DISINFECTION OF FECES AND URINE.
Disinfect the feces and urine by mixing with each evacuation double its volume of 1 per cent. chlorid of lime solution or double its volume of 5 per cent. carbolic acid solution. Cover the vessel and allow it to stand for from one to two hours before emptying its contents into the closet.
Put all typhoid linens in cans used for that purpose only. Sprinkle with formalin and keep covered until sent to laundry.
N. B.—While performing work in which the hands come in contact with soiled linen and bed-pans, fill finger-nails with soap to keep them clean and to prevent them from acting as carriers of disease.
A WASHING FLUID FOR
SOILED CLOTHES.
| One can of lye, | 10 | cents; |
| Lump of ammonia, | 5 | “ |
| Salts of tartar, | 5 | “ |
Put in a stone jar and set it in the open air. Pour over it 1 gallon of boiling water. Use ½ cupful to a boiler of clothes and add ½ bar of soap. Soak clothes over night in cold water; then place clothes into the boiler and boil for twenty minutes. Plain pieces need very little rubbing. Rinse two or three times in clear water before hanging clothes out to dry.
INCUBATION PERIOD
AND QUARANTINE.
A constant period of incubation is not to be expected. In most instances, as will be seen from the following table, the difference between the maximum and the minimum period is not very great. It seems remarkable, however, that a disease should show such extremes as typhoid fever:
| Normal. | Maximum. | Minimum. | ||||
|---|---|---|---|---|---|---|
| Variola | 12 | days. | 14 | days. | 9 | days. |
| Varicella | 14 | “ | 19 | “ | 13 | “ |
| Measles | 10 | “ | 14 | “ | 4 | “ |
| Rubella | 18 | “ | 21 | “ | 8 | “ |
| Scarlatina | 2 | “ | 7 | “ | 1 | day. |
| Influenza | 3 | “ | 5 | “ | 1 | “ |
| Diphtheria | 2 | “ | 7 | “ | 2 | days. |
| Typhoid fever | 12 | “ | 23 | “ | 5 | “ |
| Mumps | 19 | “ | 23 | “ | 12 | “ |
It is a peculiar fact that the diseases in which the period of incubation is shortest are those in which the infection persists the longest.
The period of quarantine must be guided largely by the period of incubation, hence the subject is an important one for a variety of reasons. The “Medical Magazine” (London) states that the period of quarantine should be at least a day longer than the maximum period of incubation for each disease. This is a very uncertain rule, however, for the patient should be free from all signs of illness, and especially from fever. The period of infection is very doubtful. It may be greatly prolonged by complications. This is especially true of small-pox, diphtheria, typhoid and scarlet fevers. The period during which a disease may be infectious cannot be stated definitely. It varies with different diseases, and must be determined according to the symptoms and character of the case. Measles, chicken-pox, and mumps lose the direct power of infection very early, and the infective principle does not remain active for a long period in the room in which the patient has been ill. Measles, mumps, and chicken-pox may be infectious in the earlier stages before becoming definite in character. Smallpox is not actually dangerous until the eruption appears.
THE CARE OF THE SKIN
AND MOUTH IN FEVERS.
By Harriet Higbee,
Graduate Illinois Training School for Nurses.
From the American Journal of Nursing.
The prevention and treatment of bed-sores have been and are frequently discussed in medical books and journals. But as it is a subject that often taxes the nurse’s ingenuity to the extreme, it can not be dwelt upon too frequently. Many preventive measures are familiar to us, as the soap and water bath for cleanliness, followed by rubbing with alcohol and dusting with boric-acid powder, or boric-acid powder and bismuth subnitrate in equal parts for dryness. The relief of pressure is most important. Make use of air-cushions, cotton-pads, pillows, water-bed and frequent change of position where that is possible. In addition to these, there are a few measures not generally used which after a thorough test have proved satisfactory. One is a simple inexpensive contrivance used to relieve pressure of heel, elbow, and ear. It is a pig’s bladder filled two-thirds full of either warm or cold water, as the case requires, tied securely, and placed under a cotton ring. The weight of the head or elbow rests on the ring and the tender point rests on the soft fluctuating mass. If the skin is inactive, as in paralysis, or there is frequent or constant moisture from perspiration or involuntary evacuations of urine or feces, the alcohol and boric acid, etc., are of very little value. They do not prevent the absorption of the moisture by the skin and its subsequent softness or excoriation, which is commonly followed by infection. In such cases the back should be washed with soap and water every six or eight hours, or after every involuntary evacuation, and thoroughly rubbed with a small amount of oil-substance, as camphorated oil or a mixture like the following:
| Mutton tallow, | ℥j; |
| Olive oil, | f℥j; |
| Carbolic acid, 95 per cent., | ♏ j. |
Render out mutton tallow on the back part of the stove; do not brown it. Strain through a piece of muslin; add the olive oil and carbolic acid; set dish into cold water and beat its contents until set. This will make an ointment the consistence of vaseline, and it will keep indefinitely. If the skin needs a great deal of stimulation, camphorated oil or, better still, castor oil may be substituted for the olive oil in the above recipe.
When the skin becomes excoriated the part should be cleansed as mentioned before, not with soap and water, but with boric-acid solution, normal salt solution, or sterile water; then gently painted with oxide of zinc ointment made into liquid form by the addition of olive oil, castor oil, and balsam of Peru in equal parts, or castor oil alone, and covered with a clean cloth fastened on with a binder. Gentle massage may be used around the excoriated surface with excellent results.
The treatment of bed-sores is usually directed by the physician; but if it is left to the nurse, she will find the following method helpful. If there is necrotic tissue or suppuration present, she may irrigate the cavity once daily with peroxid of hydrogen, one glass syringeful, followed by normal salt solution, boric-acid solution, or sterile water. Then apply a hot boric-acid dressing, one inch thick, every four hours until wound is clean. If the stimulation of the tissues is needed, fill the cavity with a sterile dressing saturated with balsam of Peru and castor oil, equal parts bovinine, castor oil, or camphorated oil alone. When the depression is filled with granulation tissue, it can be treated as an excoriation.