3. Careful inspection of the food, espe cially of the milk.
4. Cleanliness of the surface, the re moval of garbage and other impurities, and the prevention of the saturation of the soil by sewage.
1. The complete isolation of the pa tient is necessary for many reasons. The attendant upon a typhoid case may con vey the bacilli directly by handling food or drink, which is given to healthy mem bers of the household. If care is not taken, the excreta may become dried and the germs may be scattered about in the dust or a few of them may light on milk or meat and there multiply indefinitely. Dried bacilli may be inhaled and swal lowed, or possibly they may be inhaled into the lungs and there multiply.
The sick-room should be well venti lated and absolutely clean. The patient should be sponged regularly and all soiled clothing at once removed. The nurse should cleanse her hands with a mild disinfectant solution whenever they are soiled.
The disinfection of the discharges should be very thoroughly made, and in small towns and country places they should not be thrown into the ordinary privy or cesspool, but should be buried. The urine should be treated in the same way, as it frequently contains bacilli.
Disinfection of typhoid urine: 1. For immediately and within five minutes, a volume of in fected urine would require the following proportion of disinfectants:— its volume of 1 to 20 carbolic-acid solution.
its volume of 1 to 40 carbolic-acid solution.
'A its volume of 1 to 1000 so lution.
its volume of 10-per-cent. formalin. its volume of chlorinated-lime so lution.
its volume of liquid chlorides.
2. For disinfection within five to fif teen minutes, a volume of urine would require:— its volume of 1 to 20 carbolic-acid solution.
its volume of 1 to 40 carbolic-acid solution.
to its volume of 1 to 1000 HgC1, solution.
its volume of 1-per-cent. formalin. V, its volume of 5-per-cent. formalin. its volume of 10-per-cent. formalin.
its volume of chlorinated-lime so lution.
Vio its volume of liquid chlorides.
3. For disinfection within one-half to one hour, a volume of urine would re quire:— to V. its volume of 1 to 20 car
bolic-acid solution.
V, its volume of 1 to 40 carbolic-acid solution.
An equal volume of 1 to 100 carbolic acid solution.
its volume of 1 to 1000 HgCI, solu tion.
'/,„ its volume of I to 2000 HgCI, solu tion.
its volume of 10-per-cent. formalin. Vio its volume of 5-per-cent. formalin, its volume of 1-per-cent. formalin. its volume of liquid chlorides.
4. For disinfection within one to two hours, a volume of urine would re quire: to its volume of 1 to 20 car bolic-acid solution.
to '/,. its volume of 1 to 40 carbolic acid solution.
More than its volume of 1 to 100 car bolic-acid solution.
to its volume of 1 to 1000 Hg solution.
its volume of 10-per-cent. formalin. its volume of 5-per-cent. formalin. its volume of 1-per-cent. formalin.
An equal volume—'/, its volume of milk-of-lime solution.
5. For disinfection within two to four hours, a volume of urine would re quire :— V,. its volume of 1 to 20 carbolic-acid solution.
to its volume of 1 to 40 car bolic-acid solution.
An equal volume of 1 to 40,000 or 50,000 HgC1, solution.
An equal volume its volume milk-of-iliac solution.
For the disinfection of the urine in the bladder and urinary system uro tropin is the only substance which can claim any direct action when adminis tered by the mouth. As irrigations, bi chloride solutions 1 to 100,000 to 1 to 50,000 have been very successful, remov ing the bacilli with much more cer tainty than any other method. Gwyn (Phila. Med. Join•., Jan. 12, 1901).
The urine of typhoid-fever patients should always be disinfected. From a hygienic stand-point bacteriological ex amination of the urine of patients con valescing from typhoid fever is impor tant and should never be omitted before patients are allowed to go at large. so that proper precautions may be taken to guard against the dissemination of typhoid bacilli by the urine. This is an often neglected source of infection that should be seriously considered in the hygiene of typhoid fever.