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and alarming forms) that all matters which the patient discharges from his
stomach and bowels are, or can become, infective. Probably, under ordinary
circumstances, the patient has no power of infecting other persons
except by means of these discharges; nor any power of infecting even
by them except in so far as particles of them are enabled to taint the
food, water, or air, which people consume. Thus, when a case of
Cholera is imported into any place, the disease is not likely to spread,
unless in proportion as it finds, locally open to it, certain facilities for
spreading by indirect infection,
4. In order rightly to appreciate what these facilities must be, the
following considerations have to be borne in mind:—First, that any
Choleraic discharge, cast without previous thorough disinfection into
any cesspool or drain, or other depository or conduit of filth, has a
faculty of infecting the excremental matters with which it there
mingles, and probably, more or less, the effluvia which those matters
evolve; secondly, that the infective power of Choleraic discharges
attaches to whatever bedding, clothing, towels and like things, have
been imbued with them, and renders these things, if not thoroughly
disinfected, as capable of spreading the disease in places to which they
are sent (for washing or other purposes) as, in like circumstances, the
patient himself would be; thirdly, that if, by leakage or soakage from
cesspools or drains, or through reckless casting out of slops and
washwater, any taint (however small) of the infective material gets
access to wells or other sources of drinking water, it imparts to enormous
volumes of water the power of propagating the disease. When
due regard is had to these possibilities of indirect infection, there will
be no difficulty in understanding that even a single case of Cholera,
perhaps of the slightest degree, and perhaps quite unsuspected in its
neighbourhood, may, if local circumstances co-operate, exert a terribly
infective power on considerable masses of population.
5. The dangers which have to be guarded against as favouring the
spread of Cholera infection are particularly two. First and above all,
there is the danger of water-supplies which are in any (even the
slightest) degree tainted by house refuse or other like kinds of
filth, as where there is outflow, leakage or filtration, from sewers,
house-drains, privies, cesspools, foul ditches, or the like, into springs,
streams, wells, or reservoirs from which the supply of water is drawn,
or into the soil in which the wells are situate; a danger which may
exist on a small scale (but, perhaps, often repeated in the same district)
at the pump or dip-well of a private house, or, on a large or even vast
scale, in the source of public water-works. And secondly, there is the
danger of breathing air which is foul with effluvia from the same
sorts of impurity.