A few brief observations on the control and prevention of infections diseases, such as small-pox, measles, scarlet fever, typhus fever, typhoid fever, cholera, &c.

The above-mentioned diseases are capable of being transmitted from those who are infected to those who are not. It is at once cheering and obligatory to know that the spread of these infectious diseases depends upon certain specific conditions, and that these conditions are primarily within the control of man. This control and prevention of infectious diseases is one of the latest and greatest achievements of modern medicine.

Small-pox is one of the most contagious diseases, but it is controlled by vaccination. Primary vaccination within certain limits, is a protection against small-pox, but it is a well ascertained fact that there is a period in the life of persons when the prophylactic or protective power of vaccinia dies out, or at the least becomes very feeble, consequently it is advisable for all who are in the proximity of those suffering from small-pox to be re-vaccinated, for the following reasons. Re-vaccination will almost without exception restore the protective power against small-pox: secondary vaccination is attended with no danger. The operation is so simple and the protection so certain and valuable.

Scarlet fever and measles, though regarded as the inevitable diseases of childhood, and for which the mother is considered the best physician, and kitchen physic the best medicine, are simple in themselves, but on account of the sequelÆ or diseases which generally follow, really require more attention in a sanitary point of view than they generally receive.Typhus, typhoid fevor, and cholera, are contagious diseases, and where the conditions of a locality are favourable they rapidly spread death and desolation around. Typhoid fever is generally caused by a specific miasm of sewers and neglected water closets, &c.

With respect to the cause of cholera, I may mention decomposed and decomposing animal and vegetable matter in drinking water, but whatever may be the essential cause or causes of cholera, I must leave for some future discussion. What is of the most practical value to know is, that the laws which govern the endemic influence of cholera, are as well known as those of typhoid fever, and equally under our control. Those conditions which are favourable to the spread of typhoid fever, are equally favourable to the spread of cholera when once it shows itself, and the same sanitary regulations which are applicable to typhoid fever, are best calculated to prevent and control cholera.

The following suggestions may be observed with advantage to the sick, and those connected with them:—

1. In cases of contagious diseases fresh air is of primary importance to both patient and attendant. The room should be well ventilated, care should be taken that no draught blows upon the patient, but a continual supply of fresh air enters the room. In cases where it is not expedient to have both window and door open a fire ought to be lighted, and the door kept open. A fire not only is a good means of ventilating a sick room, but it also dries the air and thus renders it a less susceptible medium for carrying and retaining infectious poisons.

2. Cleanliness is very desirable in health, but it is imperatively necessary in disease, both the room and the patient should be kept thoroughly clean. Both body and bed linen should be frequently changed, and as soon as the soiled linen is removed it should be placed in water and thoroughly washed, and not rolled up and kept till the regular washing day. There is a great objection to change the linen of patients suffering from fever for fear they should catch cold, this is an ignorant prejudice. Fever patients do not take cold if ordinary care be employed. The skin of fever patients not only becomes hot and uncomfortable but dirty. It is often advisable to sponge them with a little luke-warm vinegar and water. The room ought to be washed out daily, and thoroughly dried. It is useful to have a little of Condy’s disinfectant fluid in the water. All carpets, curtains, and woollen furniture is better removed out of the sick chamber. All discharges from the patient ought to be immediately emptied, and the utensils washed out with Condy’s fluid and water; and further, all water closets &c., ought, at these times, to be daily (at least) well flushed with water.

3. Nurses, relatives, friends, and visitors, ought to avoid breathing the patient’s breath, and ought not to remain in close proximity longer than duty requires. They should not swallow their spittle, and on leaving the sick chamber, they should clear their mouth and nostrils. Smoking is only of service in so far as it promotes expectoration; and snuff, only because it induces sneezing.

With respect to disenfectants I would say, better that they should never be used, than that their use should tend to supercede fresh air and cleanliness. In order to disabuse the minds of some who look upon disinfectants as charms, I give a list of some of them, with their supposed action:—

Charcoal absorbs moisture and noxious effluvia; its value depends upon its being fresh and dry; it stops meat from becoming putrid.

Bromine is the most efficient antiseptic known, but it requires great care and caution in its employment, consequently it is best left to the direction of the medical attendant as to how, when, and where, it should be employed.

Condy’s disenfectant, Darby’s fluid and ozonized water, are but solutions of the permanganate of potassa, and it is upon this that their value as antiseptics and deodorizers depend. Carbolic acid and coal tar are also antiseptic and deodorant in their action. McDougall’s powder contains carbolate of lime, and is a very valuable preparation in arresting putrescence and controlling effluvia. Chloride of lime is a common disinfectant, and is useful in destroying noxious compound gases.

Heat is the last disinfectant that I shall mention. It is at once cheap and effectual, and is by far the most valuable in destroying contagious virus, transportable infections. All bedding, garments, &c., should be purified by hot air or steam, as it will effectually destroy cell life, cryptogamic and infusorial organisms.