The days of hospital gangrene, of outbreaks of erysipelas, pyaemia and puerperal fever in hospitals have passed, but we have still too many cases of typhoid fever, diphtheria and other diseases developing in hospitals and institutions of various kinds in this twentieth century. The teachings of Pasteur and Lister that bacteria are the cause of a large number of the ills that flesh is heir to, and that these micro-organisms may be destroyed by the use of proper means—these teachings have revolutionized some departments of hospital work. One very important department that has not been entirely revolutionized is the hospital kitchen. The number of sanitary kitchens is increasing, it is true, but in many hospitals the kitchen is out of harmony with the other departments. It is not unusual to find a beautiful and imposing front entrance, to find marble and tile entering largely into the construction of many parts of the building, to find a costly modern equipment in many departments, and to find the kitchen of that same institution, dark, too small, poorly equipped, poorly ventilated, cheaply constructed throughout, and thoroughly unsanitary, a splendid place for the development of germs—a place that is, if not a disgrace to the institution, at least far from creditable. Who is to blame? Somebody surely is. Certainly when so much value is being placed on the food supplies sent from the kitchen as weapons in the fight with disease no hospital built in the twentieth century should have in it a kitchen that is not in keeping with the rest of the building, that will not bear critical inspection, that cannot be shown with as much confidence and satisfaction as the operating room or the wards. And not only in the situation, construction and equipment of the hospital kitchen is this lack of progress evident, but in no part of the hospital is the germ theory so little regarded in practical work. Pure blood is regarded as one of the great essentials of health, and much study has been devoted to that important part of the human system. The most perfect apparatus for examining the blood is considered none too good, but how often in the average hospital are tests applied to the materials from which blood is made? Are all butchers and bakers and grocers and dairymen so honorable that occasional analysis of the products supplied is quite unnecessary? An examination of the ice supply in a certain hospital, not many months ago, led to the discovery of the ice as the cause of an epidemic of typhoid fever, that seriously embarrassed the institution. A careful inquiry into such matters might have prevented serious embarrassments in a number of other institutions within recent years. Prevention is better than cure, and far cheaper. It is always better to be sure than sorry, and now that scientific research is popular, it ought to be possible for every hospital to arrange for periodical examination of its food and water supplies.
Filters and Water
Filters are now regarded as essential in every hospital, but it is quite possible for too much confidence to be placed in filters. The filter that will run fast is likely to be the favorite, whether it really filters or not. Elmer G. Horton, B. S., bacteriologist to the Ohio State Board of Health, in speaking of the weaknesses of domestic filters, says:
“If the rate of filtration is not moderately fast, the consumer will not buy. The maker realizes this, and slights efficiency in order to gain a more rapid flow. The filtering material is made coarser or more porous, and, with the resistance decreased, the water passes through more readily, and so do the bacteria.
“No filter will continuously yield a perfect effluent without being often cleaned. Whatever a filter takes out of the water remains in the filter until removed by cleansing; and if that cleansing be delayed the filter will dispose of the accumulated filth by way of the passing water. We must expect an unclean or foul filter to yield an effluent of like character, although that effluent may appear clear.
“After all, the more harmful things in a water are not so much the easily discernible ones—mud, floating vegetation, iron, odors, etc., but the invisible living micro-organisms, and especially those forms capable of producing disease in man. It is true, and greatly to be regretted, that clearness is the criterion by which the average citizen measures the efficiency of his filter, but let it never be forgotten that the clearness of a water is no guarantee of its purity. This bottle of water which I pass around is clear enough, and no doubt looks good enough to drink, but it actually contains not thousands but millions of typhoid fever bacilli.
“A sample of filtered water from the filter in the dining room of a large boarding-house was examined and found to contain five times as many bacteria as the unfiltered water.
“Recently samples of filtered and unfiltered water were taken from a filter in one of the offices of the State House. The 2,200 bacteria per cc. of the untreated water had increased to 14,000 in passing through their “germ-proof” filter. Organic matter collects in the filter and serves as food, and there is developed a breeding nest for the bacteria.”
Parkes in his manual of hygiene suggests this plan for the examination of water: First, a physical examination of water; second, a microscopical examination of suspended matters and sediment; third, a quantitative examination of dissolved solids; fourth, a biological examination.
Air