the same careful surveillance until all danger of the development of disease in them or from them has passed.*

At all times the duly appointed health officer should be invested with ample authority to act in any emergency. Should cholera or other dangerous diseases come there will be then no time to call the health board together for the discussion of plans. These must be definitely decided on beforehand, so that what can be done and what is to be done, shall be clearly understood. 1 cholera or small-pox or other virulent diseases appear in a private house, it should be at once quarantined, all well persons whose presence is not absolutely needful therein should be removed, and closely contiguous houses should either be abandoned for the time being or kept under the closest watch. death occur the burial of the body should be speedy and private.

DISINFECTION AND DISINFECTANTS.

Should

For

The terms disinfection is used here rather in its popular than in its strict sense. cleansing premises in the absence of any specific "germs" or disease, the use of those germicides or true disinfectants which would be recommended in the presence of such germs is not necessary. To deodorize and sufficiently to disinfect privy-vaults, cesspools, drains, and similar places as a measure of cleanliness the plentiful use of copperas or sulphate of iron, or chloride of lime (as recommended by the committee on disinfectants of the American Public Health Association) will be sufficient. The copperas may be prepared for use by dissolving one and one-half pounds in a gallon of water. The chloride of lime may be used either by sprinkling the dry powder freely over any place or material which it is needful to disinfect, or by dissolving one pound in four gallons of water Of either solution, a sufficient quantity to keep down all offensive odors should be used daily or as often as occasion may require. Fresh lime should not be used. Should cholera or other virulent disease make its appearance more powerful and specific disinfectants will be required, and full directions for preparing such and for their safe and efficient use will be published in due season by this board.

The duty of preparation which devolves upon local health boards also devolves upon the officers and managers of our State institutions of every kind. Such officers should see that a thorough examination of the buildings under their care is made, and that all unhealthful conditions are removed. The water supply, the sewerage, all matters relating to the disposition of filth or refuse material of any kind should be inspected with a view to the removal of all defects, and the maintenance of the highest and best sanitary conditions. The same duty is incumbent on sheriffs and keepers of jails, upon the heads of reformatory institutions of every kind, to any one of which persons in the incipient stages of disease may be brought at any time. The power of these officers is ample and undoubted for these purposes, and there can be no reasonable excuse if in or about any such institution there are at any time conditions which favor the development of disease if it should unfortunately be brought to them. By direction of the State Board of Health.

J. T. REEVE, M. D.,
Secretary.

CALIFORNIA.

Facts for the people regarding cholera.

The legislature of the State of California, during its last session, 1885, having, with the utmost indifference to the sanitary welfare of the people, in utter disregard of the suggestions offered by his excellency Governor Stoneman, in his biennial message, and equally regardless of the importunities of the State Board of Health, refused to appropriate a single dollar to protect the State from the invasion of infectious or contagious diseases; therefore, in view of the possibility, or rather the probability, of cholera extending its ravages to the Pacific coast this summer, the State Board of Health deem it prudent to offer to the public a few words of warning as to the necessity of the early employment of sanitary measures, to arrest the development of disease or mitigate its virulence if, unfortunately, it should appear among us.

Cholera being essentially a preventable disease, all questions concerning its cause, diffusion, and prevention must interest the people of this coast just now, when Europe is again the theater of its manifestations; and as all preventive measures are based

*In either of these cases it is practicable to disinfect the baggage of new-comers by fumigating it with sulphur; it would be wise to do so.

upon the assumption that the virus or germ of the disease is a living organism capable of transmission through water, food, clothing, or personal contact, and, like all living matter, is itself susceptible of death, the prevention of its dissemination or the means of its speedy destruction are the desiderata to be sought.

Cholera upon these shores is a foreigner and has never yet visited us, except by importation and then only after ample warning. Last year the, warning came to us from France and Italy; this year it comes from Spain and the shores of the Mediterranean. How soon it may reach New York or other seaports upon the Atlantic border is a question of time. It is sure to come along the highway of travel, and once landed on our shores, will make its way across the continent quite speedily. Had the question of quarantine, efficiently exercised, been entertained by the last legislature, and provision made for its maintenance, we believe we could have kept cholera, yellow fever, and small-pox out of California. The highway is now open, and we must expect to reap the fruits of the criminal negligence, ignorance, and stupidity of our law-makers.

What can be done in the way of prevention locally? Much may be done if the officers of health or the properly constituted authorities do their duty. Cholera, as was said before, is a preventable disease; its habitat is among a crowd; it revels in filth and decomposing organisms, but failing to find suitable conditions for its growth and maintenance it dies out. Consequently the very first thing to be done is for each individual to see that his house, outhouse, and yard is put into a good sanitary condition. Do not wait for any health officer; see to it yourself. Have your drains cleaned out and flushed with water, your privy or cesspool emptied and disinfected immediately. See that your cellar is cleared of all decaying substances, have it thoroughly whitewashed, and all filth, rags, &c., burned. If you have a well see that the water thereof is not contaminated by drainage from the house or outhouses. If you have the slightest suspicion that it is, boil the water before using, or, better still, shut up that well and dig another away from all chance of such contamination. If you use river water, which is always more or less polluted, see that it is boiled before drinking it, and you will save your health for the trouble. Avoid crowding in sleeping rooms. See that each room is properly ventilated, nothing being so conducive to disease as an overcrowded and ill-ventilated apartment. Plenty of fresh, pure air, pure water, and wholesome food, with household and personal cleanliness, will do more to prevent the access of cholera to your dwellings than all the supplications of the credulous or the nostrums of the charlatan. While there is danger of cholera, or, indeed, any epidemic disease, developing in your midst, it is an act of prudence to avoid excessive fatigue from any source, as the system when tired or exhausted is much more liable to infection and less able to resist it than in other conditions. It is also indispensable that the stomach and bowels be kept in a healthy state by avoiding all unripe fruit, decaying vegetables, fish, flesh, or any food that is not perfectly sweet and fresh. Temperance in all things should be enjoined, and especially in alcoholic beverages, as it is found by experience that the intemperate, or those addicted to drinking intoxicating fluids habitually, are the first to die in an epidemic of cholera. Nature knows no mercy in dealing with the violators of nature's laws; if her laws are transgressed the punishment is swift and certain. Food should not be kept in the same room with the sick from any infectious disease; neither should that unconsumed by the sick be used by others, but either burned or disposed of in some other equally safe way.

If cholera should appear in your dwelling the first thing to do is to isolate the patient, put him in a comfortable room without carpets and with as little furniture as is consistent with comfort, disinfect immediately all discharges from the body, and either burn or bury them; do not throw them into either privy or cesspool to poison your family or your neighbors; see that the patient has medical attendance promptly; do not wait ten or twelve hours to see if he will get better-delay in cholera means death. Cholera always gives warning of its approach by premonitory diarrhea; this is the favorable opportunity to arrest the disease, the attack is then under the control of medicine judiciously chosen and administered; a few hours delay and it will have passed from comparative safety into extreme danger, perhaps beyond the power of remedies to save; act, then, promptly and intelligently, and a valuable life may be rescued from a fatal illness.

If there is no medical man within easy call, and a person be attacked with premonitory diarrhea, place him in bed at once, apply warmth to the feet, a mustard poultice over the abdomen, and give a teaspoonful of paregoric (which is to be found in every family) every hour until your medical attendant arrives. Do not give, indiscriminately, stimulants-brandy, red pepper, camphor, ginger, &c., advised by busy bodies; wait for skilled medical advice-more people are killed by quackery and meddlesome trifling than by disease.

If traveling, avoid as much as possible using urinals of water-closets at railway sta

tions; they are constant sources of infection, if not properly taken care of and daily disinfected.

Remember that cholera is always, in this country, imported; it seeks crowds, and follows, as a rule, the line of travel; railway companies and lines of transportation generally should see that all urinals, water-closets, and baggage-rooms belonging to the company, or about their premises, are daily cleansed, purified, and disinfected.

DISINFECTION AND DISINFECTANTS.

De

Disinfection is the destruction of the poisons of infectious or contagious diseases. odorizers, or substances which destroy smells, are not necessarily disinfectants, and disinfectants do not necessarily have an odor. Disinfection cannot compensate for want of cleanliness or of ventilation.

DISINFECTANTS TO BE EMPLOYED.

Roll sulphur (brimstone), for fumigation. This is a cheap and efficient substance for fumigating rooms. It is positively destructive to disease germs when efficiently used. Sulphate of iron (copperas), dissolved in the proportion of one and a half pounds to the gallon of water, is a cheap and reliable deodorizer and antiseptic for privies, cesspools, sewers, &c.

Sulphate of zinc, in the proportion of four ounces of sulphate and two ounces of common salt to the gallon of water, is efficient and harmless for clothing, bed linen, blankets, &c. It should be used boiling hot, and the articles to be disinfected plunged into it and thoroughly boiled.

Corrosive sublimate, in the proportion of a quarter of an ounce to the gallon, is an unsurpassed germicide and disinfectant, but has the disadvantage of being excessively poisonous and therefore dangerous for general use.

Carbolic acid is of uncertain strength, is expensive, and experience has shown that it must be employed in comparatively large quantities to be of any use. It is also liable, by its strong odor, to give a false sense of security.

HOW TO USE DISINFECTANTS.

(1) In the sick room.-The most available agents are fresh air and cleanliness. The clothing, towels, bed linen, &c., should, on removal from the patient, be placed in a tub of the zinc solution, boiling hot if possible. All discharges from the patient should either be received in vessels containing the copperas or corrosive sublimate solution, or, if this is impracticable, should be covered with the solution. Unnecessary furniture, especially that which is stuffed, carpets, and hangings, should be removed from the room at the outset, if possible, otherwise they should remain for fumigation and treatment. (2) Fumigation with sulphur is the only practicable method of disinfecting the house. For this purpose the rooms to be disinfected must be vacated. Heavy clothing, blankets, bedding, and other articles which cannot be treated with the zinc solution should be opened and exposed during fumigation, as directed below: Close the rooms as tightly as possible, stopping up every crevice and keyhole; place the sulphur in iron pans supported upon bricks placed in washtubs containing a little water, set it on fire with alcohol or kerosene sprinkled upon it, and allow the room to remain closed twenty-four hours. For a room ten feet square at least two pounds of sulphur will be required; for larger rooms proportionately larger quantities will be necessary.

(3) Premises, cellars, yards, stables, gutters, privies, cesspools, water-closets, sewers, drains, should be liberally treated with the copperas solution; it is cheap and effective, and may save your life. The copperas solution may be easily prepared by hanging a basket containing about sixty pounds of copperas in a barrel of water.

(4) Body and bedclothing. It is best to burn all articles which have been in contact with persons sick of infectious or contagious diseases. Articles too valuable to be destroyed should be treated as follows: Cotton, linen, flannels, blankets, &c., should be treated with the boiling hot zinc solution; introduce piece by piece; secure thorough wetting, and boil for half an hour. Furs, silks, heavy woolen clothing, bedcovers, and beds, which cannot be thus treated with the zinc solution, should be hung in the room during fumigation, their surfaces fully exposed and their pockets turned inside out; afterward they should be hung in the open air-beaten and shaken. Pillows, beds, stuffed mattresses, upholstered furniture, &c., should be cut open, the contents spread out, and thoroughly fumigated. Carpets are best fumigated on the floor, but should afterward be removed to the open air and thoroughly shaken and beaten.

(5) Corpses should be washed thoroughly with the zinc or corrosive sublimate solution, then wrapped in a sheet wet with the solution, and buried at once. Metallic or metal

lined coffins should be used when possible, and always when the body is to be transported for any considerable distance.

If these notes of warning and guides to action are heeded, and fear does not usurp the place of common sense, we have little to dread from cholera personally. It is the unthinking multitude, the selfish egotist, the "wait until it comes" people, that we have to fear. "An ounce of prevention is worth a pound of cure,” and there is no disease to which this aphorism so aptly applies as cholera.

By order of the Board.

SACRAMENTO, April 24, 1885.

GERRARD G. TYRRELL, M. D., Permanent Secretary State Board of Health.

To the public:

SAN FRANCISCO, CAL.

In view of the epidemic of cholera now prevailing in France, its probable extension to other countries in Europe, and its possible introduction into our Atlantic States, our local board of health have deemed it necessary to take active measures to enforce in this city those sanitary regulations which are necessary to exclude, if possible, this terrible scourge, and if not possible to exclude it then to modify and lessen as far as possible its malignancy. The board of health, the board of supervisors, and our police department, upon this subject, are in entire accord. Our sanitary laws will be immediately and efficiently enforced. The assistance of all good citizens is earnestly invoked to aid the authorities in this good work.

You are particularly requested to see that your premises are put and kept in the most cleanly condition. Garbage of all kinds should be removed at least twice a week. Privy-vaults, kitchen sinks and cesspools should be thoroughly deodorized and disinfected weekly. Your cellars should be thoroughly ventilated by opening doors and windows. Their sanitary condition can be much improved by white-washing and sprinkling unslacked lime or chloride of lime in moist places.

The most effective deodorizer and disinfectant for privy-vaults, sinks, cesspools, soiled vessels or decaying animal and vegetable måtter is a solution of copperas (three pounds to two gallons of water).

Garments soiled by infectious or contagious diseases should be soaked in a solution of sulphate of zinc (white vitriol) half a pound to three gallons of water before washing.

All houses, after the occurrence of contagious diseases, should be thoroughly disinfected; but as this requires more or less expert knowledge, those desiring such disinfection should always obtain the same by application to the health office, free of cost.

We have good food, fair water, and a healthy temperature, and we only require ordinary attention to sanitary laws to escape much of the sickness now prevailing, and to materially lessen our death rate.

The disinfectants recommended are, when obtained from wholesale druggists, so inexpensive as to be within the reach of every one, and will add much both to comfort and health.

While it is not contended that they destroy the germs of cholera or any other malignant disease, we do contend that they act as palliatives and correctives, and neutralize disease producers and those decaying elements of animal and vegetable matter upon which epidemic diseases feed, and by which their germs are multiplied.

It is to be hoped that householders will attend to these simple sanitary regulations, and report to this office all violations of sanitary laws that come within their knowledge. Every house in the thickly populated portions of the city will be visited by a sanitary inspector of the Board of Health, wearing a badge of authority, or by police officers detailed for the purpose.

J. L. MEARES, M. D.,

Health Officer City and County of San Francisco.

Issued by resolution of Board of Health, city and county San Francisco, July 29, 1884.

APPENDIX A 4.

ABSTRACTS FROM CONSULAR REPORTS CONCERNING CHOLERA AND OTHER CONTAGIOUS OR INFECTIOUS DISEASES IN FOREIGN COUNTRIES.

No. 1.

NATIONAL BOARD OF HEALTH, July 28, 1885.

The following abstracts from consular reports just received at this office are furnished for your information. The Board will hereafter receive reports regularly, and you will be furnished promptly with all information received on matters affecting the public health:

Cholera in Spain from March 4, date of reappearance, to July 4.