(30)
Those attending on the patients must not themselves eat any food in the sick-room; and before resuming outside intercourse, and before eating, they must remove infected clothing and must radically disinfect the face and hands.
If plague breaks out in a house in which articles of food and drink are offered for sale, the shop must be closed.
The bodies of those that have died of plague must not remain in the houses until their burial, but must be wrapped in sheets soaked in a 1‰ sublimate or a 5% carbolic acid or creolin solution, and carried to a mortuary. In the bottom of the coffin, lime, peat, or saw-dust should be sprinkled.
In every case of plague, the source of the infection must if possible be discovered and rendered harmless. It is therefore absolutely necessary that all houses should be visited in which the presence of plague is known or suspected. These houses should be thoroughly disinfected, and their hygienic condition in the matter of privies, drains, wells, and water-supply should be enquired into. Public latrines also, being liable to contamination, should be subject to regular inspection and disinfection.
Privies are best disinfected in the following manner. The contents of the closet pan should be mixed with milk of lime, and can then be removed after an hour or two. The exit pipe should be flushed with milk of lime, or thoroughly washed with a 5‰ solution of creolin or carbolic acid, and after four or five hours flushed with water.
Open wells that are exposed to contamination from above or from the sides should be closed.
A prophylactic inspection of the trade in articles of food and drink is also to be undertaken by the sanitary authority. Spoiled or suspicious articles of food must be destroyed. The milk-trade and the diluting of milk with water must be subjected to a strict control.
The water-supply demands especial attention. A warning should be issued against the drinking of unfiltered river or harbour water. It would be better if boiled water only were used for drinking, since in times of epidemic, water that has been filtered merely cannot be regarded as quite free from objection.
( $1 )
195
IX-INCUBATION.
The experience of the epidemic of 1894 showed that the period of incubation of plague might extend to nine days, but was usually three to six days only. Similar observations were, generally speaking, made in 1896. It was for the most part impossible to obtain precise information as to when and in what manner Chinese patients were infected. In one case, an incubation period of fifteen days must be assumed. This was the case of a Chinese who on May 25th, 1896, was imprisoned in the English jail, being then in good health. On June 10th he was suddenly taken ill with typical symptoms of bubonic plague, and he died of the disease on June 15th. During the course of the illness, plague bacilli were found in the blood; and the autopsy showed inflammatory swelling of the inguinal glands of both sides up to the size of a hazel-nut. Culture experiments demonstrated the presence of plague bacilli in the spleen and the glands. The jail was at the time, and remained, free from other cases of plague.
The infection of river and harbour water must be prevented as far as possible by supervision of ships and their inhabitants. It must also be pointed out that closets and drains discharging into rivers may infect the water.
Since it is especially when men gather together in large numbers in a small space that the contagium of the plague is rapidly conveyed from person to person, the aggregation of men at fairs and markets is to be prevented. Excessive overcrowding of small rooms is to be forbidden. Regulations should be made to provide for sufficient light and air in the streets and the houses.
The disinfection of ships must especially regard the berths and cabins of the sick, the closets, and the bilges.
The public must be enlightened as far as possible concerning the nature of plague; and concerning the method of its dissemination by the pus from buboes, by the fæces, urine, and expectoration, and by uncleanliness.
B.-Measures of Private Hygiene.
The measures to be taken by individuals with a view to avoiding the infection of plague consist, first, in care that no plague bacilli gain entrance to the body by contaminated wounds of the skin or by contaminated articles of food and drink; and, secondly, in a regular mode of life without excesses in eating and drinking.
With regard to the first point, the body should be frequently cleansed by baths, the hands further should be washed often, and the most insignificant wounds should be kept scrupulously clean; food should be cooked, or, if raw, entirely above suspicion, and the plates and dishes on which food is served should be cleansed with water that has been boiled or is of undoubted purity.
The use of strange privies is to be avoided, more especially if they are open to suspicion of infection.
Houses that are known or suspected to contain cases of plague should not be visited.
( 30 )
Those attending on the patients must not themselves eat any food in the sick-room; and before resuming outside intercourse, and before eating, they must remove infected clothing and must radically
disinfect the face and hands.
If plague breaks out in a house in which articles of food and drink are offered for sale, the shop
must be closed.
The bodies of those that have died of plague must not remain in the houses until their burial, bat must be wrapped in sheets soaked in a 1°, sublimate or a 5 % carbolic acid or creolin solution, and carried to a mortuary. In the bottom of the coffin, lime, peat, or saw-dust should he sprinkled,
presence
In every case of plague, the source of the infection must if possible be discovered and rendered harmless. It is therefore absolutely necessary that all houses should be visited in which the of plague is known or suspected. These houses should be thoroughly disinfected, and their hygienic condition in the matter of privies, drains, wells, and water-supply should be enquired into. Public latrines also, being liable to contamination, should be subject to regular inspection and disinfection. The contents of the closet are to be thoroughly Privies are best disinfected in the following manner.
The of the closet and
pan mixed with milk of lime, and can then be removed after an hour or two. the exitpipe should be flushed with milk of lime, or thoroughly washed with a 5 °。 solution of creolin or carbolic acid, and after four or five hours flushed with water.
Open wells that are exposed to contamination from above or from the sides should be closed.
A prophylactic inspection of the trade in articles of food and drink is also to be undertaken by the sanitary authority. Spoiled or suspicious articles of food must be destroyed. The milk-trade and the diluting of milk with water must be subjected to a strict control.
The water-supply demands especial attention.
It would A warning should be issued against the drinking of unfiltered river or harbour water. be better if boiled water only were used for drinking, since in times of epidemic, water that has been filtered merely cannot be regarded as quite free from objection.
( $1 )
195
IX-INCUBATION.
The experience of the epidemic of 1894 showed that the period of incubation of plague might extend to nine days, but was usually three to six days only. Similar observations were, generally It was for the most part impossible to obtain precise information as to speaking, made in 1896. when and in what manner Chinese patients were infected. In one case, an incubation period of fifteen days must be assumed. This was the case of a Chinese who on May 25th, 1896, was imprisoned On June 10th he was suddenly taken ill with typical in the English jail, being then in good health. symptoms of bubonic plague, and he died of the disease on June 15th. During the course of the mess, plague bacilli were found in the blood; and the autopsy showed inflammatory swelling of the presence of plague bacilli in the spleen and the glands. The jail was at the time, and remained, free fairguinal glands of both sides up to the size of a hazel-nnt. Culture experiments demonstrated the
from other cases of plague.
The infection of river and harbour water must be prevented as far as possible by supervision of ships and their inhabitants. It must also be pointed out that closets and drains discharging into rivers may infect the water.
Since it is especially when men gather together in large numbers in a small space that the contagium of the plague is rapidly conveyed from person to person, the aggregation of men at and markets is to be prevented. Excessive overcrowding of small rooms is to be forbidden. Regulations should be made to provide for sufficient light and air in the strects and the houses.
The disinfection of ships must especially regard the berths and cabins of the sick, the closets, and the bilges.
The public must be enlightened as far as possible concerning the nature of plague; and concern- ing the method of its dissemination by the pus from buboes, by the fæces, urine, and expectoration and by uncleanliness.
B.-Measures of Private Hygiene.
The measures to be taken by individuals with a view to avoiding the infection of plague consist first, in care that no plague bacilli gain entrance to the body by contaminated wounds of the skin e by contaminated articles of food and drink; and, secondly, in a regular mode of life without excesss in eating and drinking.
With regard to the first point, the body should be frequently cleansed by baths, the hands further, should be washed often, and the most insignificant wounds should be kept scrupulously clean; food should be cooked, or, if raw, entirely above suspicion, and the plates and dishes on which food served should be cleansed with water that has been boiled or is of undoubted purity.
The use of strange privies is to be avoided, more especially if they are open to suspicion a infection.
Houses that are known or suspected to contain cases of plague should not be visited.
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