Chapter 21 - Domestic Management of the Sick Room
Choice of the Sick Room
Fumigation
Freezing Mixtures
Attendants
Prognostics
Bed Sores
Diet in Disease and Convalescence
Fluid Aliments

21.2 Fumigation

Fumigation. AFTER every contagious disease, like diphtheria, scarlet fever, etc., the room, furniture, bed, etc., are to be thoroughly disinfected, to prevent the development and spreading of the germs. Sulphur fumes have been used for many years for this purpose, but this method is not secure, agreeable nor efficient. It no doubt kills many germs exposed any length of time to its fumes, but never destroys their spores. So much so called fumigation, as usually practiced, is useless, that it might as well not have been done, as it gives a false impression of security. Most virulent germs are capable of reproduction and dissemination years after their original occupation of a house. Old bedding and clothing, brought out months after the so called fumigation, have caused the death of many a little one, and the dangerous sickness of others. Sulphur and its allies have been found to be so altogether uncertain and untrustworthy that boards of health are no longer willing to endorse its usefulness. The only reliable, practical measure against the life of contagious germs is the same as now used in case of surgical diseases. Corrosive sublimate, carbolic acid, boiling water, steaming, and baking are sure and safe remedies. Of this number corrosive sublimate is easily the leader in efficiency. It is not the dangerous drug to use as commonly supposed, since the quantity necessary to kill cannot be collected in a room subjected to its use. Every piece of furniture and all woodwork, even the paper of the wall, can be safely washed in a solution of this drug, made by dissolving one tablet in two quarts of water, and fear need not be entertained, either, of its efficacy or its harmfulness. Doors, windows, and other woodwork should be thoroughly washed with it. Carpets should be first wet with it from a sprinkler, dried and beaten. The paper need not be removed, if only it can be wiped with this solution. Bedding should be steamed, bed clothing boiled, and all articles not readily washed may be likewise steamed. A solution of carbolic acid, 1 part to 40 of water, is likewise efficient. The great danger of doing poor work in the matter of fumigation lies in the practice of carrying things out of the room during the illness, before fumigation has been commenced. The nurse or mother traveling from one room to another may carry in her clothing germs sufficient to infect a whole neighborhood. The attendants of such a case should wear some thin linen, cotton, cambric, or other washable dress, that may now and then be put into the boiler, and thus thoroughly cleansed. The hair of patient and attendant should be thoroughly washed in the corrosive wash on leaving the room, before disinfection of same. Hands are to be scrubbed in soap and water, and then washed in corrosive solution on leaving the room, and finally the room is to be thoroughly aired. If the work is done well and care has been exercised not to have contaminated other portions of the house except that occupied by the patient, all will be well. Frequently during the illness sheets wrung Out Of the corrosive solution are hung up on one side of the door to filter the air passing out of the room. It has also been found that the evaporation of some mild antiseptic in the room during the sickness not only modifies the virulence of the germ, but is actually beneficial in the treatment of these diseases. Of these drugs the following is an excellent combination, which may be evaporated in a tin dish cover placed over a light, a stove, or other heated surface. It should be burned during the continuance of the disease. Carbolic Acid, 1 oz. Turpentine, . 1 oz. Oil of Eucalyptus, 1 oz. Alcohol, 1 pint Let the rate of evaporation be very slow, and, if much carbolic acid be used in case of children, see that the drug is not absorbed into the system to such extent as to cause black urine or a backache. Sulphur Fumigation. This mode of fumigating chambers after measles, scarlet fever, and diphtheria is perhaps the most common, and, while not an ideal method, it is very easy of application, and quite practical. Buy two sulphur candles for every room to be fumigated, and, having lit them, shut up all windows and doors, and stuff all crevices in the doors with cotton batting. Allow the fumes to penetrate every closet and drawer for twenty four hours. The room may then be occupied. Nitric Acid Fumigation. The efficiency of nitric acid in the form of gas, in arresting contagion, and in cleansing infected rooms, ships, and other places, is well established. To obtain the gas, pour one ounce of sulphuric acid upon two ounces of nitrate of potash in a large tea cup, the cup being placed in a basin containing hot water. The gas or vapor will be immediately disengaged. This quantity will thoroughly cleanse a small apartment, but if used in a sick room, should be placed at some distance from the patient. In a large room two cups will be required; and ff a whole house is to be fumigated, let several be placed in various apartments, and the doors and windows be closed for half an hour. Chloride of Zinc. A solution of the chloride of zinc has great power in arresting contagion, and in cleansing infected places. A small quantity of it will, in a few minutes, cleanse the most offensive apartments. Chloride of Lime. This is one of the most powerful disinfecting or cleansing agents known. To prepare it for use, add four gallons of water to a pound of the chloride of lime; stir the mixture well, and after allowing it to settle for a short time, pour off the clear solution, and keep it in well corked bottles. Chloride of Soda. This, in disinfecting power, is about equal to the chloride of lime. In order that it may retain its properties, it must be kept from the light, in a well stopped glass bottle. When used, it must be mixed in the proportion of one ounce, or two large spoonfuls, to the pint of water. It is excellent for cleansing carbuncles, gangrenous sores, bad ulcers, ulcerated sore throat, and fetid discharges of every kind. A weak solution should be frequently applied. Uses of Chlorides of Lime and Soda. These articles almost instantly destroy every bad smell, and all effluvia arising from animal and vegetable decomposition, and entirely prevent their bad influence. While infectious or contagious diseases prevail in large towns or cities, the rooms should be sprinkled, morning and evening, with some of one of these solutions. Some of it should be placed in the different rooms, in shallow dishes, the small bed rooms being particularly remembered. It must be remembered that whatever can be boiled, like linen sheets, towels, etc., and whatever can be subjected to prolonged steaming, or the presence of boiling water, can be made absolutely clean and germ free. No fear need be caused after such a disinfection. In houses where there are typhoid and putrid fevers, and infectious complaints, it is highly proper to sprinkle the solution about the rooms, and occasionally upon the bed linen; and the air of the room should be frequently renewed. A wineglassful added to the chamber vessel or the bed pan will remove all smell. The most frequently used disinfectants for the stools of typhoid patients is carbolic acid, in the strength of one teaspoonful to the pint of water; of this use half or third of the quantity for each stool. Before sending the bed and other linen to the wash, let it be immersed, five or six minutes, in one of these solutions, diluted, as mere washing will not always remove the infection. But the linen should be immediately rinsed in pure water after the immersion; to allow it to dry without such rinsing might injure it. By pouring a quart of one of these mixtures, added to a pail full of water, into drains, sewers or cesspools, and repeating the application as may be required, will destroy all their offensive effluvia. Meat will keep for some time without any taint, and without the molestation of flies, if immersed in one of these solutions for an instant, and hung up; and all tainted meat, fish, game, etc., will be rendered sweet by a little sprinkling of the same. To purify water in cisterns, and destroy the animalcules in it, add to every one hundred gallons about a pint of one of the solutions. The washing of bedsteads with one of the solutions, and putting it into all the crevices, will destroy bugs. A room just painted may be slept in safely, if one of the mixtures be sprinkled about, and left in shallow dishes. Stables, slaughter houses, hog sties, privies, and all places from which offensive smells arise, may be thoroughly purified by these mixtures; or, still better, by the use of sulphur naphtha, ,oil of milk," which is to be diluted in the proportion of one teaspoonful to a quart of water, and used very freely. This is one of the most excellent wound dressings now known, but should be used in one half strength solutions. Being guardians of the public health of such wide application, and of so great utility, it is surprising that they are not more used.

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