Another book for food supplies should be brought to the kitchen or storeroom each time supplies are replenished. Another book for keeping track of surgical supplies should be brought with each requisition. Some hospitals have also a “linen book,” which tells the amount of each kind of linen sent to the laundry from each department. Clean linen is noted in the book also when given out. These books should be sent to the office each week (Monday morning is usually a good time) and the amounts supplied to each department reckoned up. When this amount in any department is excessive an investigation can be made with facts as a basis. Regarding this system, Sir Henry Burdette in “The Commissariat” says: “No true economy can ever be expected under a system by which the persons who order and use supplies, and the person who is responsible for the bills, both work independently and pull different ways. It is absolutely essential to a well-balanced administration that a spirit of responsibility should permeate the whole establishment, from the manager, on whom the multifarious charges accumulate for payment, down to the youngest probationer charged with serving out the rice pudding in her ward. And this spirit of responsibility must in all cases recognize a double duty. There is the duty towards those for whom each person invested with authority of any kind is called on to provide, and there is the duty toward the institution, represented by the person next in authority. Where this dual sense of responsibility is nicely balanced in every member of the institution, the management may be considered perfect.
To that end, it is, above all things, necessary that there should be one person invested with general control and endowed with a grasp of the whole situation. It cannot be too often repeated that in these matters to know is to control. There is no other road to economy. It cannot be compassed by appeals to conscience, not by nagging, not by a grudging, stingy giving out of necessary articles as though the consumer were guilty in requiring them. Let each housemaid know how many yards of cloth she is expected to use in her cleaning in a given time, let each pound of lint be registered against someone’s name, who shall be accountable; let each article be given out at the right time, on the right day, to the right person, and with the understanding that the transaction, slight though it may be, has been noted down and will duly find its place in the weekly average and in the record of the whole expenditure. Let such a system once take root and then, be the institution large or small, rich or poor, hampered with old traditions or brimming over with untried theories, a spirit of true economy will reign throughout every department, worth far more, indeed, than the trifling secretarial labor expended in its production.”
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.