Middlebury register. (Middlebury, Vt.) 1886-1937, 1888-10-05
CoMMLN lCA5Le CiSEN5z5.
A subject Of Vital Importance to Commu-
ni.ies-P tcautions.

groups. Oi these none, upon the whole.
are so formidable as those termed COM
m'nicable diseases. We use this term
in preference to contagious or infectious,
because these two words have in use de-
parted SO far from their oriSsSal mean.
ing as to convey no correct Ma of their
relationship. There is great variety in
the method in which diseases are COM.
municable. Some, like %hydrophobia in
man and CHAMBERS in horses, are con-
veyed only by direct contact with an
abraded surface, which is equivalent to
incubation. Even u common vaccine
disease can only be induced in this way.
Other diseases which are communicable
require some special and abnormal con-
dition OF h particular tissue to which
they will attach. Thus, although the
bacillus of tuberculosis is probably trans
Missile, it is only to those whose lungs
are in a peculiar state of receptivity.
Other diseases, such as the
e%ruptions, vary exceedingly as to the de-
gree of their communicating.
1t is sometimes quite difficult to deter
mine the extent to which the commune
eating particle can be carried. 1t is prob
able that the air from a smallpox hospital
has given the disease to a person a mile
distant. On the contrary, scarlet fever
has been brought into the ward of a full
but well aired hospital and continued
there a day without a single person con-
tracing the disease. If we could be
sure as to the secretions and all the skin
separations from scarlet fever it would
not be a very communicable disease; vet
we have known a dress folded up at the
bed of a dying patient and placed in a
trunk, to convey the poison to a family
of children four miles distant, when the
dress was unfolded in their presence
three months afterward. Whooping
cough and diphtheria are probably never
conveyed by the first case occurring. ex-
cept by the breath or sputa of the patient.
Measles, on the other hand, are COM
municated at much greater dis
tances. In general, any one of
this class of diseases having be-
come epidemic, the communication
to Others is from houses and clothing far
more than from persons. Difficult as it
is to determine accurately all the facts as
to the conveyance of these diseases, their
transmissibility, their times of inception
and the time of greatest risk of conta-
gion, or when the patient ceases to be a
risk to others, no subject is of more vital
importance to communities.
DR.. Vacher, the medical officer of
B~irkenhead, and DR.. Dukes, of Rugby,
have given much attention to the subject
and have classified a large number Of
cases as to the time from the first synp-
tom to the beginning of eruption, the
time from beginning of eruption to cessa-
ton Of fever, and the time from the be-
g--.nin3 of eruption to when the patient
ceases to be infective. They state the
latter as follows: For smallpox, SO days;
measles, % days; scarlet fever, 40 days;
diphtheria, % days; humps. 81 days;
typhoid fever, 20 days.
These will serve as general guides. In
all cases where schools are concerned the
time of return should be guarded. 1t is
to be remembered that more depends
upon the cleanliness of the house and
family and upon the garments worn than
upon the person. 1t is often a question
how far boards of health shall require re-
ports Of contagious diseases. In any
good system Of sanitary government such
report is required as to smallpox, scarlet
fever, diphtheria, typhus fever, cholera,
and as to measles when extensively cpl
demic. We think strict rules should be
enforced upon physicians as to such re-
port, but that they should be paid there
for, inasmuch as such report is of special
service, quite different from the certifica-
ton of a death. The habits of different
countries and states differ much, but all
agree that the report should be made by
some one. This is rendered more essen
tial by recent facts, which show hat by
early and strict isolation the common
communicable diseases are often pre-
vented from becoming epidemic.
1t Is often a question how far attend
ance at funerals should be prevented in
cases of death from communicable dis
eases We know of a recent cas- in
which the attendance of children at a
church funeral, the death having been
caused by malignant diphtheria. proba-
bly, led to a dozen deaths and many cases
in q sparse country village. The exposure
is far greater for children than for adults.
If all details as to the washing of the
dead body, the dealing with clothing, the
time Of transfer to the coffin. the use of
disinfectants, could be carefully regu-
lated, it is probable that the risk would
be very little; but as we cannot rely upon
the carrying out of all these details, it is
better to prohibit public funerals and to
announce cause of death in all cases of
the more dangerous communicable dis
eases.
Similar caution is needed as to the
visits of friends upon those who are thus
sick. While there is no need of such fear
as will preclude assistance from older
persons where there is need of help, there
is no excuse for exposing the young.
With due %precaution as to airing gar
ments, it is very rare that communicable
diseases are carried to others by the
casual visitor. We thus desire to caution
all against unnecessary exposure, and &c
secure public opinion as an aid in pre-
venting the spread of a class of diseases
which counts so many victims. New
York Independent