Besides measures of disinfection and cleanliness, the patient must be placed under the best conditions for overcoming the disease. The same measures tend to prevent infection. Thus abundant food, an open-air life, sleeping with bedroom windows widely open, avoidance of dust, abundance of sunshine, are all important. The importance of sunlight in the prevention of consumption can scarcely be exaggerated. Koch found that tubercle bacilli were killed in from a few minutes to some hours, according to the thickness of the layer in which they were exposed to the sunlight. He found that even ordinary daylight produced the same effect, if it lasted long enough; cultures of tubercle bacilli dying in from five to seven days if exposed at the window in compact masses. These experimental facts emphasise the importance of abundant open space about dwelling-houses (see p. 203), the provision of a large window-area (see pages 202 and 216), of staircase ventilation, and lighting, &c.
Scrofula means a tubercular affection of the lymphatic glands. It occurs most commonly in the neck. The infection is usually received from some neighbouring mucous surface, as from the throat, being derived from dried expectoration or diseased milk. The same indications as for the prevention of phthisis hold good for scrofula.
[CHAPTER XLVI.]
NOTIFICATION AND ISOLATION.
We are confident from the actual discovery of the micro-organisms causing certain infective diseases, that the other diseases of an analogous nature are similarly caused by living contagia. On this supposition, action is taken for the prevention of these diseases. This action comes under a number of different heads, which may be classified as follows:—
1. Means for the early recognition of the infectious character of a disease. The bacteriological aids to recognition in diphtheria (page [299]), enteric fever (page [301]), and phthisis (page 310) have been already mentioned. It is important to call in medical aid when any suspicious symptoms arise, even when these symptoms do not appear to be urgent. If an infectious disease is not recognised in its early stage, it may be easily overlooked, and the patient cause a serious epidemic. The following hints for teachers are in Brighton sent with each circular letter as to excluding infected children from school. The list is not exhaustive, but may aid in drawing attention to suspicious symptoms. The only safe rule when in doubt is to act as though a case is infectious until a skilled opinion can be obtained.
HINTS AS TO INFECTIOUS DISEASES.
As infection is sometimes spread by means of children attending school while suffering from undetected infectious diseases, the following hints may be useful to the teacher:—
1. Any scholar having a sore throat should be sent home and regarded as infectious until the throat has been examined by a doctor.
If a scholar has enlarged glands in the neck, and especially if he or she is very pallid, the suspicion of possible diphtheria should be entertained. Many slight cases of diphtheria escape detection.