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CHAPTER IX.

DISINFECTION-CONTAGIOUS AND INFECTIOUS

DISEASES (a).

SOME knowledge of contagious and infectious diseases, and the reasons why persons affected by or recovering from them should not appear in public, is of the utmost importance to the inspector. By the term contagious disease, we understand a disease which imparts its infection by contact or touch; by the term infectious disease, we understand a disease which transmits or imparts a diseased matter known as a germ, not necessarily for such transmission to be by actual or direct contact alone. The following are some of the principal diseases with which the inspector will have to contend : Small-pox, typhus fever, scarlet fever, typhoid fever.

All work which the inspector has a desire to undertake for the purpose of preventing the spread of infectious diseases should be done with the consent of the medical officer of health; and although this work is really under the direct orders of that officer, it is essential that the inspector should be well versed in the practice of disinfection, and putting the orders of the medical officer into practical operation.

(a) Disinfection in the metropolis : see Sanitary Act, 1866, ss. 22, 23, 24.

The inspector will generally receive a copy of the registrar's weekly return from the medical officer, by which he will find all houses where deaths have occurred from infectious diseases during the week. He will at once proceed to call at each house, and fill up a report sheet for each case (the forms may be had at the publishers of sanitary forms). He will then make arrangements, to suit the convenience of the householder, for having the house stoved; that is, if the patient is recovered, or removed to an hospital, or when unfortunately removed by death. The stoving should in all cases be undertaken by the sanitary authority, as provided for by section 120 of the Act of 1875. Isolation is another matter which the inspector will do well to direct his attention to. If his sanitary authority have an hospital, or an arrangement for the use of some other hospital, the work will not be quite so difficult. If he finds that a patient cannot be properly isolated at home, which be it remembered can only seldom be thoroughly done, it will be his duty to inform the medical officer of the fact, who will probably write him an order out for the immediate removal of the patient (a); that is, presuming the medical officer to be satisfied that there is not sufficient lodging or accommodation for the patient without removal, as per section 124, Act, 1875.

In visiting houses where infectious diseases have occurred, great care must be taken in making a strict

(a) Removal of sick person to hospital in the metropolis : see section 1, Sanitary Law Amendment Act, 1874.

investigation into the sanitary condition, not only of the individual house but of the whole street, noting minutely the mode of ventilating the sewer and private drains, also the position of the watercloset soil pipe, also the proximity of the common privy to the well or water supply; if he is investigating after a case of scarlet fever, inquire what school the child attended, or if an adult, the proximity of the dwelling to a slaughterhouse, or pools of stagnant water; if a case of typhoid, inquire as to purity of milk and water supply, also as to ventilation of private drains; if inquiring after a case of typhus, bear in mind how highly infectious this disease is known to be, avd direct his attention to want of isolation, destitution, and overcrowding.

It may be here remarked that properly constructed mortuaries are essential to sanitary progress.

Disinfection may be briefly explained as follows :A process by which chemically to destroy specific morbid poisons."

Now to do this effectually has been the subject of much discussion, not so much upon the fact that certain chemical agents, acting upon the organic matter contained in such morbid poisons, change their composition, and thereby rendering them non-effective as propagators of disease; but the discussion has mostly been directed to the nature of the agent required for the special purpose, and upon this point is the great liability to get wrong, inasmuch as it is not an un. common occurrence to introduce a strong smelling acid, which only replaces the previous offensiveness, without in the least answering the purposes of a disinfectant. As to the disinfecting of bedding there is not much difference of opinion; the effectiveness of subjecting it to a dry heat of 230 degrees seems to be generally acknowledged. We have, however, to deal with articles which cannot be so treated with dry heat, the room, for instance, from which the patient has been removed, must be made as nearly air-tight as possible by pasting stout paper over every crevice, then burn sulphur in an iron pan (which gives off sulphuric acid gas, some medical men advise chlorine; your medical officer will advise you on this point), and keep the room closed for several hours, after which allow a free circulation of air by opening windows and doors.

Then follows a very important item in the art of disinfection—that is to have the paper stripped clean from the walls, not leaving a single particle; to get this thoroughly done, you will have to persevere, but never mind, it must be done. Serve notice upon the owner to cleanse and disinfect under section 120, Act, 1875, which gives ample powers, and see that it is carried into effect; anything short of this will not be disinfection.

Amongst the most useful disinfectants for general purposes, the following may be mentioned :

Chloride of lime, in powder and solution, carbolic acid, chlorine, chloralum, turpentine, and terebene.

It will be advisable for us to glance at the effects of some of these disinfectants upon organic matter, so that we may understand the work upon which we are engaged.

Disinfectants are of two classes, those which hasten decomposition, and thereby bring the organic matter to rest by destroying, and those which preserve organic matter from decomposition.

To the first class, chlorine and permanganate of potash (Condy's fluid), and ozone belong.

To the second class carbolic acid belongs.

We will take chlorine first as one of the most important.

Chlorine is a gas of a suffocating nature, and when breathed irritates the air passages; it is heavier than air, it decomposes matters containing hydrogen with great energy, it immediately decomposes sulphuretted hydrogen, when mixed with hydrogen it forms hydrocloric acid.

Chlorine is undoubtedly a powerful disinfectant.

Remembering that it is in a gaseous form, we must bear in mind that it is not applicable in its gaseous. form entirely for disinfecting purposes.

We, however, find that H. Ledger and Co. supply us with chlorine in the form of the Universal Disinfecting Powder,” which is composed of 70 per cent. of chloride of sodium and chloride of calcium, and 12 per cent. of sulphate of zinc, and the rest moisture.

This powder, when coming in contact with water, liberates chlorine, and thus produces one of the best known disinfectants for cesspools, ashpits, privies, urinals, slaughter-houses, drains, sewers, hospitals, and sick rooms.

Permanganate of potash (Condy's fluid) has the power of rapidly and effectually oxidizing organic matter, it has no corrosive action and no smell, it is well adapted for use in the sick room.

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