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attend to them best at home. But when they found that cases treated thus in their
own homes were fatal, and that other members of the family became attacked one
after the other, this objection faded away; and whenever the case was seen sufficiently
early, and the locality was not too distant, removal to the hospital became a rule of
our practice. Prior to this, the labour and anxiety of the attendance fell upon the
District Medical Officers of the parish, or at a later period, upon the Medical Visitor—
whichever first saw the case. Out of the 110 cases which I have tabulated, 40 were
treated in one or other of the hospitals, and the remainder either by one of these
gentlemen, or by private practitioners at their own homes. Of the 40 treated in
the hospitals, 26 died, that is 65 per cent; while of the 70 treated at home, 40
died, or 57 per cent. It must not be concluded at once, from these numbers, that it
was a bad thing to remove the patients to the hospital, for it is to be kept in mind
that it was just the cases which were most severe and alarming, and those who where
the most poverty stricken, and from the most fatal neighbourhood, which were thus
removed. Such cases would have probably died just the same had they remained at
home; and it is quite certain from the experiences of what happened in the same
family, that some of the patients were saved by removal to the airy wards who would
most assuredly have died had they not been removed.
Disinfection, &c.
The object of what is termed disinfection is the destruction of the specific virus
of the disease. What this precisely is, science has not determined, but enough is
known of its nature and characters to guide our practice. Thus it is believed, like
other viruses of specific diseases to be something living, and it is known to be given
off from the person attacked, mixed with the specific discharges of the disease, the
stools and the vomit. It is further believed to be harmless, or probably so, when
these are tolerably fresh, but to acquire especial activity when they become alkaline
as they do after a time. It is further believed that it, (the virus mixed with particles
of dry discharges or otherwise may be wafted by the air), may generate probably in
collections of filth, and may be received by other persons in the air they breathe, or
in the food and drink they partake of. It is certain that those are most endangered
who are most with the sick; especially when the surrounding circumstances are such,
or the ignorance is such, that it becomes impossible to adopt those precautions which
are necessary for safety. Apart then from the treatment of persons attacked with
what may be the premonitory diarrhoea of cholera, and apart from ordinary measures
of cleanliness, it becomes an important part of the duty of a Sanitary Officer to use
his utmost endeavours, not only to remove the person whose continual discharges
give rise to danger to other persons in a house or room, but also to prevent the
further extension of the specific cause of the disease by destroying the energy of
the virus given off in the discharges from the sick, wherever he has reason to believe
they have fallen. The selection of the "disinfectant" for use, is also a matter in this
view of the case of very great importance. Free exposure to the air, the action