450 DISINFECTION 



After Diphtheria. — The bacillus of diphtheria is non-sporulating, 

 and has comparatively little resistance against disinfectants. Ordi- 

 nary means of disinfection are therefore sufficient. Local disinfec- 

 tants should he used for the throat until bacteriological ezamination 

 is negative to the Klebs-Loffler bacillus, which may persist in the 

 throat for long periods. The throat may be painted with a solution 

 of perchloride of mercury (1-500); 15 to 20 minims of such a 

 solution would be a suitable amount to use for a single application. 

 Gargles or sprays may be employed, consisting of chlorine water, or 

 permanganate of potash (1-300). The throat and nose discharges 

 should be received on rags which can be burned. 



After Typhoid Fever and Cholera.— Bedding and articles 

 which have come into contact with the patient require attention 

 in typhoid fever and cholera. The disinfection of the excreta 

 (faeces and urine) is the most important item. These discharges 

 should not be passed into the house drains until disinfected. 

 They should stand for some hours thoroughly mixed with the 

 disinfectant before being considered disinfected. Chloride of lime 

 (1-500 of the total mixture), izal (1-200 of the total mixture) and 

 carbolic acid (1-40 of the total mixture) are all used in this way. 

 If there is no house-drainage or water-carriage system, the excreta 

 should be treated as above, and deeply buried remote from any well 

 or water-course. The nurse's hands must be kept thoroughly 

 cleansed (thorough washing with hot water, soap, and perchloride 

 solution, 1-1000), especially before meals. 



After Plague. — The detailed arrangements for the removal of 

 cases and disinfection of infected tenements after plague should be 

 under the personal supervision of the medical staff, and may be 

 detailed as follows : — 



(a) Eemoval of patient to hospital. 



(b) Eemoval of "contacts" to reception house, and kept under 

 medical observation for fourteen days. 



(c) Fumigation of infected house by liquefied sulphur dioxide or 

 formic aldehyde from twelve to twenty-four hours, the disinfectant 

 being used in proportion to the cubic space dealt with. 



(d) After the fumigation the house is entered ; all articles of 

 clothing, etc., to be removed are first of all thoroughly wetted with 

 2 per cent, solution of formalin (1 gallon 40-per-cent. solution 

 formaldehyde to 50 gallons water), or 2 per cent, chloride of lime, 

 then wrapped up in sheets soaked in the same fluid and removed to 

 the sanitary wash-house. There all articles which cannot be boiled 

 or steamed, or treated with formaldehyde, are burned. 



(e) The walls, ceiling, flooring, woodwork, etc., and furniture of 

 the infected house are also sprayed with the formalin solution (1 

 gallon to 50 gallons water) or chloride of lime. 



