When temperature falls and convalescence begins, the stimulants should be lessened, and afterwards a tonic with quinine, acid nitromuriatic dil., tincture calumba or quassia may be given with infusion aurantii.

Serum treatment.—The whole system of serum therapeutics is due to the genius of Pasteur. Diphtheria and tetanus are diseases that are caused by specific germs and are now successfully treated by immunised serum. Tetanus can be prevented and even cured by the injection of serum of other animals vaccinated against this disease: this process has been applied by Yersin for producing a plague serum, for which a prophylactic and curative power is claimed, and this serum may be called plague antitoxin. Yersin treated his first case in Canton. At Amoy, the people were less averse to treatment, and in 10 days he was able to treat 23 with two deaths only. As yet Yersin’s serum has been tried in the declared diseases, but Yersin also proposes to use it as a preventive. Haffkine also proposes to make use of his serum for curative purpose. Yersin’s serum is older than Haffkine’s, otherwise bacteriologically they are identical. The subject is in far too unsettled a condition at present, but it has no doubt a hopeful future before it.

DISINFECTION.

Substances which can prevent infectious diseases from spreading by destroying their specific germs are called disinfectants. These disinfectants can kill pathogenic germs. Heat is a most powerful agent in killing-germs, therefore anything which is subjected to prolonged boiling becomes sterile or germ-free. For purification of clothes and bedding, heat is the best agent, either by boiling them in water or by placing them in a hot-air chamber. The usual arrangement is a furnace with the smoke shaft passing under or on one side of a brick chamber and with a hot-air blast from a shaft running through or under the fire into the chamber itself, or into a passage below it, whence it passes into the chamber through a valve; an exit for the hot-air is provided at the top of the chamber, the clothes are suspended in the chamber, at a little distance from the walls. Various kinds of ingenious apparatus have been recently contrived and are used. Steam disinfecting chambers are necessary for the disinfection of clothes, &c., of a large population, and all large towns and railway stations should have them. High pressure steam in an apparatus contrived for the intermission of its pressure is found to give the best heat penetration to large non-conducting articles such as bedding. Fumigation by burning sulphur or chlorine is a very useful method for disinfection of rooms. Large bonfires of sulphur may also have a beneficial effect on the air.

PURIFICATION OF A ROOM AFTER PLAGUE CASES—

All woodwork should be thoroughly cleansed with soft soap and water, to which a little carbolic acid has been added. The walls should be scraped and then washed with hot lime to which carbolic acid should be added in the proportion of one pint to four gallons of water. Then the room should be fumigated for 3 hours, with all doors and windows and the chimney being closed, sulphur about 1 seer for every 100 cubic feet of space should be put in a metallic dish, a little alcohol is poured on it, and it is lighted. After 3 hours the doors and windows should be opened and kept open for 24 or 36 hours. Rooms may be disinfected by chlorine. Carbolic acid in 5 per cent. solution is useful for all ordinary purposes, such as washing hands, utensils, &c.

Quicklime is the cheapest and the most easily procurable disinfectant for drains and for disinfection of discharges. Carbolic powder made by adding carbolic acid to lime is very useful for the disinfection of public latrines, drains and sewers. Corrosive sublimate, in the proportion of 1 part in 4,000, is the most efficient germicide known and should be used diluted with water for sprinkling on public roads and for flushing drains and washing latrines, &c. It is, however, poisonous and corrodes metal drain pipes. In quarantine or isolation camp the latrines should be of the dry earth system. Carbolic acid powder should be largely used in them. The question of suitable disposal of sewage depends on the circumstances of each town or village, but incineration is the most sanitary method during an epidemic. Other disinfectants too, such as Jey’s Fluid, Creoline, Phenyle, Izal, Sanitas, may also be used.

Transcriber’s Notes