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EPIDEMIC DISEASES, SANITARY CONTROL OF. 



days afterward no communication was allowed 

 between the town and the camp. It also es- 

 caped the general infection. 



CONTROL AFTER AN EPIDEMIC HAS BROKEN 

 OUT. From the foregoing it will he seen that 

 the most active measures should be taken to 

 prevent the introduction of infectious or con- 

 tagious diseases, preventive measures taking 

 in all cases the highest rank, cleanliness and 

 watchfulness being the most important. Dr. 

 Blanc's plan at Sattara could not well be im- 

 proved upon. Unfortunately, however, in the 

 United States, a land of universal liberty, lib- 

 erty is too often interpreted to mean license, 

 and the people are impatient of sanitary regu- 

 lations sufficiently rigid to prevent the intro- 

 duction of specific diseases. It therefore fol- 

 lows that it is only in great public exigencies 

 that the reasonable and necessary means for 

 their prevention can be carried into effect. We 

 must, then, make up our minds to combat dis- 

 ease after it has appeared and becomes epi- 

 demic, rather than expect to prevent it, in the 

 present state of popular information upon this 

 subject. 



The common carriers of commerce are usu- 

 ally the vehicles by which diseases are trans- 

 mitted from place to place. Ships and steam- 

 boats afford more favorable conditions for the 

 growth and propagation of germs than railway- 

 cars, on account of the ever-present moisture 

 in the vessels, and the greater humidity of the 

 air immediately surrounding them. Maritime 

 quarantines, therefore, are essentially neces- 

 sary to guard against the natural tendency of 

 water-craft to spread contagion, but it would be 

 more in accordance with the nomenclature of 

 the day if the term " quarantine " were aban- 

 doned and "inspection-station" substituted, 

 for all vessels should be periodically inspected, 

 whether infected or not. The sanitary inspec- 

 tor should be not only well informed in re- 

 gard to fomites and the sanitary condition of 

 the port or place from which the vessel has 

 arrived, but he should be sufficiently versed 

 in marine architecture to enable him to thor- 

 oughly examine every portion of the vessel. 

 The crew and passengers should be mustered, 

 and, if any are sick from contagious disease, 

 they should be immediately removed from the 

 vessel, and the state-room or berth, with the 

 bedding therein contained, thoroughly fumi- 

 gated and disinfected, or preferably burned, 

 and the sick persons themselves removed to 

 a hospital for contagious diseases, established 

 for that purpose. If the vessel be otherwise 

 thoroughly clean, she will be healthful, and 

 may be allowed to pass without detention. 

 On the other hand, should the vessel be 

 found in an unclean state and the bilge-wa- 

 ter foul, she should be pumped out as dry 

 as possible, and thoroughly disinfected. It is 

 always safe to pump out the bilge-water when- 

 ever opportunity offers. Various kinds of dis- 

 infectants have been recommended, but it has 

 been found by experience that the one of most 



easy application in such cases is sulphurous 

 acid gas. This is applied by placing a brazier 

 in which charcoal has been lighted in the place 

 to be fumigated, and throwing on the red-hot 

 coals, or in a basin placed thereon, a quantity 

 of crude sulphur. As the sulphur burns, 

 sulphurous acid gas is thrown off, and per- 

 meates every portion of the apartment in 

 which it is placed. It is highly destructive to 

 bacteroid growths. Before placing the brazier 

 in the hold, the bilge-water may be replaced 

 by new sea-water itself a capital disinfectant 

 and again pumped out. 



When a case of small-pox or yellow fever is 

 found to exist in a house in town or city, prac- 

 tically the same measures should be taken 

 namely, removal of the sick to a special hos- 

 pital, disinfection of the apartment, thorough 

 fumigation of the entire house, and the pre- 

 vention of well or unprotected persons gaining 

 access to the apartment. If it be a house in 

 a crowded portion of the city, it should be 

 promptly quarantined, and the patient removed 

 to a hospital for contagious diseases ; or, if this 

 be not practicable, the patient should be effect- 

 ually isolated. All bedding and clothing ex- 

 posed to infection, carpets, window-hangings, 

 wall-paper if the room be papered pictui 

 backs, when covered with paper, and every- 

 thing capable of retaining the disease-germs 

 (fomites) should be burned or buried in 

 trench. When a case of cholera has appeared, 

 the discharges from the bowels should be cov- 

 ered with chloride of lime, and, whenever prac- 

 ticable, thrown into a furnace. No such mat- 

 ters should be thrown upon the ground or 

 allowed to gain access to the public sewer, 

 and all persons should be warned to promptly 

 check any attack of diarrhoea, however slight. 

 By these means alone it is possible to prevent 

 the spread of these epidemic diseases in town 

 or city ; provided, however, that the sur- 

 roundings of the infected house be cleaned 

 and properly disinfected. Out-door disinfec- 

 tants for use in such cases consist of copperas, 

 ordinary quicklime, or chloride of lime the 

 latter being the most powerful, but objection- 

 able to many on account of its giving off chlo- 

 rine, which has a very pungent, acrid odor. 



Public funerals in all cases of death from 

 small-pox, cholera, yellow fever, and diphthe- 

 ria, should be prohibited and the coffins her- 

 metically sealed ; when this is impracticable on 

 account of the expense, the same result may 

 be attained by coating the body with tar. The 

 practice of cremation instead of the ordinary 

 inhumation is to be commended, on sanitary 

 grounds, in all such cases. 



SANITARY CORDONS. Sometimes, however, 

 cases of infectious disease have escaped con- 

 trol by the ordinary measures. In order to 

 prevent the spread of the disease to contiguous 

 villages, towns, and adjoining districts, it has 

 been found expedient to establish a sanitary 

 cordon about the town or city, while, at the 

 same time, sanitary measures are being carried 



