APPENDIX.
Disinfection—Infected clothing from wards should be immediately placed in a vessel containing sufficient disinfecting fluid to cover it, and should be kept in it till disinfection is accomplished. The length of time varies with different disinfectants. By actual experiment, the length of time to destroy bacteria should be learned. Too much so-called disinfection is on the shot-gun plan, and no attempt is made to find out whether it produces the desired results. Most disinfectants are more powerful if used hot. Other conditions that modify the power of disinfectants are the kind and number of bacteria to be destroyed, the quality of associated material, as well as the strength and temperature of the solution. Bichloride of mercury destroys all forms of pathogenic micro-organisms and spores. For the latter a solution of 1 in 500 is needed, the exposure to be not less than one hour. It should not be used for the disinfection of excreta, because of its property of precipitating albuminous matter. This forms a coating around the bacteria, which prevents the penetration of the solution. This solution may be used in disinfecting clothing or rooms, but should never be used on metal substances.
A solution that is highly recommended for clothing contains the following:
| Carbolic acid | 3 | parts |
| Common soft soap | 1½ | parts |
| Water | 100 | parts |
Common laundry soap is first dissolved in water, the carbolic acid is added and the mixture is vigorously stirred. Experiments with this solution show that non-spore forming bacteria are destroyed in an exposure of one-half hour. Commercial carbolic acid may be used, which is somewhat less expensive than the purified product.
For the disinfection of excreta, a solution known as the American Standard is officially prescribed in the United States Army, it being specially stated that the chloride of lime should be of good quality, and not have undergone decomposition. It is made by dissolving six ounces of chloride of lime in a gallon of water.
For the disinfection of mattresses, live steam should be used whenever possible. When no facilities exist for steam disinfection of mattresses and pillows, a fumigation can will be found very valuable.
Fumigation Can—This can is made of galvanized iron, with a tight-fitting cover. It needs to be about four and a half feet high, and at least two feet and a half in diameter. A slat shelf, with iron or wire hooks that fasten over the top of the can, will be useful in sterilizing small articles. This contrivance is superior to any closet, as it confines the formaldehyde in small space, and can be made almost entirely air tight. It should always be remembered that formaldehyde has almost no power of penetration, and therefore special care is needed to expose all possible surfaces to the fumes.
Extermination of Vermin—To prevent bedbugs in hospital is no easy matter where patients and visitors are coming from all kinds of homes. A leading hospital superintendent recommends sulphur fumigation. It is said to be the only thing that will effectually destroy them. “In order to secure the desired results the fumes must be very dense. In preparing for fumigation large pans are used made to hold from twenty-five to thirty pounds of sulphur, and other pans are filled with water. The heat from the burning sulphur will cause steam, which makes the sulphur fumigation more effective. In order to accomplish the entire destruction of the bedbug, it is necessary to fumigate three or four times in a month. It takes three weeks for the bugs to be hatched and eleven weeks to mature. By successive fumigations in this way a room or ward may be considered safe, but this treatment should be repeated twice a year.
For keeping beds free from bugs, the following prescription is recommended:
| Corrosive sublimate | 1 | ounce |
| Spirits of turpentine | 1 | pint |
| Coal oil | 1 | pint |
The corrosive sublimate should first be dissolved in alcohol and the mixture used through an atomizer or oil can.
To exterminate pediculi of the head, saturate the hair thoroughly with kerosene for three successive days and wash with warm water and green soap.
For pediculi on other parts of the body the following is recommended: Salicylic acid, 2 parts; toilet vinegar, 25 parts; alcohol, 75 parts. Apply with a flannel or piece of absorbent cotton. One application is usually sufficient.