Ewes. of course. should be disinfected at all stages of the disease, but, the organisms being present generally only from the beginning of the second week to the fall of the fever and the patient during this period usually being confined to bed, the ffeees are not such a source of infection to the community at large as the urine.
The bacilli may, on account of the lung and throat lesions, be present in the mouth of those suffering from ty phoid fever; hcnce the expectoration should be disinfected, as well as all eating utensils, etc., used by the pa tients. P. His, Jr. (Med. News, May 11, 1901).
W. Gilman Thompson (Yew York Med. Jour.) gives the following direc tions for the disinfection of the excreta: A solution 1 to 500 of corrosive sub limate, rendered acid to prevent the formation of albuminate, is a powerful disinfectant, but has an injurious effect on the plumbing. A 10-per-cent. solu tion of carbolic acid may be substituted. A half-pint of this may be kept con stantly in the bed-pan, which must be covered. After a movement the peri neum should be cleaned by a 1 to 2000 solution of corrosive sublimate. In the country the stools should be mixed with saw-dust and cremated or buried in a trench four feet deep. The disinfection of the stools should be continued for three or four weeks after the temperature has become normal.
In the disinfection of excreta chlorin ated lime is very frequently employed. A part of a solution of 4 ounces to the gallon is used for each stool. A thorough mixture should be made and allowed to stand fifteen or twenty minutes before it is thrown into the water-closet. The latter should be frequently flushed. A solution of corrosive sublimate and per manganate of potash, 2 drachms of each to a gallon of water, has the advantage of being odorless. but is a strong poison.
The soiled clothing may be disinfected by being first placed in a weak solu tion of corrosive sublimate and perman ganate of potash and afterward subject ing it to boiling in water for half an hour. The solution is made by dissolving cor rosive sublimate in water 1 to 16. Take 4 ounces of this to a gallon of water and add to it 1 drachm of potassium per manganate. Of this standard solution 1 fluidounce added to a gallon of water will make it sufficiently strong for the disinfection of clothing (Shattuck). A
5-per-cent. solution of carbolic acid may be used for the same purpose.
2. Typhoid fever is, no doubt, in the great majority of cases a water-borne disease. This has been proved to a dem onstration by the lessened mortality of cities from typhoid after a system of water-works has been introduced and pure water obtained. Bacilli have not only been found in the drinking-water, but their multiplication especially in that containing sewage has been amply demonstrated. It is probable that a small number of bacilli may be sufficient to produce the disease in an individual predisposed to it. The multiplication of germs in impure being so much greater than in pure water shows how necessary it is that, apart from the presence of ba cilli, the water should be free from all contamination. The source of supply should be carefully and frequently in spected. It has been abundantly shown in the past that water which is thought to be pure may at any time accidentally become polluted.
The well in country places should be situated at a distance from any source of contamination. It should be deep and protected to prevent the surface-water from running in. Well-water should be occasionally inspected for general im purities as well as bacteriologically.
When water is not pure, boiling and filtering should be recommended. Filter ing, such as done on a large scale in Lon don, England, renders water almost free from typhoid bacilli. Boiling will de stroy all germs, but will not remove the toxins.
Ice is often the source of typhoid fever, as the bacilli are not destroyed by freez ing. It is therefore safer to cool water in a refrigerator than to place ice in it when the source of the latter is not well known.
3. Several epidemics of typhoid fever have been produced by contaminated milk. In all large cities dairies should be inspected to see that the disease does not exist in the neighborhood, that the uten sils are cleansed with pure water, while general cleanliness is insisted upon. If milk be suspected to contain bacilli, the danger may be removed by boiling.