“Clothes to be baked, or to be placed at once in boiling water, as directed further back. The clothes should not be washed at a common laundry. Chlorine or euchlorine should be diffused in the air, the saucer being put some little distance above the head of the patient. Carbolic acid and ether or carbolic-acid spray may be used instead.
“Smallpox.—In this, as in all cases, there can be no use in employing aërial disinfectants, unless they are constantly in the air, so as to act on any particle of poison which may pass into the atmosphere.
“The skin and the discharges from the mouth, nose, and eyes are to be attacked. There is much greater difficulty with the skin, as inunction cannot be so well performed. By smearing with oil and a little carbolic acid and glycerin, or, in difficult cases, applying carbolised glycerin to the papules and commencing pustules, might be tried. The permanganate and sulphurious acid solutions should be used for the mouth, nose, and eyes. The clothing should always be baked before washing, if it can be done.
“The particles which pass into the air are enclosed in small dry pieces of pus and epithelial scales; and Bakewell, who has lately examined them, expresses great doubts whether any air purifier would touch them. Still it must be proper to use euchlorine or carbolic acid. Iodine has been recommended by Richardson and Hoffmann.
“Measles.—Oily applications to the skin and air purifiers, and chlorides of zinc and aluminium in the vessels receiving the expectoration, appear to be the proper measures.
“Typhus (Exanthematicus).—Two measures seem sufficient to prevent the spread of typhus, viz. most complete ventilation and immediate disinfection and cleansing of clothes. But there is also more evidence of use from air purifiers than in the exanthemata. The nitrous acid fumes were tried very largely towards the close of last century and the beginning of this in the hulks and prisons where Spanish, French, and Russian prisoners of war were confined. At that time so rapidly did the disease spread in the confined spaces where so many men were kept, that the efficacy even of ventilation was doubted, though there can be no question that the amount of ventilation which was necessary was very much underrated. Both at Windsor and Sheerness the circumstances were most difficult. At the latter place (in 1785), in the hulk, 200 men, 150 of whom had typhus, were closely crowded together; 10 attendants and 24 men of the crew were attacked; 3 medical officers had died when the experiments commenced. After the fumigations one attendant only was attacked, and it appeared as if the disease in those already suffering became milder. In 1797 it was again tried with success, and many reports were made on the subject by army and naval surgeons. It was subsequently largely employed on the Continent, and everywhere seems to have been useful.
“These facts lead to the inference that the evolutions of nitrous acid should be practised in typhus-fever wards, proper precautions being taken to diffuse it equally through the room, and in a highly dilute form.
“Hydrochloric acid was employed for the same purpose by Guyton de Morveau in 1773, but it is doubtless much inferior to nitrous acid. Chlorine has also been employed, and apparently with good results.
“In typhus it would seem probable that the contagia pass off entirely by the skin, at least the effect of ventilation, and the way in which the agent coheres to the body linen seems to show this.
“The agent is not also enclosed in quantities of dry discharges and epidemics, as in the exanthemata, and is therefore less persistent and more easily destroyed than in those cases. Hence possibly the greater benefit of fumigations, and the reason of the arrest by ventilation. The clothes should be baked, steeped, and washed, as in the exanthemata.