Evening star. [volume] (Washington, D.C.) 1854-1972, 1896-09-17
HOW TO AVERT CHOLERA
Some Suggestions by d.. James F. Love to
Surgeon General Wyman.
Rigid Examination Of PILGRIMS to
Mecca RecOmnended-The Source
Of the Scourge.

DR.. James F. Love, q citizen of Philadel-
phia, row practicing his profession in Alex
andria. Egypt. sends an interesting and
valuable report on cholera in the east to DR..
Walter Wyman, surgeon general Of the
United States marine hospital service.
ALEXANDRIA, Egypt, August TO- 1895
Sir: The present epidemic of cholera in
Egypt emphasizes the Importance which at
| taches to international sanitation and the
geography Of disease.
The cutting Of the Suez canal when
| viewed. from some Of its effects, is not an
! unmixed blessing. Restoring to Egypt the
position lost to her for 800 years. that of
| the key to the orient, it has so altered the
currents Of commerce and travel that fac
tors are involved which have much sani-
tary interest as any with which medical
science has to deal.
AS the ultimate inquiry deals with the
exact origin Of the scourge. we may accept
without cavil the finding of the Koch COM
mission, that the home and source of the
comma bacillus is in the delta of the
Ganges.
The researches Of Professor Proust, in
speetor general Of the French sanitary ser
vice, are of immense interest in this connec-
ton. He reiterates that cholera Is endemic
In the portions Of India named and that
under lily defined or comprehended condi-
lions the scourge becomes epidemic.
AS IS well known. there was the origin Of
the epidemic which devastated Egypt in
1880. 1910, 1865, 1888 and in 1895.
Professor Proust's studies indicate an in
crease in the virulence Of the germs at their
very source. That region of the Ganges
bounded upon the west by one of the
branches of the Hoogly river, and upon the
east by the Brahmapootra and extending
as far Into the interior as Benares, Is the
seat of endemic cholera. The region is tri-
n hQ ted re haS a
desolate waste The latter Is the Swader
ban region. covering an area Of 800 square
| miles. Each high tide resembles an mum
dation, and. on subsiding. leaves vast areas
| of Shiny ooze. Pernicious fever is almost
certain to any one staying in the locality.
Add to these marshy masses the sewage
brought by the great rivers from upper In
Ola and there Is furnished the soil for the
development Of the cholera bacillus. These
| contaminated waters are used for drinking
purposes by the natives. The introduction
| even Of filters. instead Of steriliZing appa-
| ratus. has reduced the death rate from
| cholera in Calcutta from 1850 to l 400 per
year: the entire death rate of India has.
| however, increased about twenty per cent
| in ten years. From this and similar geo.
| graphical situations. a stream Of travel Of
| Mohammedans is constantly going toward
Mecca by way of the Red sea These pill
erims undergo no sanitary examination
| prior to their departure nor before their
| entry into Mecca. Pilgrims from other
| regions come by way Of the Suez canal and
1
Leaving Mecca there is constant stream
| of travellers from Mecca to Damietta, Alex
andria and Cairo Coming in contact with
| pilgrims from the regions where cholera
| Is endemic 1t necessarily follows that In
| their return the pilgrims from Egypt i'm
port the bacillus. This was unquestionably
| the source Of the epidemic of 1895. 1t made
| its appearance about September, 1898, at
| Salhieh, a village north of the delta of the
| Nile. Cholera was epidemic at Mecca at
this time. the period of the pilgrimage.
A number Of deaths occurred in the vii
| lage named. before the sanitary officers
| appeared to be cognizant of the existence
| of the disease. Their attention was doubt
less diverted by their confidence in the
| precautions taken by the quarantine coun-
| Gil of Egypt.
A month later the disease appeared sud-
| denly at Damfetta. In fact. 1t was only
| upon its appearance there that the malady
| was correctly diagnosed. Vigorous sanitary
measures were at once begun by his ex-
| cellency Rogers Pasha. the director gen
eral Of the sanitary service OF Egypt. and
by his colleagues. Drs. Schiess Bey, Pin
ching. Bitter. Garner and Prince Bey.
| Without aid from the international quar-
antine sanitary service which was strange
| ly apathetic, these former gentlemen un-
der the direction of II. E. Rogers, Pasha,
by their courage and devotion undoubtedly
limited the spread of the scourge.
The path Of the disease was up the Nile
to the ancient city of Minzalda, and follow
ing branch of the Nile called the Rahr
Ell Zughair the little lake., remaining
! localized until the end of the year 1885.
The first case in Alexandria appeared in
January, 1896, where its progress was so
successfully combated by DR.. Schiess' Bey
and DIR. Bitter that its extent was very
limited during four months. The disease
became epidemic in May 1896 and very
threatening. but the unceasing energy of
the sanitary administration soon reduced
the mortality to but few cases a day.
Late In May cases Of cholera were found
in Cairo. and it's spread was rapid. The
same praiseworthy devotion Of the sanitary
authorities promptly reduced the mortality
to but two or three cases day in a city
Of over half a million people.
The British army operating against the
dervishes of Upper Egypt was not exempt
from many victims of cholera
The sanitary service following and check
ing the disease wherever 1t appeared, noted
that the epidemic was much less virulent
than those Of 1865 and 1883.
| 1t Is confidently believed ard asserted by
medical authorities here that the disease
will vanish soon as cold weather ap-
pears.
The national quarantine against the in
PRODUCTION of cholera Is as follows: BY in
ternational agreement a sanitary Gordon
has been established upon the peninsula
Of Sinai
| At these places returning pilgrims have
their baggage disinfected, and are under
surveillance for a period of ten days. If
no cases Of cholera appear, the pilgrims
are dismissed. Should any cases appear,
the pilgrims are detained at Gebel ell Tor
| cred.
Your correspondent dwells upon the sub
ject, as it is In reality the keynote to sue
cessful sanitary service in Egypt that its
provisions be actually administered.
| The cold season appears here in october,
when the cholera will probably be entirely
| suppressed.
During the last season there was not one
case of cholera among 6,SGO tourists In
Egypt. In point Of fact, the last epidemic
expended its force almost entirely upon the
persons Of the poor classes. 1t is the rule
appear with the hot weather. To prevent
the deportation of the disease to European
and Am erican ports. 1t has been decided
that the rags for export, the principal To-
mites, should receive a thorough and de-
tailed disinfection. to be done under COM
petent and careful supervision. Each ships
cargo is to be accompanied by a certif-