\ THE BROOKLYN .DAILY EAGLE 
HEAT VERSUS CHOLERA. 
was scarcely any interruption of travel or 
t raffle, serves to Show that sanitary measures 
are of more value than all else beside. The 
cholera germ is not the most important factor, 
but is rather the incidental cause. The question 
of prime importance is the sanitary condition 
of the individual. The introduction of a person 
infected with cholera into a filthy town is like 
bringing a match into a powder magazine; but 
there would be no explosion unless the powder 
was there ready to explode. Therefore, the 
most effective means to prepare our peo- 
ple against an epidemic of cholera is an 
enforcement of all sanitary measures, chief 
among which is the establishment of large public 
Turkish baths, which I had the honor of advo- 
cating before this body in a paper read last 
year. By so doing we would establish a higher 
standard of health in the community, and not 
only would the poorer classes be less liable to 
any invasion of cholera, but of all other filth 
diseases as well, such as diphtheria, etc. One 
of the most effective quarantine measures 
would be a large Turkish bath, where every 
immigrant could be thoroughly cleansed, com- 
pletely disinfected, and his clothing and per- 
sonal effects sterilized. Let the people under- 
stand that the cholera is non contagious. The 
atmosphere is not permeated by germs that 
endanger health, in fact the air may be 
thrown out of consideration almost entirely. 
The source of danger is the food and water that 
have been contaminated by want of attention 
to the gastric and alvine discharges of the sick, 
or to the careless handling of the bedding and 
linen that have been soiled by them. It is not 
so much the dirt of the streets or the emanation 
of the sewers as the filthy people themselves 
that generate disease. The most injurious 
thing that can be done with cholera excreta is 
to dump it in the sewage to pollute the rivers 
of any town. As it is at present, a large river 
in a city is an active element in the distribution 
and propagation of contagion, and the surest pre- 
vention of cholera is to burn or otherwise con- 
sume all sewage, instead of dumping it into the 
waterways. Strict attention to cleanliness is of the 
greatest importance in such cases and renders 
cholera no more dangerous than a case of 
typhoid fever. In London, during the year 
1866, it was found that one family that bad es- 
caped from Egypt to dwell on the banks of the 
river Lee, from which the supply for East Lon- 
don was drawn, so contaminated the water as 
to produce an epidemic that carried off 6,000 
people. The trouble in Hamburg last year 
arose from the pollution of the river Elbe, from 
which the water supply of that famous city was 
drawn. Seven thousand victims in one month 
was a fearful retribution for the sin of neglect. 
The Indian Medical Gazette of May, 1887, re- 
ports an outbreak of cholera on board a ship at 
Calcutta, from milk supplied by a native. 
This milk was proved to have contained 
25 per cent, of water from tanks contaminated 
with choleraic matter. No more cases occurred 
when the supply of milk was stopped. Thus it 
is apparent that the most perfect personal de- 
fense against bacteria of all kinds, but particu- 
larly of cholera, is a vigorous digestion in a well 
conditioned body, and the one fluid that is ab- 
solutely fatal to the bacillus of cholera is 
healthy gastric juice, furthermore, it would 
seem, from a series of experiments on them- 
selves, conducted Dy Professor Pettenkoffer and 
Professor Emmerich of Germany, wherein each 
swallowed one centimeter of fresh culture of 
coma bacillus, direct from Hamburg, that 
measures directed against the germ itself, such 
as quarantine, disinfection, etc., were less 
important than attention to hygienic con- 
ditions, diet and personal surroundings. 
This most desirable consummation is to be at- 
tuned by the action of heat, through a process 
that commends Itself to every thinking mind, 
and is at the same time both pleasurable and in- 
vigorating. The highest medical authorities in 
this and other lands have given their fullest en- 
dorsements of its use and advantages. It has 
stood the test in several previous epidemics 
with eminent success. The great need of our 
country is large public establishments, where 
the people can resort at all times, and by a 
complete course of sanitation ward off all 
danger of an epidemic. It is as a preventa- 
tive that the great value of heat will be 
demonstrated, and the treatment that strives 
simply to augment in every way the vital 
resistance of the system to the successive 
invasion of choleraic poisoning is what.we 
would most seriously urge. Hot baths, com- 
bined with absolute rest of the body, should be. 
availed of at the earliest moment. That heat 
has manifold uses and confers untold benefits, 
all will admit. Its effects arc apparent through- 
out the world, but none are of greater service 
than those directljT applicable to the human 
body. Heat comes directly as well as indirectly 
from sunlight, which is itself but an electric 
force. There was a time when mankind 
worshiped the sun. Through heat we 
live, move and havo our being ; without 
heat we die. While it is so powerful an agent 
If health, it cannot be thought strange 
that it is equally powerful in disease, 
whether as a preventive or cure. Heat puri- 
fies the air that we breathe, the water that we 
drink, the food that we eat, and thus becomes 
the best and most important disinfectant. 
Through the medium of the Turkish bath, which 
Is found to be the most perfect form of admin- 
istering heat to the human body, a record has 
been made tnat is astonishing to all who are not 
familiar with its practical working. The ex- 
perimental stage has long passed. Our food 
and drink are rendered both more palatable 
and germ proof by the action of heat. We can 
rely perfectly on heat as a means of steriliza- 
tion. The germ cannot live in food that has 
been thoroughly cooked, nor will it sur- 
vive in water, milk, tea or coffee that 
have been on the fire long enough to 
boil. Heat is also death to the cholera germ, if 
applied in air, steam or water. Dr. Sternberg 
says that free exposure to air and sunshine is 
one of the most reliable methods of disinfecting 
articles which have attached to them the cholera 
spirillum. Its low death point, which he places 
at 125.6 degrees Fahrenheit, justifies us in giving 
heat the first place as an agent for the destruc- 
tion of this pathogenic micro organism. Ten 
minutes' exposure to 140 degrees may be relied 
on for its destruction. Milk or water heated to 
that point is rendered safe. The germs are 
also very quickly destroyed by desiccation. 
A weak solution of sulphuric, hydrochloric or 
carbolic acid will also quickly destroy the germ. 
Er. J. T. Talbot of Boston says: "There is no 
disinfectant or antiseptic equal to heat in a high 
degree, and in all these poisonous conditions 
depending on germ life the germs have ten times 
the resisting power of drugs, although they will 
in every case be destroyed by a sufficient de- 
gree of heat." Medical Director Bogart reports 
that when on government vessels in Chinese 
and Japanese seas, in 1878 and 1885, the cholera 
broke out among the crew but was promptly 
checked by cleanliness and heat. All clothing, 
bedding and personal effects were subjected to 
dry heat and the ships were steamed by 
their own boilers. Dr. Louisa B. Smith, 
who was in Turkey during the epidemic 
last year, states as her observation that the ma- 
jority of cholera cases can be saved if proper 
means are used at the beginning, and that the 
infection is powerless among people who are 
careful to cook all water and food. She worked 
freely among the sufferers, but took only boiled 
water and hot food. A Russian physician re- 
ports excellent results in cases of pronounced 
cholera from placing the patient in a bath of 
warm water (99 Fah.). As a result, the vomit- 
ing ceases immediately and does not reappear 
as long as the patient remains in the bath, 
which ought to be at least half an hour. Ac- 
cording to Dr. Mariano Semmola of Italy 
the sheet anchor of physiologic treatment 
is by means of complete fasting from the 
very moment the smallest manifestations of 
diarrhea appear, to be continued at least twen- 
ty-four hours after favorable reaction has set 
in. First in order of treatment comes hot baths, 
given at 100 to 104 degs. Fah. and repeated as 
occasion requires. He states that the favorable 
moments for the hot baths is the first stage of 
the disease, before the algid period has begun, 
or when the patient commences to fee! a sensa- 
tion of uneasiness in the epigastrium, with or 
without vomiting. He further says that he has 
seen hundreds of cases where the simple diarrhea, 
which had been obstinate and persistent for sev- 
eral days, and which would later on, no doubt, 
have developed into a regular attack of cholera, 
suddenly disappear after one or two hot baths 
followed by abundant perspiration. * * * 
The return to alimentation ought to be made 
with the greatest prudence, as the smallest er- 
ror may be fatal. Milk in small doses is the 
preferable form of food when it becomes neces- 
. sary to recommence alimentation. The bath 
was a religious and civil law of the Hebrews. 
During the epidemic last year in Russia, an in- 
vestigation was made to ascertain the mortality 
among the Jews,and it was found to be only for- 
ty victims out of a total mortality of nearly a 
quarter of a million. This fact is a most emphat- 
ic comment on the Mosaic laws of cleanliness 
given that people over two thousand years ago. 
A man in England once treated cholera patients 
by wrapping them up in blankets and placing 
them before a hot fire, and he claimed to cure 
every case he undertook. Mr. Urquhart, during 
an epidemic in Turkey, subjected every mem- 
ber of his household to hot air treatment daily, 
witn the result of complete immunity, while 
deaths were constantly occurring in his im- 
mediate vicinity. During the prevalence of 
cholera in Cork, Ireland, some yearsago, the 
men employed in cleaningout the brewers' vats, 
wherein was heat sufficient to cause profuse 
sweating, were free from the disease, and the 
other workmen in the establishment petitioned 
to be put at that work. What more fitting 
than the use of heat for the cremation 
instead of the burying of the cholera corpse. 
It has the sanction of the highest authorities 
and all sanitarians recommend it. This is com- 
plete sterilization of the dead body. Virchow's 
advice as to the best factor in the prevention of 
an epidemic and in the destruction of any con- 
tagious carrier is '''heat or cremation." This 
has been successful wherever tried. Over thirty 
years' experience in the use of heat as a re- 
medial agent has demonstrated that all diseases 
of a diarrheal nature are quickly controlled 
by its proper use and, during the summer of 
1865, when cholera was with us to a limited ex- 
tent, many cases of painless diarrhea were at 
once corrected by the action of the Turkish bath. 
Thus fortified both by theory and practice, we 
can but conclude that by no other means can 
one so thoroughly protect himself against the 
cholera as well as against all other diseasf s as 
by the frequent use of a hot air bath, otherwise 
called the Turkish bath. 
Dr. Shepard's Paper Before the 
American. Medical Association. 
The Physicians Assembled at Milwaukee, Wis. 
How to Kill Germs-Civic Sanitation-A 
Turkish Bath Recommended as a Quarantine 
Appendage-The Conditions in India. 
At the fourth annual meeting of the American 
Medical association in session at Milwaukee, 
Wis., Dr. Charles H. Shepard of this city, read 
a paper on "Heat a Preventive of Cholera," be- 
fore the section of state medicine. The paper, 
which was well received, was as follows: 
While we hope by reason of good sanitation 
to escape the scourge of cholera this year, yet 
the bare possibility of its coming renders all 
matters of hygiene of supreme importance. 
Therefore, whatever may contribute to our 
welfare in that direction is at this particu- 
lar time worthy of more than ordinary con- 
sideration. In order thoroughly to master any 
disease it is necessary to know somewhat of its 
characteristics. The home of cholera is in 
movable and it is there only by virtue of re- 
natives causes. The personal habits of the 
India are cleanly, but they have no public 
water supply and in the larger cities the only 
water they can obtain becomes polluted from 
their own excretions. It has been demonstrated 
that where pure water was furnished the in- 
habitants, as in Madras and Calcutta, the rav- 
ages of the cholera were greatly reduced and 
the same has been observed in other countries. 
Dr. Pauline Root, who lived eight years in 
Southern India, reports that there is always 
more or Jess cholera prevalent in that section and 
• hat ft ic more comm rn after certain religious 
iestlvals. Drainage, with the exception of the 
open sewer, is unknown, and the total lack of 
sanitation is responsible for the consequent 
spread of the disease. The study of the history 
of various epidemics has made many things 
plain, but the first radical step toward the un- 
derstanding of cholera was taken when Robert 
Koch, the leader of the scientific expedition in 
Egypt, in 1883, discovered the exciting cause 
of that disease in the coma like bacillus. 
Shortly afterward Reitsch and Nicati, by 
introduction into the duodenum of culti- 
vated coma bacilli, produced the veritable 
Asiatic cholera in guinea pigs, and the 
.same effect has been confirmed by other 
investigators. It has also been demonstrated 
that the cholera germ is not an animal growth 
which can be suffocated by fumigating gases, 
but a vegetable, like the yeast plant, which 
needs a moderate amount of heat lor its devel- 
opment, but apply more heat to the yeast plant 
or cholera germ, say 140 degrees Fahrenheit, 
and the germ is dead. The introduction of this 
specific form of micro organism is found to 
.be necessary for the production of the dis- 
ease. These germs must reach the in- 
testinal canal alive, otherwise the disease 
cannot be developed. They necessarily pass 
[through the stomach, but an acid medium 
is death to their existence. In fact, they 
are the most easily destroyed of all the 
[Pathogenic organisms known. If they safely 
run the gauntlet of the stomach, they come in 
contact with an alkaline medium and an albu- 
minoid pabulum in which they develop and 
multiply with startling rapidity. These germs 
always come from the dejections of a cholera 
jpatient, and are commonly reintroduced into 
■the alimentary canal of a second person, either 
lin drinking water or in food. They do not 
'enter the blood or tissues of the body, but re- 
main in the lumen of the intestinal canal until 
they have exhausted their period of existence 
or killed the patient. They require for their 
rapid growth and developmant a large amount 
of water, an albuminous pabulum, a moderate 
. degree of heat, an alkaline medium, and 
a quick removal of their products. The water 
is obtained by a rapid outpouring of this fluid 
from the blood. This large outpouring, to- 
gether with the irritation by the growing bac- 
Iteria, naturally increases the peristalsis and 
starts a diarrhea, which at first is painless, but 
later becomes a pronounced symptom. The 
continual flow of water into the intestinal canal 
dehydrates the blood and prevents the absorp- 
tion of nutrition, thus at once parching and 
starving the victim. This readily explains the 
fother symptoms and lesions. The accelerated 
heart beat is due to the small volume of blood 
which flows with difficulty through the cap- 
illaries. The pulse is small and thready, 
became there is not sacugh blood to 
fill the arteries. The dyspena is marked 
because the blood carries but little oxygen. The 
brain is sluggish and irregular in action from 
an incomplete blood supply. The muscular 
contractions are painful on account of the In- 
tense dryness and a consequent binding of the 
filers as they play one upon another, and the 
liver and kidneys degenerate from the same 
cause. The surface epithelium in the intestines 
degenerates, dies and desquamates, producing 
the characteristic rice water discharges. These 
symptoms and pathological conditions are ident- 
ical with a severe attack of simple cholera mor- 
bus. Both the simple and Asiatic types of 
cholera can result fatally through the abstrac- 
tion of water from the system. The discovery 
of the bacteriologist that the cholera germ 
will not live longer than twenty-four hours en- 
tirely without moisture, and that excessive 
heat, or excessive cold will kill it. relieves us 
from all fear of taking the disease by breathing 
the germs in the air. Furthermore the cholera 
germs do not produce spores or seeds. Repro- 
duction is effected by rapidly progressing phy- 
sical extension. It has been found impossible 
to cure cholera when at its worst, for under 
whatever treatment tried, nearly one-half of 
those attacked die. It is about as hopeless to 
expect to find a drug or nostrum which can go 
through the process known as curing chol- 
era as to find a drug which can cure 
a man who has taken a dose of ar- 
senic. Cholera once thoroughly established, 
drugs are of little avail. So said a prominent 
physician of England, and this statement but 
emphasises the importance of all preventive 
measures. In the present state of medical 
knowledge and sanitary science cholera can be 
reduced to one of the least dangerous of mala- 
dies, instead of being one of the most dreaded. 
In theory it is possible to eradicate Asiatic 
cholera from the face of the earth by thorough 
disinfection. The most important matter is the 
establishment of a system of civic sanitation 
which shall have for its object the preven- 
tion of an outbreak of cholera. Cleanliness 
is the one great safeguard against this 
enemy of mankind. Its victims are chiefly 
those who are already in an unhealthy condi- 
tion or in unwholesome surroundings. It we 
put the surroundings in good order, but more 
than all, if we put ourselves in a thoroughly 
sanitary condition, we can defy the foreign 
plague. A healthy stomach has the best guard 
against the cholera bacillus in the acid condi- 
tion of the gastric juice. The more effectually 
to secure this action large quantities of fluids, 
even water, should not be taken with the food. 
By swallowing a large amount of liquid at 
once part of the contents of the stomach 
will immediately pass the pylorus and thus 
ever provided there were germs in the 
stomach that would have beea destroyed 
If allowed to remain in contact with the acid of 
the gastric juice they may be passed on to be- 
gin the work of destruction. Ail agree that it 
is of the greatest importance to treat the first 
symptoms of looseness of the bowels, and in 
this treatment the usefulness of acid astringent 
drinks is most valuable. The bacteriologist 
finds that the healthy normal gastrinjuice of an 
animal's stomach will quickly destroy the 
cholera germ, even when literally fed on the 
same. "Therefore." he says, "let each individ- 
ual quarantine his own system, by keeping it 
clean and healthy at all times. Avoid stimu- 
lants, narcotics, dietary excesses and dis- 
sipation. Don't overwork." Quarantine has 
been aptly described as an elaborate system 
of leakiness. If complete, it would be impos- 
sible for a commercial country, and if incom- 
plete, it gives only a false security, as all for- 
eign and continental experience thoroughly 
proves. The custom comes down to us from 
ancient times and had its origin in the fears of 
the superstitious. These barbarous regulations 
are still observed in many European countries 
and our own experience in New York harbor 
last autumn was more worthy of the middle 
ages than of the nineteenth century. The fu- 
tility of such measures is shown by the complete 
system of isolation enjoined by the Chinese and 
yet in no country are destructive epidemics 
more common. On the contrary, the British 
have almost no quarantine, and at the same time 
are more exposed by their intimate commercial 
relations with the rest of the world than any 
other nation, yet last summer, while wo were 
wildly excited over the matter, the. English 
were more more concerned about cleanliness 
than quarantine. The commercial interests of 
that country have given wisdom to their man- 
ner of dealing with infectious diseases of 
foreign origin, and the result has been the re- 
duction of quarantine to the simplest form,with 
special attention to the sanitary condition of 
seaports, cities and towns. England has ex- 
pended, within the last fifteen years, about 
$450,000,000, in local hygienic improvements, 
exclusive of a large amount of money 
spent by the government to supplement 
the efforts of the local boards. The fact 
that during last year that country was 
practically free from the disease and that there