THE NEW ZEALAND GAZETTE. 261

and tended, medical advice should be taken as to the
propriety of removing him to an infirmary or hospital.
In extreme cases, special infirmaries may become
necessary for the sick, or special houses of refuge for
the endangered.

14. Privation, as predisposing to disease, may
    require special measures of relief.

15. In certain cases, special medical arrangements
    are necessary. For instance, as cholera in this
    country almost always begins somewhat gradually
    in the comparatively tractable form of what is called
    "premonitory diarrhœa," it is essential that, where
    cholera is epidemic, arrangements should be made for
    affording medical relief without delay to persons
    attacked, even slightly, with looseness of bowels.
    So again, where smallpox is the prevailing disease, it
    is essential that all unvaccinated persons (unless
    they previously have had smallpox) should very
    promptly be vaccinated; and re-vaccination should
    also be offered, both to persons above puberty who
    have not been vaccinated since childhood, and to
    younger persons whose marks of vaccination are
    unsatisfactory.

16. It is always to be desired that the people
    should, as far as possible, know what real precautions
    they can take against the disease which threatens
    them, what vigilance is needful with regard to its
    early symptoms, and what (if any) special arrange-
    ments have been made for giving medical assistance
    within the district. Especially in case of smallpox or
    cholera, such information ought to be spread abroad
    by printed handbills or placards. In any case where
    danger is great, house-to-house visitation by discreet
    and competent persons may be of the utmost service,
    both in quieting unreasonable alarm, and in leading
    or assisting the less educated and the destitute parts
    of the population to do what is needful for safety.

17. The present Memorandum relates to occasions
    of emergency. Therefore the measures suggested in
    it are all of an extemporaneous kind; and permanent
    provisions for securing the public health have not
    been in expressed terms insisted on. It is to be
    remembered, however, that in proportion as a district
    is habitually well cared for by its Sanitary Authorities,
    the more formidable emergencies of epidemic disease
    are not likely to arise in it.

18. For detailed advice on disinfection, see the
    office memorandum on that subject.

JOHN SIMON.

Medical Department of the Council Office,
July, 1866.

MEMORANDUM, BY THE MEDICAL OFFICER OF THE
PRIVY COUNCIL, ON THE PRECAUTIONS TO BE
TAKEN AGAINST CHOLERA, UNDER THE REGU-
LATIONS RECENTLY ISSUED BY THE LORDS OF
THE COUNCIL, AND OTHERWISE.

1. Asiatic Cholera, which for more than a year
   past has again been affecting in succession many
   parts of continental Europe, has recently shown some
   disposition to spread in a few parts of England. It
   is probable that henceforth, for some weeks or months
   to come, the disease will be seen, in more or less
   considerable groups of cases, in other parts of this
   country. It is possible that in some such parts,
   amid pre-disposing conditions, the disease may
   suddenly become of great local importance. And
   under these circumstances the Lords of Her Majesty's
   Council have seen fit (by Order dated July 14th) to
   put in force the provisions of "The Diseases Prevent-
   ion Act, 1855."

2. Also their Lordships have seen fit to issue
   Regulations under the Act. Those Regulations
   (contained in two Orders of Council, dated respec-
   tively the 20th and the 21st July) direct the appointed
   local authorities to do in their respective districts, so
   far as necessary, certain things which are chiefly in
   the nature of medical relief. The authorities who have
   to give effect to those Medical Relief Regulations are
   as follows:---First, within the metropolis, with excep-
   tion of the City of London, the respective Vestries or
   District Boards of the several parishes or districts;
   secondly, outside the Metropolis, and also in the
   three Unions of the City of London, the Boards of
   Guardians or Overseers of the Poor of the several
   unions, parishes, and places respectively. The main
   objects for which the regulations purport to provide
   are briefly, and in the words of the Statute, as
   follows:---" for the speedy interment of the dead;
   for house-to-house visitation; for the dispensing of
   medicines, guarding against the spread of disease,
   and affording to persons afflicted by or threatened
   with such epidemic, endemic or contagious, diseases
   such medical aid and such accommodation as may be
   required." In order that these objects should be
   promptly and adequately fulfilled in any district
   where cholera may show itself, it is necessary that
   all authorities who will be responsible for fulfilling
   them should betimes, in their respective districts,
   pre-consider and pre-arrange the measures which, in
   case of need, are to be taken. Therefore the Regu-
   lations require, that in all cases (not only in cases
   where cholera is actually present within the juris-
   diction) an immediate meeting of the authority shall
   be held, and certain preparatory directions be given.
   But, except to this extent, no action under the
   Diseases Prevention Act is required of any district,
   unless cholera be actually present there.

3. There are other respects, however, in which
   local action has to be taken against cholera, and in
   which the interests of the public health require,
   above everything, that the action should be taken
   from beforehand. This precautionary action against
   cholera (as against many other diseases) is an object
   for which the Nuisances Removal Acts enable local
   provision to be made. The authorities who have to
   administer these Acts are in many places the same,
   but in many other places (chiefly wherever there are
   Town Councils, Improvement Commissioners, or
   Local Boards of Health) are not the same, as the
   authorities who have to act under the Medical Relief
   Regulations. The Lords of the Council have no
   authority to issue regulations or orders for any
   purposes of the Nuisances Removal Acts. But a
   year ago, in anticipation of the danger which now
   threatens the country, their Lordships drew the
   attention of nuisance authorities, and of the public
   generally, to the renewed presence of Asiatic cholera
   in Europe, and suggested the precautionary pro-
   ceedings which under the circumstances were called
   for. It was their Lorships' hope, that, after this
   warning, the interval which might elapse before a
   re-appearance of cholera in England would be
   vigorously used by the nuisance authorities of the
   country in preparing their respective districts for the
   contingency which has now come. The paper which
   was circulated on the above occasion by the Lords of
   the Council (the "General Memorandum, on the
   proceedings which are advisable in places attacked
   or threatened by epidemic disease") is now again
   commended by their Lordships to the consideration
   of the nuisance authorities and of the public. And,
   on the present occasion, parts of it must be specially
   insisted on.

4. In relation to Asiatic cholera, as now threaten-
   ing us, there are two principal dangers against which
   extreme and exceptional vigilance ought to be used.
   First, there is the danger of drinking water which is
   in any (even the slightest) degree tainted by house-
   refuse or other like kinds of filth; as where there is
   out-flow, leakage or filtration, from sewers, house-
   drains, privies, cesspools, foul ditches, or the like,