CONTROL OF INPECTIOTJS DISEASES 853 



body of its discharges in health is a process dependent on the 

 individual, carried out by him consciously or unconsciously all his 

 life by methods chiefly directed to conserve convenience rather than 

 to prevent their spread. In health, the careless scattering of these 

 discharges is not of great moment, but of course the habits of indifferent 

 and careless discharge, acquired in health, persist after disease is con- 

 tracted. The presence of an infective agent in the discharges renders 

 the previously harmless scattering of the discharges the greatest 

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

 primary requisite in the personal warfare against the infectious diseases 

 is to establish among all people such habits during health that even 

 the normal discharges are not exchanged. 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, the care of the sick by watchful, 

 well-trained nurses who wiU prevent the spread of the discharges 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 are cared for at home 

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

 trying to learn in the actual face of the enemy, the technic and knowl- 

 edge acquired quietly and systematically by the trained nurse. Hence, 

 within the home, and atpresent, 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 pas- 

 sage from patient to prospective patient; and this must be largely con- 

 fined 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 faeces and urine, 

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

 tact with the patient, and especially the disinfection of the hands of 

 attendants. The throats of attendants often contain the germ, espe- 

 cially 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. The use of a respirator is useful. 



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



