity and the place may
even obtain immunity against the disease.
Not only In India has the demonstration of
the connection between drinking water
and cholera Infection been furnished, but
also i'm England. One of the most notable
of these was the celebrated Broad-street
pump. In London. which, in 1854, was con-
nected with q severe epidemic. Milk may,
$1,000 80 ''sAAO 49, 1870
The disease Is always carried along lines
~ travel and not through the atmosphere.
Places situated ut scale Eel are more prone
TO the disease than those further inland.
In high attitudes the disease does not so
extensively prevail. A high temperature
favors the development of the disease, but
in Europe and America the epidemios ave
been chiefly in the late summer and in
the autumn. The disease Is particularly
apt to attack persons debilitated by want
of food. etc. Fear has a marked influence.
1t is doubtful If an attack furnishes im-
munity against a second one.
VIVA THE SYMPTOMS ARE.
A period of incubation probably not more
than from two to five days precedes the de-
veiopment OF the symptoms. Three stages
may be recognized in the attack-the pro-
liminary diarrhea, the collapse stage and
the period of reaction. The djarrhGa sets
in without any previous indications-from
one to two days colicky pains In the ali
domen, looseness OF the bowels and pcr-
haps vomiting headache and depression of
spirits. There may DO no fever. Then q
sense OF exhaustion and collapse, extreme
thirst, white tongue, severe cramp IS in the
legs and feet and within o few hours IN
cessant vomiting. The face assumes q
ciammy and the pulse is fiicEering'
but Consciousness is retained until
near the end. When the parent
survives. the cyanoels gradually disap-
pears. warmth returns to the skin, the
heart stronger, urine increases In quantity,
the irritabllity of the stomach disappears,
the stools are at longer intervals, and no
abdominal pains linRer. During epidemics
attacks arc found OF all grades of severity.
There are cases of diarrhoea with gripping
pains. liquid, copious stools. vomiting. and
cramps. with slight collapse. These cases
are called cholerine. There are cases also
in which the patients are overwhelmed
with the poison and die comatose. without
the preliminary stages of collapse. A
troublesome sy IN ptom of convalescence may
be cramps in the muscles of the arms and
legs. Attacks very similar to Asiatic choi-
era are produced In poisoning by arsenic,
corrosive sublimate and certain fungi.
PREVENTIVE MEASURES.
Preventive measures are all-important,
isolation of the sick, and thorough dis
infection have efiectually prevented the
disease entering England or the United
States since 1873. During epidemlcs the
greatest care should be exercised In the dis
infection of stools and linen of the patents.
When on epidemic prevails persons should
drink no water not previously boiled.
Errors In diet should be avoided. As the
disease il not more contagious than ~ pboid
fever, the bance of % person passing
safely through an epidemic depends upon
how far he Is able to carry ont prophy Tactic
measures. Digestive disturbances should
be treated prom pity. and particularly In
diarrhea, which 40 often Is q preliminary
symptom. For this opium and acetate of
lead and large doses of bismuth should be
sna, ra