WEDNESDAY, SEPTEMBER 6. 1876.

Nelson Evening Mail, Volume XL, Issue 219, 6 September 1876, Page 2

WEDNESDAY, SEPTEMBER 6. 1876.

Oub morning contemporary on Monday last returned to his advocacy of the nonisolation of scarlet fever patients, and in doing so hurled Professor "Bennett at our heads, apparently inferring that we ought to accept without reserve the ipse dixit of so high aH authority, together with the deductions he himself has drawn from it. To this we must at once demur, for although in Professor Bennett we recognise an authority, preeminent no doubt, still we cannot shut our eyes to the fact that his preeminence is owing almost as much to his eccentricities as to his ability. That all his opinions were not received without question is clearly shown by the extraordinary passagea-at-arms that occurred between him and some of his Edinburgh colleagues. Most certainly his views in regard to fever were not adopted in England, or we should not have seen so many lever hospitals erected in the larger cities of the home country within the last few years. Further, we most assuredly doubt whether Professor Bennett himself would have adopted the same course of treatment in a patient suffering from an exanthematous disease such as Bcarlatina — which is propagated by a specific animal poison — as that carried out in the case of the boy May. To go still further we doubt whether even our contemporary would advocate so much in a case of small-pox, which is also a pure exanthem. But, apart from the danger of spreading contagion, we cannot think it couducive to the recovery of the other patients to be aware that a case of this character is located in the same ward. That the Provincial Surgeon will do his utmost under the circumstances we implicitly believe, for in his skill and attention all who know him must have every confidence, but we consider that he is placed in an unfair position, which must, perforce, be defended, for no one can believe otherwise than that, had there been a proper ward available, the lad May would have been isolated at once. Whilst on this subject we may state that there is not a ward in connection with the Hospital fitted up for the reception of noisy patients, so that unfortunates suffering from delirium tremens — which, although selfinflicted, is not insanity — cannot be admitted. To have them placed under control, it is necessary that they should be converted into lunatics on the certificates of two medical men. Such a thing may seem absurd, but ifc is no less true. To place medical men in such a false position is manifestly unfair, for they must either, by signing Buch a certificate, render themselves liable to an action at law, should the patient or his friends see fit to bring ifc, or, by refusing to do so, lose for him all the advantages of being placed under proper control aud carefully nuraed. J

In order to show 'that we have not acted as alarmists, 1 bat have simply for the public good; advanced opinions which we regard! as unassailable, we cannot do betteb than publish the recommendations forwarded to the x Registrar-General by such a representative body as the Association of Medical Officers of Health of London in reply to his weekly return of September ! 25, 1869, in. which, whilst enumerating the deaths from scarlatina, he says : — " The Medical Officers of Health will, no doubt, endeavor to suggest some practical means of preventing its further extension." It may as well be stated that the Metropolitan Medical; Officers of Health are upwards of forty-five in number, and comprise in their ranks some of the leading minds of the day aswell as men who have made sanitary science a speciality. Although the whole of the memorandum does not bear upon the particular subject just now under consideration, it contains so many useful hints that we give it in full, the italics being our own : —

?' The Association of Medical Officers of Health beg to forward to the RegistrarGeneral the following memorandum*. — " It is quite possible to check scarlet fever if 'adequate means, be taken to destroy the. emanations of the sick, so that, they shall not infect the healthy. For this purpose the sick must be separated, either by patting them into rooms apart, or by sending them out to a sick house, or, which is better, by removing the healthy, to another house'. The infecting matter of the disease resides in the excretions of the mouthy throat, and lungs, of the bowdls and kidneys, of the skin, and of the suppurating surfaces common towards the close of the disease. Disinfectants should be applied assiduously to the mouth, nose, and throat, as each case may require, by gargling, swabbing, or syringing with a teaspoonf ul of Condy's Fluid toa pint of water; the excreta of the bowels and kidneys, should be well dosed with strong carbolic acid before they leave the bedside; the air of the sick room should be. occasionally freshened by dispersing Condy's Fluid (diluted as above) by means of a vaporizer ; and the doorway should be hung with a sheet well sprinkled with carbolic acid, so that there may be no mixing of tainted air with that of the body of the house. It can do no harm' to oil the skin during the height of fever, but what is of real consequence is the persevering use of warm soapy baths so soon as the patient can take them, [and. through the convalescence till the skin has done pealing, and the throat and nose are healed. All handkerchiefs, towels, and linen, before leaving the room, should be steeped in boiling water containing a teaspoonful of solution of chloride of soda, or of Condy's Fluid, to a pint; and when the disease is over, the bedding and clothing of the patient and his attendants, all floors, walls, and ceilings, and the surface of all furniture on which infectious matters may have settled, should be scraped or cleaned with a disinfectant, and fumigated. Moreover, disinfecting flaids (as carbolic acid) should be poured freely, after the slops from the sick room, into the closets, sinks, drains, and se .vers, and into every place around the house where decaying organic matter can be harbored. The persons attending on the sick should wear glazed or smooth dresses by preference; they should often wash their hands especially before eating, and should mix as little as possible with tbe family. For fumigating infected rooms and their contents nothing is better than sulphur. A quarter of a pound of brimstone, broken into small pieces should be put into an iron dish (or the lid of an iron saucepan turned upside down) supported by a pair of tongs over a bucket of water. The chimney and other openings are then closed with paper pasted on, and a shovelful of live coals is put upon the brimstone. The door is then quickly shut, the crevices covered with paper and paste, and the room kept closed for five or six hours. After this, a thorough cleansing should be effected ; everything washable should be washed, and all other things be cleansed by proper means. Fumigation of clothes, &c, may be easily carried out on a small scale by burning a sufficient quantity of brimstone matches. Provided there be no unsuspected drain, sewer, gully, water closet, pipe, or cistern, or other source whence the inmates receive fresh infection, scarlet fever can be and is daily arrested in private houses by the above means carried out in detail; but only by persons having space, wealth, intelligence, and the wish to save life. It is far otherwise in the crowded houses of the poor, where the healthy are mixed up with the sick, and even with the dead."