58 



adopted a system of public spittoons, and patients are re- 

 quested not to spit anywhere else except in these receptacles. 



The New York Board of Health has also a system of 

 spittoons in their public buildings, railway stations, and other 

 public institutions. 



These spittoons are made of porcelain, and can be washed 

 in boiling water and disinfected. Others are made portable 

 of porcelain or glass and carried about by patients. 



So much for the destroying of the expectoration. 



But the respired air of the patient may also be dangerous 

 by its immediate inhalation. We should avoid being too 

 closely shut in with consumptives, hence it follows no one 

 should sleep in the same room. Consumptives' rooms should 

 always be well ventilated — such patients are not only more 

 comfortable but their health is much better. 



Should the patients die or be removed the room and every- 

 thing in it ought to be disinfected. While cleaning opera- 

 tions are going on the floors and walls should be kept moist 

 so as to prevent dust from flying about and with it the 

 bacteria. 



Curtains, bedding, and clothing should be boiled, blankets 

 steamed, and all other furniture cleaned and disinfected. 



Paper on the walls should be stripped off and burned and 

 the walls washed with chlorhstated lime, the onlv disinfec- 

 tant E-ansome and Delepine have found to be effective. 

 Ordinary fumigations by chlorine, euchlorine, and sul- 

 phurous acid are useless even in the hands of experienced 

 t'umigators. 



In intestinal and other forms of tuberculosis all excretions 

 ought to be disinfected with 10 per cent, carbolic acid solu- 

 tion, which is more effective for this purpose, according to 

 Fischer, than corrosive sublimate solution (1 in 500) equal 

 parts. 



These are all minute details, but a strict adherence to * 

 them has reduced the mortality in the Grand Duchy of 

 Baden by no less than '28 per 1,000 living. In 1882 the 

 death rate there was 3*08. In 1887, it was after these pre- 

 cautions had been taken, 2*80 per 1,000 living. This seem- 

 ingl}^ small reduction, if applied to the United Kingdom, 

 would mean an annual saving of life from consumption of 

 10,000 people. 



At San Remo — a favourite residence for consumptives — all 

 these precautions are carried out, and at the end of the 

 season all public rooms and sleeping apartments are cleaned 

 and disinfected. 



*Sims Wooclhead : Bacteria and their Products, p. 221. 



