Prophylaxis.—Anti-choleraic inoculations are now practised. They not only afford a considerable degree of protection but lessen the risk of a fatal issue in the inoculated. Hence it is advisable to be vaccinated against cholera whenever there is risk of infection. The inoculation must be repeated after the lapse of four months if the epidemic still persists, as the protection afforded is only temporary. Persons travelling in regions where cholera is present in an endemic form should take a little lactic acid in tea, or add a little vinegar or thirty drops of dilute hydrochloric acid to every ounce of drinking water.
At times of epidemic prevalence it is essential that all water should be boiled. The practice of hand-shaking should be discouraged, indigestible diet should be avoided, and raw fruit, raw vegetables, and meat jellies should not be eaten. Lettuces and celery, being moist and eaten uncooked, are specially dangerous. Patients and contact cases must be isolated, and the former should be protected from flies. It is very necessary to maintain a strict supervision of cooks and cooking arrangements. All kitchen cloths should be washed in permanganate solution or boiled. Milk should always be boiled.
Cholera stools may be disinfected by adding a five per cent. cresol solution to them and allowing it to remain in contact with the stool for at least one hour. Quicklime is excellent as a disinfectant. Add together equal parts of fresh quicklime and water, dilute with three times as much water as previously used, add a quantity of this slaked lime equal to the amount of stool to be disinfected and allow it to remain in contact with the stool for one hour. When the ground has been fouled by dejecta or vomit, disinfect with cresol, or rake hot ashes over it or pour kerosene oil upon it and set the latter alight. Cholera-soiled clothing, bed linen and blankets should be soaked in a two and a half per cent. cresol solution.
Treatment.—Isolate the patient, keep him warm, and give ice to suck. Apply hot bottle to the feet, and mustard leaves to the pit of the stomach.
It is advisable to clear the bowel of irritating material at the outset by giving half an ounce of castor oil with a teaspoonful of brandy. Drugs are of little use in cholera, but some like to give one drop of carbolic acid, together with twenty drops of spirit of camphor (or peppermint, or a little brandy), five grains of bismuth, and ten grains of soda, suspended in one ounce of gum water, every four hours. Chlorodyne may be given to allay severe pain.
Even in the mildest cases absolute rest in bed is essential, and a warm bed-pan should be provided.
In the early stages no food at all should be given, but plenty of fluid should be allowed, though it must be administered only in sips. Stimulants may be necessary. Later on fluid food such as milk should be given carefully, and the quantity gradually increased.
The special treatment for cholera can only be carried out by a medical man, and recourse should be had to his help at the earliest possible moment, as everything depends upon immediate treatment. If, after the acute symptoms subside, diarrhœa continues a dose of bismuth is often useful.