PRACTICAL, DIRECTIONS FOR DISINFECTION. 211 



measures to be taken to prevent the spread of diphtheria. His con- 

 clusions are summarized as follows : 



1. The cause of diphtheria is the diphtheria bacillus, which is found in the 

 secretions of the affected mucous membrane. 



2. With this secretion it is distributed outside of the body and may be 

 deposited upon anything in the vicinity of the sick. 



3. Those sick with diphtheria carry about bacilli capable of infecting 

 others so long as there is the slightest trace of diphtheritic deposit, and even 

 for several days after such deposit has disappeared. 



4. Those sick with diphtheria are to be rigidly isolated so long as tbe 

 diphtheria bacilli are present in their secretions. Children who have been 

 sick with diphtheria should be kept from school for at least four weeks. 



5. The diphtheria bacilli may preserve their vitality in dried fragments 

 of diphtheritic membrane for four or five months. Therefore all objects 

 which may have been exposed to contact with the excretions of .those sick 

 with diphtheria, such as linen, bedclothing, utensils, clothing of nurses, etc., 

 should be disinfected by boiling in water or treated with steam at 100 C. 

 In the same way the rooms occupied by diphtheria patients are to be care- 

 fully disinfected. The floors should be repeatedly scrubbed with hot sub- 

 limate solution (1: 1,000) and the walls rubbed down with bread. 



The recommendation made by Loftier with reference to rubbing 

 down the walls of an infected apartment with bread is based upon 

 the experiments of Esmarch (1887), as a result of which he arrived 

 at the conclusion that this is the most reliable method of removing 

 bacteria attached fo the walls of an apartment. Fresh bread is used, 

 and, after having been used, is destroyed by burning. We judge 

 that this method would be especially applicable to painted surfaces 

 or to walls covered with paper. For plastered walls the liberal ap- 

 plication of lime wash is probably the safest method of disinfection. 



