240 Arthropods as Essential Hosts of Pathogenic Protozoa 



to keep clean — the notorious filth disease has decreased or dis- 

 appeared. In localities where it still prevails, its further reduction 

 or complete eradication waits on a further improvement in, or exten- 

 sion of, the improved economic status of those afflicted. Economic 

 evolution is very slow process, and, while doing what we can to hasten 

 it, we must take such precautions as existing conditions permit, 

 looking to a reduction in or complete eradication of the disease.'' 



"When possible, public bath houses and public wash houses, 

 where the poor may bathe and do their washings at a minimum or 

 without cost, should be provided. Similar provision should be 

 made in military and construction camps. Troops in the field should 

 be given the opportunity as frequently as possible to wash and scald 

 or boil their body linen." 



"Lodging houses, cheap boarding houses, night shelters, hospitals, 

 jails and prisons, are important factors in the spread and frequently 

 constitute foci of the disease. They should receive rigid sanitary 

 supervision, including the enforcement of measures to free all inmates 

 of such institutions of lice on admission." 



"So far as individual foci of the disease are concerned these 

 should be dealt with by segregating and keeping under observation 

 all exposed individuals for 14 days — the period of incubation — from 

 the last exposure, by disinfecting (boiling or steaming) the suspected 

 bedding, body linen, and clothes, for the destruction of any possible 

 vermin that they may harbor, and by fumigating (with sulphur) 

 the quarters that they may have occupied." 



"It will be noted that nothing has been said as to the disposition 

 of the patient. So far as the patient is concerned, he should be 

 removed to 'clean' surroundings, making sure that he does not 

 take with him any vermin. This may be done by bathing, treating 

 the hair with an insecticide (coal oil, tincture of larkspur), and a 

 complete change of body linen. Aside from this, the patient may 

 be treated or cared for in a general hospital ward or in a private house, 

 provided the sanitary officer is satisfied that the new surroundings 

 to which the patient has been removed are 'clean,' that is, free 

 from vermin. Indeed, it is reasonably safe to permit a 'clean' 

 patient to remain in his own home if this is 'clean,' for, as has al- 

 ready been emphasized, there can be no spread in the absence of lice. 

 This is a common experience in native famiHes of the better class 

 and of Europeans in Mexico City." 



"Similarly the sulphur fumigation above prescribed may be 

 dispensed with as unnecessary in this class of cases." 



