HH62/2/LANARK/90

Transcription

[Page] 89

with if the patient be allowed to remain at home. It is
utterly unreasonable to expect that infection can be
confined to a house consisting of one or two rooms with
the inmates constantly passing in and out, eating their food
and sleeping in near proximity to the sick person. It is
well, also, that people should understand that a little
Condy's fluid placed in a saucer on the floor or sprinkled
about is of little more value than so much water in
arresting the spread of infection.
Obviously, therefore, the only safe course is the
immediate isolation of the patient in a properly equipped
hospital reserved solely for cases of infectious disease.
Upon the sanitary authority rests the responsibility of
providing such an hospital.
After removal to the hospital, or (where for any reason
this unfortunately is not effected) at the close of a case of
infectious disease, it then becomes necessary to carry out
the process of disinfection.
All articles of little value used by the patient, or which
are likely to have become infected, should be at once burnt.
Then all washable articles, bedding, mattresses, pillows,
blankets, carpets, clothing, curtains, anything, in fact, liable
to be contaminated and which cannot be injured by heat,
should be removed in a van kept exclusively for the
purpose to the disinfecting station, there to be dealt with
under the direction of the sanitary staff.
Meanwhile the room occupied by the patient and, if
deemed necessary, any adjoining room should be entirely
closed and made as air-tight as possible. Some difference of
opinion exists as to the efficacy of either sulphur of chlorine
as disinfecting agents, but they, no doubt, possess consider-
able value, and their use has this advantage, that before the
room can be inhabited it must be thoroughly ventilated for
some hours.
Sulphur is employed in the form of sulphurous acid gas,
and is produced by burning sulphur on a shovel, flat stone,
or in a specially constructed iron vessel. The quantity to
be employed should not be less than 1 lb. to every 1,000
cubic feet of space.
Chlorine is credited with better results than sulphurous
acid, especially when the air is saturated with moisture. It
is generated by "gently heating a mixture of 4 parts of
common salt and 1 part of binoxide of manganese with
dilute sulphuric acid (half acid and half water)."

[Page] 90

After the use of one or other of these fumigating agents,
the apartment must be kept closed for from two to four
hours, and then the windows are to be kept open for at
least another four hours, so as to allow a free current of fresh
air to be kept up during that time.
The next step in the thorough disinfection of a house is
the removal of wall-papers and the limewashing of ceiling
and walls. In removing wall-papers great care should be
taken not to allow patches of paper to remain about the
floors, or blown about the streets, but the whole should be
carefully removed and burnt.
The wood work, floors, furniture, &c., should then be
cleansed with a strong solution of disinfectant. Carbolic
acid, in the proportion of 1 part to 20 of water, is the one
generally used; but, so far as recent researches go, it has
been found that mercuric chloride (corrosive sublimate),
dissolved in water, 1 part per 1,000, is by far the most
powerful. In order to avoid accidents, for it is a powerful
poison, it has been recommended to have the solution
coloured in such a way as to readily distinguish it.
Certain conditions may make it inadvisable to remove a
patient from his or her home, and in that case it becomes
the duty of the sanitary staff to see that all possible pre-
cautions are adopted to limit the spread of the disease
during the illness.
If the house be a large one, the patient must be isolated
in a separate apartment, as far as possible from the principal
rooms - preferably at the top of the house. Outside the
door of the sick-room there should be hung a sheet, kept
constantly moist with the solution of carbolic acid or
perchloride of mercury.
All articles not required in nursing the patient, including
carpets, curtains, clothing, books, &c., should be removed
before the patient is placed in the room.
No one should, under ordinary circumstances, be allowed
to enter the room except those actually engaged in nursing,
and the nurse or nurses ought not to visit other parts of the
house.
All discharges from the patient should be rendered harm-
less by the addition of the solution of mercuric chloride
already referred to. This is especially necessary in the case
of a patient suffering from typhoid fever, as the poison is
conveyed in the discharges from the bowels.
The soiled sheets, handkerchiefs, and other washable