The Birmingham age-herald., 1914-05-17
City Health Officer Tells How to Kill Germs in
 Bulletin No. 4
URGES LIBERAL USE
 OF DISTNFECTANT
Food Should Be Kept and Prepared Outside the Sick Room-Tells of Other Precauti0ns-TO Dis
 cuss Malaria Next Sunday

In health bulletin No. 4, the preven- ton, or rather the treatment of typoid fever, is the subject discussed by Dr. R. M. Cunningham, city health officer. It is probably the most important bull letin issued since the series began.
 There is not family in the city, says pr. Cunningham, which cannot profit by memorizing and observing some of the rules laid down in this bull letin. pr. Cunningham next Sunday will discuss malaria fever in bulletin No. 5. No. is as follows
 The Prevention of Typhoid
 "The prevention of typhoid fever be- gins with the management of a case of the disease. The sick room should be screened. well lighted and ventilated Only such furniture as is absolutely necessary should be in the room. An drapery, curtains or carpets should be removed. The utensils employed in the room should be as few as possible, and used only for the patient and attend- ants, and should be sterilized by heat after each use. There should be a daily change of linen, sheets, pillow cases and sleeping gowns. One or two light blankets should be at hand. that can be boiled. A vessel that will hold one half to one gallon for disinfecting so- lutions. A vessel of sufficient size to hold the kidney and bowel dis charges for a few hours, with such amount of disinfecting solution as may be necessary. A wash bowl for the nurse. A bed pan and an adequate sup ply of clean old cloths, food and drink cf1 hA on rAd Ia convenient outside of the room.
 The first rule is absolute cleanliness It is said that cleanliness is next to sodiness, but in the management of typhoid cases, it comes first. Recall ing the fact that the discharges from the typhoid patient contain the germs of the disease. it is self,evident that if these discharges are at once com pletely sterilized the germs would then and there be killed and could not in- fleet the other members of the family or the outside-water, food, or be car ried around by flies or other insects. The pigs are killed when they are born, and, therefore, no pigs to get Into the garden. (See Bulletin No. D. If this were done in every case thor oughly and effectually, typhoid germs would in a short time go out of busi- ness The Best method for killing the germs is' to boil or burn all these dis ti.par8cS.i 1llS IS not alWayS, indeed very rarely, practical. Therefore. chemical germicides must be employed one part of carbolic acid to 20 parts of water or one part of bichloride of mercury to one thousand parts of water are( re- liable and safe. Three ounce of carbolic acid and one gallon of water, or 60 grains of bchloride of mercury and one gallon of water make good solutions to be kept in the room and carefully labeled Poison" After each bowel or kidney discharge it should be mixed in twice it's volume with the disinfect- ant solution (carbolic or bichlorde) em- ployed, poured into the vessel used for that purpose, throughly mixed and all lowed to stand from two to four hours and then emptied into the closet.
 - ,"When the linen is removed it should be immersed in carbolic acid solution, to 20, and remain there until sent to the 1uandry, as soon as possible. The sputum should be collected upon old cloths and promptly burned. Now, if a single drop of any of these discharges should soil the linen, furniture or floor when it dries it may go off in dust and infect others. or affold a breakfast fol fly, which latter may later lunch upon some raw or cold food and thus spread the infection. If tub baths are used one-half pound of chloride of lime tc 50 gallons of water will disnfect the water after the bath. The nurse should wash her hands in a l to 1000 solution oi bichloride of mercury every time sht handles the patient and so should the doctor and other attendants. The atten. ton, care and work in carrying out the above are very great, and an industrious and intelligent nurse is required. All oi the above details should be given by and under the direction of the attend. ing physician. It may be said here thai an early diagnosis of the typhoid is neces- sary. This can only be done, in man, cases. in the laboratory. Do not ob. Ject, then, if the doctor wants little blood from the patient.
 Notwithstanding the best efforts tc