694 MICROBIOLOGY OF THE DISEASES OF MAN AND ANIMALS. 



discharges of the infective agent renders the previously harmless discharges 

 the greatest menace that is known to the health of the associates. Hence 

 one primary requisite in the control of the infectious diseases is to estab- 

 lish such habits during health that even the normal discharges are not 

 spread to others. This must be achieved by teaching the individual 

 not to scatter his discharges and by teaching his associates not to receive 

 them, if he does. 



Accepting conditions as they are, however, the care of the sick by 

 watchful, well trained nurses who will prevent the spread of the dis- 

 charges must largely take the place of the earlier training of the patient. 

 Usually this also is impossible. It would seem that at least 95 per cent 

 of the total cases of infectious disease in this country is cared for at home 

 by the home folks, i. e., untrained, worried, exhausted mothers chiefly, 

 learning in the actual face of the enemy, the technic and knowledge 

 acquired quietly and without strain by the trained nurse. Hence, within 

 the home, at present sanitary nursing to prevent spread of disease is a 

 poor and often broken defence. 



The third method of control is the destruction of the germs in passage 

 from patient to prospective patient; and this must be largely confined to 

 the actual discharges when accumulated in one place; the finer discharges 

 thrown into the air can hardly be followed. 



Under this head may be classed the -disinfection of feces and urine, 

 the disinfection of bed clothing, eating utensils, etc., coming into contact 

 with the patient, and especially the disinfection of the hands of attendants. 

 The throats of attendants often contain the germ, especially when 

 diphtheria, scarlet fever, measles, etc., are concerned. Unfortunately, 

 the disinfection of the throat is extremely difficult and the scientific nurse 

 will take every precaution to avoid receiving the germ into the mouth, 

 rather than try to dislodge or destroy it after its reception. 



As outlined in the preceding section, the principles involved in con- 

 trolling infectious diseases are very simple, but in practice the individual 

 cannot be trusted to avoid spreading his discharges, partly from ignorance, 

 partly from carelessness, often from mere ingrained bad habits regarding 

 the disposal of discharges, especially those of nose and mouth, indulged 

 unconsciously by those who both know how and mean to be careful. 



This would matter little were the infected persons always so sick as 

 to be confined to the house or to bed, especially if during such confinement 

 their discharges were under strict surveillance by scientific trained nurses. 



