Care of the Skin in Contagious Diseases.—As in all other sick conditions, the skin of the patient should be bathed frequently with an alcoholic solution. In the later stages of measles and scarlet fever it is essential to anoint the skin while the patient is scaling. This may be done with carbolated vaseline. Mothers should understand why this is necessary. These diseases have a distinct rash or eruption. This eruption practically kills the skin cells and at a certain period these cells are cast off by the new growth of skin underneath. This process is called scaling. In measles the scales are small, and are cast off in the form of bran like dust. In scarlet fever, the cells adhere together and are cast off in large scales. These scales are contagious. They are very light and will float in the air if dry. The movement of the patient, changing the bed clothing, etc., will waft a multitude of these contagious scales into the air of the room and infect every article they may land on. This would make the disinfection of the room difficult and tedious. In order to obviate this tendency experience has taught us that much of the difficulty and nearly all of the risk of contagion may be overcome by rubbing some oily or sticky substance on the skin. By this method the dust and scales are rendered heavier than the air, stick together and will not float. During the scaling period there is a constant itch present which irritates the little patient. By using carbolated vaseline to anoint the skin we accomplish two purposes. The carbolic acid in the vaseline relieves the itch, and the vaseline itself greases the skin so that the scales remain in the bed. Each day the nurse changes the bed-sheet, gathers the scales in the sheet and puts all in the disinfecting solution.
Convalescence After a Contagious Disease.—Complete isolation must be kept up until all danger from contagion is passed. In diphtheria this period is not reached until the examination of the throat contents under the microscope is returned negative. In diseases Which have a rash this period is not reached until all scaling is completed. Even then, and for a number of days or weeks, the patient may be taken out for exercise daily, but must not be allowed to play with other children until his strength justifies active exercise. It takes a much longer period to rid the system of the poison of a contagious disease than most mothers appreciate. Many children have died from heart failure after they were considered well simply because the active exercise overtaxed the heart before the system was wholly free from the poison of the disease.
Before the child is removed from the sick-room for the first time he should have a disinfecting bath. This bath should be in a solution of bichloride of mercury, the strength of which should be one part to five thousand parts of water. The towels used to dry the patient after the bath should be fresh and should not have been in the sick-room. He should then be dressed in clothing which has never been in the sick-room.
DISINFECTING THE SICK-CHAMBER
How to Disinfect a Room.—The most efficient way to disinfect a room is by means of formaldehyde gas. This, however, requires a special apparatus which can only be used by one familiar with the process. In all large cities the Department of Health usually undertakes the disinfection of rooms after any contagious disease. The next best method is by sulphur.
When sulphur is employed it should be used in the form of powder or in small pieces. This is placed in a shallow iron pan set on a couple of boards in a tub partly filled with water. The sulphur is moistened with alcohol before it is set on fire.
It is always necessary, of course, before disinfecting by any process to make the room as nearly air tight as is possible. To accomplish this the windows must be tightly closed, the doors locked, and the cracks and keyhole sealed with pieces of paper or adhesive paper. The room should remain closed for six or eight hours, after which it should be thoroughly aired for several days.
The After Treatment of a Disinfected Room.—The walls, ceiling, and all flat surfaces, such as mantels, window-sills, etc., should be washed with a fresh chloride of lime solution. The floor should be scrubbed with a four per cent. soda solution. All carpets and curtains, if any, should be removed, taken to a vacant lot and thoroughly beaten and then exposed to direct sunlight for a number of hours. The room should then be well aired again for a couple of days before it is again occupied.
How to Disinfect the Bed Clothing and Clothes.—The surest way is to boil them for half an hour; otherwise they may be left in the room while it is being disinfected. Spraying the clothes with a spray of formaldehyde is an effective way of disinfecting them.