Although it is quite possible that few may be able to follow every instruction or precaution advised to guard against the spread of diseases, we may at least outline the conditions to be aimed at and secured as nearly as possible. In spite of the additional labor that it makes, the ideal place for a sick room in a private house is as far from the ground as possible. To be of any service at all isolation must be real and complete. A room should be selected in the topmost story, the door kept closed, a fire, large or small, according to the weather, kept burning, and the windows open as much as possible. Even in the winter this can be done without danger under most circumstances by lowering the upper sash and breaking the draught by a blind or a screen. The staircase and hall windows should be kept open day and night. The other inmates of the house should keep their own rooms thoroughly ventilated. The persons nursing the patient should on no account mix with other members of the family, or if that cannot be helped they should take off their dresses in the sick room, and after washing their hands and faces, put on other dresses kept hanging outside the room, or in an adjoining apartment.
All dishes used in the room should be washed separately, and not with others in the kitchen. The room itself, except in case of measles and whooping-cough, the poison of which does not retain its vitality for any length of time, should be as scantily furnished as possible, containing nothing which can retain infection. All woolen carpets, curtains and bed hangings should be removed, and only wooden or cane-bottomed chairs kept. There should be no sofa, and iron bedsteads are better than wood. A straw mattress of little value, which may be destroyed afterwards, is better than a hair one, which can be disinfected, but feather beds and such coverings should be absolutely forbidden.
In scarlet fever, diphtheria, smallpox and typhoid, all soiled clothing and bedding should be immediately put into an earthenware vessel, containing a solution of corrosive sublimate (one drachm to a gallon of water) and left to soak for some hours before being washed. On being taken from this disinfecting solution they must, even at risk of spoiling flannels, be thrown into boiling water and boiled for some minutes before soaping and washing. No infected clothes should, under any circumstances, be sent out of the house, unless all of these precautions are absolutely guarded.
In cases of typhoid and scarlet fever the vessel which receives the passages from the bowels should have in it a solution of corrosive sublimate or of carbolic acid. The contents then should be stirred with a poker before being poured into the water closet, and the same disinfectant should be sprinkled liberally into the closet.
After the peeling in scarlet fever or the shedding of scabs in smallpox has set in, the patient should take, at intervals of three or four days, hot baths with soft soap, the hair, previously cut short, being well scrubbed with the same. In scarlet fever and diphtheria the mouth and throat should be frequently sprayed, washed out or gargled with a pretty strong solution of permanganate of potash or a weak one of chlorinated soda.
DISINFECTION, ITS IMPORTANCE AND ITS METHODS
There are few subjects on which greater ignorance exists, not only among the public but among medical men as well, than on that of disinfectants. The word is used vaguely to mean deodorants, which destroy bad odors; antiseptics, which prevent the spread of injury by putrefaction in a wound; and germicides, which actually destroy the bacteria or microbes which produce contagion in a disease. In some cases one of these may serve the function of another, but that is merely incidental. Deodorants may be such simple things as perfumery, tobacco smoke or camphor, and they serve very useful purposes in masking bad smells, but they are entirely useless in preventing disease.
Permanganate of potash, or “Condy’s fluid,” as the druggists call it, is a powerful antiseptic, instantly destroying the matter that is beginning to putrefy by what is really a burning process. It sweetens the foul discharges from wounds and bad throats, but is nearly powerless to destroy the living germs of disease.
The disinfectants of most practical value, which are at the same time germicides, are carbolic acid, chloride of zinc, sulphurous acid, chlorine and corrosive sublimate. Carbolic acid, when strong enough, is fairly satisfactory. Five per cent solutions (one part in twenty) stop the activity of bacteria, but do not actually destroy their vitality. Solutions twice as strong do, but water will not dissolve so much, and the odor that remains is an objection to their use for disinfecting linen. Chloride of zinc is far more powerful. If too strong a mixture is used it may injure cloth, so that this wants to be guarded against.
Sulphurous acid (the fumes of burning sulphur) is a most convenient disinfectant. Shut the windows down tight, leave all the clothing in its place and open trunks and drawers. Put a thick layer of ashes in an old iron pot, over which place a shovel of live coals; throw a teacup of pulverized sulphur on the coals and run out, closing the doors in your exit. Stay out several hours. On returning open all doors and windows, and the odor will soon be gone, also the bugs, insects and the germs of any disease that may be lodged in the clothing, etc.