CONTROL OF INFECTIOUS DISEASES 771 



DISINFECTION 



Two systems of disinfection have been long recognized, concurrent 

 and terminal. The former concerns the daily, hourly attention to, 

 and disinfection of, everything coming in contact with the patient, 

 especially with his discharges and all that they may contaminate. 

 The latter concerns the final disinfection of the patient's room, per- 

 haps of the whole house, occupied by him during the attack, after the 

 recovery of the patient. 



Very much undue emphasis has been given to terminal disinfection. 

 Large expenditures are made for this purpose and great faith placed in 

 it, unfortunately to the exclusion of attention to, and reliance on, the 

 infinitely more useful and logical concurrent disinfection, which, 

 properly done, ought almost wholly to displace it. 



Terminal disinfection should be done following tuberculosis of the 

 lungs, anthrax and plague; in tuberculosis because of the great numbers 

 and wide distribution of the bacteria thrown out by the patient, 

 especially the careless patient; in anthrax because of the existence of 

 resistant spores possibly attached to furniture, etc. ; in plague because 

 of the intense virulence of the organism and its tendency, like anthrax, 

 to infect directly through the skin. In the ordinary diseases of the 

 temperate zone, however, terminal disinfection cannot for a moment 

 take the place of concurrent disinfection and is unnecessary if the 

 former be properly carried out. 



METHODS OF DISINFECTION 



CONCURRENT DISINFECTION. The disinfection of infected discharges, and of 

 everything coming into contact with the discharges, whether the discharges be of 

 the nose, mouth, bladder, or bowel, and whether the things which come into con- 

 tact with the discharges be utensils, clothing, hands, furniture, etc., should be done 

 at once, as soon as the discharges appear, or the articles, hands, etc., become 

 contaminated. 



Bladder and bowel discharges deposited directly in proper sewer-connected 

 toilet-bowls require no disinfectant treatment; but the seat, door-knobs, toilet 

 paper rack, flush pull and so on, which the discharges may reach, directly or through 

 the patient's hands, should receive disinfection every time the toilet is used by such a 

 patient. Where bed-pans or urinals are used and then emptied into such a toilet- 

 bowl, disinfection should be done of the hands of the attendant who empties the 

 pan, of the whole pan itself, and of any part of seat or bowl (not reached by the 

 flush) contaminated by splash or dribbles from the bed-pan or urinal. 



