PRACTICAL DIRECTIONS FOR DISINFECTION. 213 



4. They are then placed in a warm saturated solution of oxalic acid, 

 where they remain until complete decolorization of the permanganate 

 occurs. 



5. They are then washed off with sterilized salt solution or water. 



6. They are immersed for two minutes in sublimate solution, 1 : 500. 

 The bacteriological examination of the skin thus treated yields almost 



uniformly negative results, the material for the cultures being taken from 

 underneath and around the nails. This is the procedure now employed in 

 the gynecological and surgical wards of the hospital. 



THE DISINFECTION OF EXCRETA. 



' The following paper by the present writer was read before the 

 Section on State Medicine at the last (1891) meeting of the American 

 Medical Association : 



The Committee on Disinfectants appointed by the American Public 

 Health Association in 1884, in its final report submitted in 1887, gives the 

 following general directions : 



"Disinfection of Excreta, etc. The infectious character of the dejections 

 of patients suffering from cholera and from typhoid fever is well established, 

 and this is true of mild cases and of the earliest stages of these diseases as 

 well as of severe and fatal cases. It is probable that epidemic dysentery, 

 tuberculosis, and perhaps diphtheria, yellow fever, scarlet fever, and typhus 

 fever, may also be transmitted by means of the alvine discharges of the 

 sick. It is, therefore, of the first importance that these should be disin- 

 fected. In cholera, diphtheria, yellow fever, and scarlet fever all vomited 

 material should also be looked upon as infectious. And in tuberculosis, 

 diphtheria, scarlet fever, and infectious pneumonia the sputa of the sick 

 should be disinfected or destroyed by fire. It seems advisable also to treat 

 the urine of patients sick with an infectious disease with one of the disinfect- 

 ing solutions below recommended. 



"Chloride of lime, or bleaching powder, is perhaps entitled to the first 

 place for disinfecting excreta, on account of the rapidity of its action. 



44 The following standard solution is recommended: 



"Dissolve chloride of lime of the best quality, ! in pure water, in the pro- 

 portion of six ounces to one gallon. Use one quart of this solution for the 

 disinfection of each discharge in cholera, typhoid fever, etc. 3 Mix well and 

 leave in the vessel for at least one hour before throwing into the privy vault 

 or water closet. 



" The same directions apply to the disinfection of vomited matters. In- 

 fected sputum should be discharged directly into a cup half-full of the solu- 

 tion. A five-per-cent solution of carbolic acid may be used instead of the 

 chloride of lime solution, the time of exposure to the action of the disinfect- 

 ant being four hours" (op. cit., pp. 237, 238). 



The object of this paper is to inquire whether these recommendations, 

 which were based upon the experimental data available at the time they 

 were made, are sustained by subsequent investigations ; and whether any 

 other agents have been shown to possess superior advantages for the pur- 

 pose in view. 



But first we desire to call attention to another portion of the report of the 



1 Good chloride of lime should contain at least twenty-five per cent of available 

 chlorine (page 92). It may be purchased by the quantity at three and one-half cents 

 per pound. The cost of the standard solution recommended if therefore but little 

 more than one cent a gallon. A clear solution may be obtained by filtration or by 

 decantation, but the insoluble sediment does no harm and this is an unnecessary re- 

 finement. 



8 For a very copious discharge use a larger quantity. 



