30 CLINICAL OBSERVATIONS 



washing since we found reason to suspect that wetting the deep 

 layers of dandruff on the scalps of some interfered with the 

 penetration of the oil and allowed lice to survive. The head was 

 finally tied up in a cloth cap to retain the oil, the patient was 

 given clean pajamas or nightshirt and carried on a wheel- 

 stretcher to his bed. 



This lousing process was performed either by typhus-immune 

 orderlies or by nurses in full protective dress, in each case under 

 the supervision of physicians. All who worked in the wards wore 

 special louse-proof gowns with closed stocking-footed trousers 

 closely sewed beneath the skirt of the gown about the waist 

 (Fig. 13). After each day's wear all gowns were deloused by 

 placing them in galvanized iron cans with a generous sprin- 

 kling of crude flake naphthalene over each gown to stand undis- 

 turbed until the following day. This method was proved to be 

 efficacious by repeatedly placing control boxes of lice among 

 the gowns; when the gowns were removed the lice in the boxes 

 were always dead. 



In delousing, bathing, and bedmaking or in other work in- 

 volving special possibilities of exposure rubber gloves fitting 

 closely over the wrists of the gown were worn, and the wrists 

 and neck-opening of the gown were sprayed with cedarwood 

 oil as a repellent. The nurses wore cloth head-coverings to 

 confine the hair. All who worked in the wards were warned to 

 be on the lookout for lice and to conduct themselves as if lice 

 were known to be present. It was also found necessary to 

 delouse the Polish ward-maids and orderlies, and to inspect 

 washing returned from outside laundries. 



As precautions against transmission of complicating dis- 

 eases from one patient to another cups, dishes, mouth-cleaning 

 instruments, linen, and excretions were treated as in typhoid. 

 In bedmaking and general care of patients the usual practice of 

 American hospitals was followed as a practical demonstration 

 of American methods. 



The diet, by agreement with the hospital management, was 

 that supplied in all other parts of the hospital, to which the 

 American Red Cross contributed food in order to relieve the 



