CHOLERA IN RELATION TO WATER AND SOIL.
March, 1885.]
Jftediiptl
MARCH,
(fa^ette.
a
noticed the discovery of cholera-bacterium in Naples by Dr. Em-
our
new
last issue
we
merich. This germ must, in the meantime, be lelt to fight it out with the celebrated " comma bacillus ; " but, as the rest of Dr. Emmerich's observ-
ations on the cholera in Naples are of considerable practical importance, a free translation of a
regarding them, recently published in the Deutschen Medicinischeu Wochenschrift,"
report "
may be of general interest. After some introductory remarks regarding his mission from Munich to Naples, the author goes on to say :?" England undertook sani-
them
while
saturated by
was
Speaking generally, where
houses.
clearly
individual
The
filthiest
exempt, whilst
apparently kept clean,
because the subsoil related to
attacked,
were
for
remained
houses
frequently neighbouring ones,
been
Spatuzzi
of
groups
lias
so
Dr.
demonstrated by houses and
1885.
CHOLERA IN RELATION TO WATER AND SOIL.
In
That this is
excreta.
Sfhe (Indian
75
cesspools. the cholera
raged everysimilar conditions
hollows and
where
favoured the accumulation of water down from various
sources.
this is afforded in the
case
streets
lying, parallel tween the Corso
An
percolating example ot
of the twelve low-
forming
a
hollow be-
Garibaldi and the Strada del
Lavinaro, as also by the region of the Ponte della Madalena, by L'Arenaccia, and by the the filthy streams of area situated between Sebeto and Tiume Reale.
In
regions impregnated by drainage
these swampy from tanneries,
tary works subsequent to the cholera of 1854, slaughter-houses, catgut and candle works? and, when the disease again appeared in Europe in these houses surrounded by cesspits, the in 1866, the towns in England provided with epidemic began, and attained a terrible degree new drainage and water-supply suffered only of intensity, extension, and duration. slightly, whilst, in the period from 1872 to 1875, That mere surface dirt is of no great etiolothey remained exempt in spite of frequent gical importance is indicated, among other importation of the disease. things, by the exemption of the fearfully dirty, The reverse was the case in Naples, in which, narrow, dark lanes and corners occupied by during 1873, only 2,000 persons were attacked, poor, starving people, at the foot of the Pizzowhilst, in 188-4, 10,000 cases were recorded. falcone, a high steep tuflf-ridge, which has in The impregnation of the soil of Naples with insurmountable every epidemic proved ail filth subsequent to 1873 must have increased obstacle to cholera. This ridge divides the done to been had since nothing town terribly: into the epidemic eastern portion and the alter the old defective drains, cesspools, &c., western which has au from these
sources
of soil
pollution
must have
re-
mained in unrestrained and continuously in-
creasing activity. If, in England, we have an example of the protection from cholera afforded V the thorough sanitation of towns, in Naples we
have
Naples
an
instance
of the
reverse
portion,
cholera.
The
exemption
people
of the two
intimate intercourse with
areas
just
as
the inhabitants of either do among
carry another
on
as
one
them-
selves. There
can
then be
no
idea here of any direct The measures of
kind. communication of cholera.
shows
us that, with the increased polluseclusion and isolation, which have in every tion of the subsoil between 1873 and 1884, the epidemic in Naples been so rigidly enforced, liability to increase in intensity and extension have avail. never been of
?f cholera had also
Moreover,
that it is
not
accordingly
augmented.
Naples clearly show conspicuous surface filth which
the facts in the
gives an impulse to tion of organic and material in the saturation with
cholera, but the accumulainorganic fungal nutritive soil, which is determined by
house-drainage,
any
The very first case in 1873 was recognised as one of Asiatic cholera by the sanitary authorities. The affected house and every one who had
come
ated. soon
In
into contact with the sick were isolspite of this, however, other cases
made their appearance, but remote from one and in different quarters of the:
urine and solid the first
'
70
THE IHDIAN MEDICAL GAZETTE.
>
[March,
1885'.
within
the epidemic area too, there are houses months previously the germs of cholera had many supplied by the good water of These buildings, been spread by traffic over the entire area of Bo]la or by the Carmignano.
because, apparently,
towii,
weeks
or
even
that,
did not escape; but, on the contrary, majority of them suffered from severe house-
however,
the town.
The well-established fact that
of
measures
the
epidemics. For example, the children's HosGermany, contagionists pital, Annunciata, suffered in this way. On the present, when, have been encouraging a hope that, by means other hand, too many houses, and even entire of early diagnosis and isolation of the first streets, situated within the area supplied solely by That even Bolla water, were epidemically attacked. They cases, epidemics may be prevented. of a enforcement the capital penalty for coming were, at the same time, invariably low-lying ones. In Naples also, then, the drinking-water is infected from an area, in combination with' the most rigid system of house isolation, was de- not to blame. But, as a German philosopher false and refuted theories, which monstrated to be of no avail as early as the remarks, of 1380?99 in Piacenza Reggio and have once gained credit, continue to defy the plague Venice. The cholera hospital, Madalena, in truth for whole centuries as a stone-breakisolation
useless deserves
are
even
note at
special
in
"
Naples,
lies within the
epidemic
area, and
a
localistic
explanation would have been ready a house-epidemic broken out in it. It seemed, however, as though cholera were determined to show the contiigionists that it is not contagious, for, although more than 1,200
to hand had
cases
of cholera it
although it
yet
was
were
treated in this
encircled
remained
hospital,
the flames of death,
by
exempt from
the
disease.
From among the doctors and their assistants, from the entire body of male and female
attendants, only a single uurse was attacked, and she had sought out many patients in their houses and fetched them thence. ,
Hundreds of similar
but what will
suffice
cases are
now on
eventually
record,
to open
the
eyes of those who still hold on to contagionist views? The non-communicability of cholera by the sick to the in
reality,
it
no
healthy longer
is
so
well established
forms
a
ground
that,
for dis-
cussion. I
had intended
theory alone, but if any of cholera
as
one
I
letting
the
drinking-water
as
already refuted,
to follow
the distribution
regard
were
it
Naples superficially, a belief might readily arise that the drinking-water "was .the cause of the epidemic. The epidemic area
in
contains cisterns
and
local
wells; other hand,
the
are higher part of the town, on the supplied, partly by the good spring-water of Bolla,; partly by the water of the Carmignano, filtered through volcanic ash. If, however, one looks mto the facts more closely, it appears .
water defies the waves of the sea."
March, 1885.]
Jftediiptl
MARCH,
(fa^ette.
a
noticed the discovery of cholera-bacterium in Naples by Dr. Em-
our
new
last issue
we
merich. This germ must, in the meantime, be lelt to fight it out with the celebrated " comma bacillus ; " but, as the rest of Dr. Emmerich's observ-
ations on the cholera in Naples are of considerable practical importance, a free translation of a
regarding them, recently published in the Deutschen Medicinischeu Wochenschrift,"
report "
may be of general interest. After some introductory remarks regarding his mission from Munich to Naples, the author goes on to say :?" England undertook sani-
them
while
saturated by
was
Speaking generally, where
houses.
clearly
individual
The
filthiest
exempt, whilst
apparently kept clean,
because the subsoil related to
attacked,
were
for
remained
houses
frequently neighbouring ones,
been
Spatuzzi
of
groups
lias
so
Dr.
demonstrated by houses and
1885.
CHOLERA IN RELATION TO WATER AND SOIL.
In
That this is
excreta.
Sfhe (Indian
75
cesspools. the cholera
raged everysimilar conditions
hollows and
where
favoured the accumulation of water down from various
sources.
this is afforded in the
case
streets
lying, parallel tween the Corso
An
percolating example ot
of the twelve low-
forming
a
hollow be-
Garibaldi and the Strada del
Lavinaro, as also by the region of the Ponte della Madalena, by L'Arenaccia, and by the the filthy streams of area situated between Sebeto and Tiume Reale.
In
regions impregnated by drainage
these swampy from tanneries,
tary works subsequent to the cholera of 1854, slaughter-houses, catgut and candle works? and, when the disease again appeared in Europe in these houses surrounded by cesspits, the in 1866, the towns in England provided with epidemic began, and attained a terrible degree new drainage and water-supply suffered only of intensity, extension, and duration. slightly, whilst, in the period from 1872 to 1875, That mere surface dirt is of no great etiolothey remained exempt in spite of frequent gical importance is indicated, among other importation of the disease. things, by the exemption of the fearfully dirty, The reverse was the case in Naples, in which, narrow, dark lanes and corners occupied by during 1873, only 2,000 persons were attacked, poor, starving people, at the foot of the Pizzowhilst, in 188-4, 10,000 cases were recorded. falcone, a high steep tuflf-ridge, which has in The impregnation of the soil of Naples with insurmountable every epidemic proved ail filth subsequent to 1873 must have increased obstacle to cholera. This ridge divides the done to been had since nothing town terribly: into the epidemic eastern portion and the alter the old defective drains, cesspools, &c., western which has au from these
sources
of soil
pollution
must have
re-
mained in unrestrained and continuously in-
creasing activity. If, in England, we have an example of the protection from cholera afforded V the thorough sanitation of towns, in Naples we
have
Naples
an
instance
of the
reverse
portion,
cholera.
The
exemption
people
of the two
intimate intercourse with
areas
just
as
the inhabitants of either do among
carry another
on
as
one
them-
selves. There
can
then be
no
idea here of any direct The measures of
kind. communication of cholera.
shows
us that, with the increased polluseclusion and isolation, which have in every tion of the subsoil between 1873 and 1884, the epidemic in Naples been so rigidly enforced, liability to increase in intensity and extension have avail. never been of
?f cholera had also
Moreover,
that it is
not
accordingly
augmented.
Naples clearly show conspicuous surface filth which
the facts in the
gives an impulse to tion of organic and material in the saturation with
cholera, but the accumulainorganic fungal nutritive soil, which is determined by
house-drainage,
any
The very first case in 1873 was recognised as one of Asiatic cholera by the sanitary authorities. The affected house and every one who had
come
ated. soon
In
into contact with the sick were isolspite of this, however, other cases
made their appearance, but remote from one and in different quarters of the:
urine and solid the first
'
70
THE IHDIAN MEDICAL GAZETTE.
>
[March,
1885'.
within
the epidemic area too, there are houses months previously the germs of cholera had many supplied by the good water of These buildings, been spread by traffic over the entire area of Bo]la or by the Carmignano.
because, apparently,
towii,
weeks
or
even
that,
did not escape; but, on the contrary, majority of them suffered from severe house-
however,
the town.
The well-established fact that
of
measures
the
epidemics. For example, the children's HosGermany, contagionists pital, Annunciata, suffered in this way. On the present, when, have been encouraging a hope that, by means other hand, too many houses, and even entire of early diagnosis and isolation of the first streets, situated within the area supplied solely by That even Bolla water, were epidemically attacked. They cases, epidemics may be prevented. of a enforcement the capital penalty for coming were, at the same time, invariably low-lying ones. In Naples also, then, the drinking-water is infected from an area, in combination with' the most rigid system of house isolation, was de- not to blame. But, as a German philosopher false and refuted theories, which monstrated to be of no avail as early as the remarks, of 1380?99 in Piacenza Reggio and have once gained credit, continue to defy the plague Venice. The cholera hospital, Madalena, in truth for whole centuries as a stone-breakisolation
useless deserves
are
even
note at
special
in
"
Naples,
lies within the
epidemic
area, and
a
localistic
explanation would have been ready a house-epidemic broken out in it. It seemed, however, as though cholera were determined to show the contiigionists that it is not contagious, for, although more than 1,200
to hand had
cases
of cholera it
although it
yet
was
were
treated in this
encircled
remained
hospital,
the flames of death,
by
exempt from
the
disease.
From among the doctors and their assistants, from the entire body of male and female
attendants, only a single uurse was attacked, and she had sought out many patients in their houses and fetched them thence. ,
Hundreds of similar
but what will
suffice
cases are
now on
eventually
record,
to open
the
eyes of those who still hold on to contagionist views? The non-communicability of cholera by the sick to the in
reality,
it
no
healthy longer
is
so
well established
forms
a
ground
that,
for dis-
cussion. I
had intended
theory alone, but if any of cholera
as
one
I
letting
the
drinking-water
as
already refuted,
to follow
the distribution
regard
were
it
Naples superficially, a belief might readily arise that the drinking-water "was .the cause of the epidemic. The epidemic area
in
contains cisterns
and
local
wells; other hand,
the
are higher part of the town, on the supplied, partly by the good spring-water of Bolla,; partly by the water of the Carmignano, filtered through volcanic ash. If, however, one looks mto the facts more closely, it appears .
water defies the waves of the sea."
