A person who has had any infectious disease and has been thoroughly disinfected, with his clothes, may be allowed to mix freely with his fellows, in school, for instance, after the following periods. Scarlet fever: Not less than eight weeks from the appearance of the rash, provided peeling has completely ceased, and there be no sore throat. Six weeks is not enough, as there are cases of direct infection after seven weeks when all symptoms have entirely disappeared. Measles and German measles: In three weeks, provided all peeling and coughing have ceased. Smallpox and chickenpox: A fortnight after the last scab has fallen off; the hair, in case of smallpox, having been cut short and scrubbed with carbolic soap or soft soap. Mumps: Four weeks from the attack if all swelling has disappeared. Whooping-cough: Six weeks from recognition of the whoop if the cough has entirely lost its spasmodic character, or four weeks if all cough whatever has ceased. Diphtheria: In a month if convalescence be complete, there being no trace of sore throat or discharge from the nose, eyes, etc. Ringworm: When the whole scalp, carefully examined in a good light, shows no stumpy broken hairs or scaly patches.
It has been very difficult to impress upon communities and individuals the extreme importance of strict obedience to the foregoing rules. There is an unfortunate tendency in too many instances for households to fail in guarding their neighbors from contact with their own members who are convalescing from disease. Even such common and simple diseases as whooping-cough, chickenpox, mumps and others that are considered especially to belong to children, frequently prove fatal to those who are susceptible to them, and it is truly wicked to permit by carelessness such an infection to reach a school or elsewhere where weaker children may suffer as a result.
COMMON SENSE IN THE SICK ROOM
Ventilation, Light, Temperature and Furnishings—Care of the Patient—His Temperature and Pulse—Bed Sores—The Characteristics of Fever—Simple Household Remedies—What to Put in a Remedy Cupboard—How to Keep the Baby Well
To every living person air must be furnished every moment if life is to be preserved. The vital element of the air is oxygen gas, the life-giving medium, and this is diluted with nitrogen, because the oxygen itself, breathed alone, would be too stimulating for our lungs. In the delicate cells of the lungs the air we have inhaled gives up its oxygen to the blood, thus purifying it, and receives in turn carbonic acid gas and water, foul with waste matter, which the blood has absorbed during its passage through the body and which we now exhale. The blood is red when it leaves the heart, pure. It returns to the heart purple from the impurities it has picked up, and by the oxygen is once more changed to red.
Manifestly if this process is so important to a person in health, it must be doubly so to one who is sick. The impurities of a sick room consist largely of organic matter, including in many instances enormous numbers of the disease germs themselves. If we uncover a scarlet fever patient in the direct rays of the sun a cloud of fine dust may be seen to rise from the body, the dust which carries the contagion itself. In an unventilated place this is but slowly scattered or destroyed, and for many days it retains its poisonous qualities. “The effect of rebreathing the air cannot be overestimated,” says Martin W. Curran of Bellevue Hospital, New York City. “We take back into our bodies that which has been just rejected, and the blood thereupon leaves the lungs bearing, not the invigorating oxygen, but gas and waste matter, which, at the best, is disagreeable to the smell, injurious to the health, and may contain the germs of disease.”
Fortunately rooms may be ventilated by means of windows in several different ways with little risk of draught. For instance, the lower sash of the window may be raised three or four inches, and a plain bar of wood an inch in thickness, extending the whole breadth of the window, may be put below the window sash, entirely filling the space. By this means the air current enters above, between the two sashes in an indirect line, and it is gradually diffused through the room without a draught. Here is a simpler way of doing the same thing. Take a heavy piece of paper or cloth, about twelve inches wide, and long enough to reach across the window. Tack it tightly at both ends and the lower edge to the frame, and raise the lower sash of the window a few inches. The air entering will be diverted by the cloth. If the air is very cold it must not be admitted at the bottom of the room, but from the top of the window, and should be directed toward the ceiling so as to fall and mix gradually with the warmer air of the room.
The influence of the sun’s rays upon the nervous system is very marked. That room is the healthiest to which the sun has freest access. The sick room should be kept looking bright and cheerful, unless the disease be one that requires the eyes to be specially guarded from the light. The eyes are weaker, however, in all sickness, and the bed should be turned so that the patient does not look directly toward the bright light of the open window.
The proper temperature for a sick room is sixty-eight degrees above zero. In the hot days of summer when this temperature is greatly exceeded, or the air is too dry, hang some thin muslin, soaked in ice water, across the opening in the windows, which will moisten the air, cool the room, and keep out many particles of floating dust. If the floor of the sick room is carpeted and the illness is serious, cover the carpet with sheets and sprinkle on them a weak solution of carbolic acid at intervals. The sheets can be changed as often as necessary. The cleanest wall is one that is painted, which can be washed and disinfected in any way desired. Nurses consider papered walls the worst ones, and plastered the next, but the latter can be made safe by frequent lime washings and occasional scraping.
Have as little furniture as possible in the sick room, and all of this of wood, metal or marble, kept clean by being wiped with a cloth wrung out of hot water. A small, light table should be placed for the patient’s use, from which he may reach his own glass of water. The bed should not be placed with one of the sides against the wall, as a nurse should be able to attend to a patient from either side.