Undoubtedly the simplest method of handling these secre ions is to collect them on old rags or paper napkins, or in spu tum cups, and incinerate these when filled. When using cloths or napkins the patient shuld be instructed to carefully fold in the contaminated area so that contamination of the fingers is reduced. Any of the substances recommended for the dis infection of feces and urine may also be used.
(c) For the disinfection of bed linen and clothing, bed pans and other contaminated objects, immersion for one hour in the foregoing solution of chlorinated lime or liquor cresolis com positus is satisfactory.
Dishes should be received into a dish pan kept for this pur pose, covered with water and boiled before washing. Food remnants should be incinerated.
8. Employment of Fumigants.—These are most commonly employed in connection with terminal disinfection. Various proprietary generators are on the market for the liberation of both formaldehyd and sulphur dioxid, but the only advantage that may be credited them is that of convenience. Most of these proprietary formaldehyd generators liberate the gas from paraformaldehyd or paraform, the solid polymer of formaldehyd.
(a) Formaldehyd is the most satisfactory fumigant available. Successful results depend upon the rapid liberation of the gas from either formalin, (its 4o per cent. aqueous solution) or solid paraformaldehyd. It accomplishes a surface disinfec tion and kills spores, though its action on them is slow and uncer tain. It does not tarnish or corrode metal or bleach pigments. It is not an insecticide. For successful results proper condi tions of heat and moisture are necessary. The quarters to he disinfected must be maintained at a temperature of '65 degrees F. or higher and the relative humidity must be 6o per cent. or higher. The following methods may be used for its liberation: 1. Spray the formalin upon moistened sheets spread out over stretched lines. Use at least eight ounces of formalin for every too° cubic feet in the apartment. One ordinary bed sheet, when previously moistened, will retain this amount of the formalin: The gas is liberated by the evaporation of the water. This is the simplest and cheapest method available.
2. The liberation of formaldehyd by means of potassium permanganate.
(a) This method was widely employed when potassium salts were cheap. A deep flaring can, or a large crock or jar is put in a tub in the apartment to be disinfected (Fig. 7). In the crock is placed 250 grams of potassium permanganate for every Too() cubic feet of space and when preparations are completed there is poured over this Soo c.c. of 4o per cent. formalin diluted with an equal value of water, for every i000 cubic feet of space.
The operator then makes a hasty exit. The crock and tub should not be placed near any draperies and the floor about the tub had best be protected by paper. The gas should act for at least 8 hours.
(b) Sulphur dioxid is a poorer germicide than formaldehyd, but is a good mammalicide and insecticide. It posesses several disadvantages, namely it tarnishes and corrodes metals, bleaches pigments and rots fabrics. However it is cheap and readily obtainable. The actual disinfection is accomplished by sul phurous acid, for whose formation water vapor is necessary. Consequently attention must be given to humidity conditions, although moisture is not necessary when it, is used as an insec ticide. For disinfecting purposes 5 pounds of sulphur for every i000 cubic feet are required. This is equivalent to 5 per cent. of gas, the maximum concentration possible in the air. For every 5 pounds of sulphur employed one pound of water should be vaporized. It is germicidal in from 6 to 24 hours. For the destruction of insects 2 pounds of sulphur per i000 cubic feet are sufficient. It should act from 2 to 12 hours when used for this purpose.
Sulphur dioxid is most commonly and conveniently generated by the burning of sulphur. Ordinary stick sulphur is crushed to fineness and the required amount is placed in a conical pile in a shallow cast iron pot or jar, which is supported on bricks in a tub containing i to 2 inches of water (Fig. 8). A small conical depression is made in the top of the pile and in this is placed a small ball of waste saturated with alcohol. The alcohol is ignited and its burning is sufficient to ignite the sul phur. It is important that the pots employed be shallow.
(c) Preparation of Quarters jor Fumigation.—All cracks around doors and windows except the door of exit should be sealed with adhesive paper, but the lower windows should not be locked (Fig. 9). Open all closet doors and bureau drawers. When the mixture of the reagents is set off, immediately leave by the unsealed door and seal this from the exterior. When the required period of exposure is completed, the ground floor win dows can be opened from the outside and ventilation estab lished. The quarters should be thoroughly aired before they are entered. When an entire home or building is to be fumi gated, ventilation after the completion of fumigation will be facilitated by the sealing of the upper story windows in the manner illustrated in Fig. lc), by which means they can be opened from the ground.
. g. Insecticides.—The employment of these will be con sidered later.