Harper's Weekly, May 26, 1866, p. 323

HOW TO ESCAPE THE CHOLERA.

THE cholera first appeared in this country over thirty years ego and such a vast mass of facts has been gathered that some think it unreasonable that the doctors have not fully settled upon the means of preventing its incursion and diffusion. But it is forgotten that in this world it takes a long time to settle even the most simple points in any new subject that comes up. And besides, there, is, after all, more ascertained by medical men in regard to the cholera than is commonly supposed; but this is very much kept out of view by the excitement that prevails in relation to the few points that are in dispute.

The world, both professional and non-professional, is in truth too much occupied with the question, whether the cholera is contagious? and every doctor is plied with it by patient and friend and stranger. And you must either be a contagionist or a nocontagionist, or you will give no satisfaction to the questioner or disputant that introduces the subject. This comes from a narrow view of the facts. One who has a certain set of facts come under his observation, decides that the disease spreads by contagion;. while another, from another set of facts, comes to an opposite decision. This is all wrong. Where there are numerous facts, and many of them apparently inconsistent, they must be extensively compared and sifted in order to reach correct conclusions. Taking this broad view of the facts revealed by the whole history of the disease, it is clear that its ordinary propagation is by some cause, as yet wholly unknown, which does emanate from the sick, and that it is only now and then contagious. For, not to go into any discussion of this point, while there are occasional facts that show that cholera is communicated from one person to another, it very commonly overleaps the strictest quarantines and sanitary cordons, and often fails to follow the freest lines of communication.

Far be it from us to say that all quarantine regulations are to be discarded. Some are necessary. And yet some which are resorted to are useless; others still are absolutely injurious, multiplying the victims of the disease; and none are to be relied upon as certain preventives of its introduction. The idea, indulged by some, of sealing up this whole country against the cholera by a universal quarantine is preposterous.

So much for quarantine measures. But there are other measures about which there is no dispute, and they are of immense importance in limiting the ravages of cholera if not in preventing its introduction. And yet their value seems to be far from being properly appreciated by the community at large.

Promoting cleanliness is one, and we use this expression in its broadest sense. You must have a clean skin, clean clothes, clean air, clean houses, yards, and streets. No filth must be covered up with all outside show of cleanliness. Dirt in cellars, in corners, may do the mischief. A musty carpet, charged with the accumulating filth of months of shiftlessness, may procure the cholera for a family. After all, this interior uncleanliness has more to do with the origination of the disease than what is outside. Bad as are the emanations from decaying vegetable and animal substances, they are nothing like as inviting to cholera and other diseases as those from personal filth, within and without, but especially within, where, pent up from the free air, they act with all their force.

Much is said about disinfectants; but, useful as they are, they never can take the place of cleanliness. We say, then, both to communities end to individuals, Clean up, clean up; and when you have done so, keep clean- for the cholera is likely to conic again; and, if not, there are other diseases, as typhus fever and cholera infantum, constantly, and therefore lees observably, destructive of life, of which filth is a chief cause.

New York and Philadelphia once presented a decided contrast in regard to the influence of cleansing measures. Philadelphia adopted them thoroughly, and had but 700 deaths from cholera; while New York, neglecting them, had 5000 deaths.

There is no fact more prominently brought out by the whole history of cholera than that intemperance in drinking is one of the principal causes of its diffusion. It acts in two ways: directly, by predisposing the individual to an attack, a large proportion of the victims being from the intemperate; and, indirectly, by promoting she uncleanliness, poor and irregular living, end crowding together of families. If, then, we could shut up the drinking places we should effectively cut off one of the chief sources--nay, the chiefest source-of the nuisances that so largely generate cholera and various other fatal diseases.

Intemperance in eating predisposes to the disease. But so also does a diet too restricted in quantity or variety. A poor diet will enfeeble the system, and thus make it liable to an attack. A diet restricted in variety does not meet the wants of the system, and so fails to fortify it properly against disease. The true course is to have just such a diet as a rational moderate liver would adopt in ordinary times. Good fresh vegetables and ripe fruits should be eaten as usual, as a part of the daily diet, and not irregularly.

No reliance should be placed upon vaunted prophylactics-that is, remedies supposed to ward off the disease. Intoxicating drinks are often taken for thus purpose, and they are really among the most likely means of bringing on .in attack. Good habits of living, the cheerful performance of duty, and a calm trust in Providence, are the best prophylactics. These are the grand preservatives of the physicians who fearlessly stand at their post in the midst of the pestilence, and very seldom does one of their number her fall a victim to it.