found to exist, the first thing to be done is to isolate, as completely as possible, the patient and his attendants. There should be two nurses for every such case, that each may get the daily open-air exercise which is more than ever important, and neither be obliged to sleep in the infected room. They should avoid contact with all outsiders as much as possible, and always change their clothes upon going out. The hair, which can not be changed, should be covered with a close cap. Nothing should be worn in the room which may not afterward be washed or destroyed.

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The directions given for the arrangement of a sickroom apply with the greatest force in these cases. All superfluous things, particularly such as can not be washed, must be taken out of the room before the patient is put in it. After he is once quarantined, every article carried out of the room must be disinfected. set of dishes should be kept for his exclusive use, and washed by the nurse. The bedding, clothing, etc., must not be sent to the general laundry, but washed by themselves after being well soaked in some disinfecting solution. For any minor dressings, and in the place of handkerchiefs when there is a discharge from the throat or nose, use old soft cloths that can be immediately burned. All excrementitious and vomited matter must be disinfected with the greatest care.

There is nothing small enough to be careless about. Even the broom which sweeps the floor should not be used again elsewhere. Do not let the air blow from the sick-room into the rest of the house any more than can not be avoided. It helps to keep the air pure to hang about the room cloths kept wet with some disinfectant. Over the doorway may be hung a sheet similarly dampened. This has at least an excellent moral effect, and

moral influences are not without value in dealing with contagion. While neglecting no possible precaution try not to create unnecessary alarm. People afraid of infection are predisposed to it by acquiring a nervous condition which renders them doubly susceptible. Yet the danger is not to be underrated, and insufficient precautions may actually be worse than none, giving an unfounded sense of security.

Take good care of yourself as well as your patient, for the confinement and the isolation make these cases doubly wearing. Try to secure rest and nourishing food at regular hours, and do not let the trouble of having to change your clothes hinder you from getting out of doors every day, even if you are tired. A brisk walk in the fresh air is the best possible disinfectant for yourself.

So, also, the best way of disinfecting the air of the sick-room is by exchanging it for pure air. Air can not be renewed by disinfecting it, any more than it can be disinfected by deodorizing. Neither process renders it fit to breathe again. In all cases of infectious disease, free ventilation is of the first importance. In those diseases in which, as in scarlet fever and small-pox, the infectious particles are largely thrown off by the skin, a good deal can be done toward keeping the air pure by inunction of the skin, which keeps its particles from flying, and by frequent bathing and changing of the clothes,

The burning of pastilles, cascarilla bark, etc., serves rather to add to than to remove the impurities of the air. Charcoal or peat, placed about the room in shallow pans, does absorb a certain amount of poisonous matter. Carbolic crystals exposed in an open dish, or a carbolic solution sprinkled about the room, and on the

screens and outer covers of the bed, will quickly correct any offensive odor; but neither of these is to be regarded as a disinfectant. Solutions of sulphate of iron, nitrate of lead, and permanganate of potash, and the various chlorides of lime, soda, and zinc, similarly used, do act as true disinfectants, the former gradually giving off oxygen, and the latter absorbing carbonic acid gas, and liberating chlorine; but as they affect only the air coming in contact with them their influence is not far reaching. The vapors of iodine and bromine and the fumes of nitrous acid have vigorous disinfecting qualities, but, as commonly employed, they are only deodorants, as they can not be used in the sick-room in quantity enough to be useful without exciting dangerous bronchitis. Indeed, any gaseous disinfectant, to be effective, must be used in quantity incompatible with human presence. Chlorine and sulphurous acid are the only two of any great practical utility.

The most powerful and rapid of the liquid disinfectants in general use is the solution of bichloride of mercury (corrosive sublimate). It is also a valuable antiseptic. The solution ordinarily used is of the strength of 1 to 1,000, about fifteen grains to the quart. There is nothing better than this for scouring walls, floors, beds, etc. It may also be used for disinfecting vessels, sinks, and drains; but not for clothing, as it makes an indelible stain. For the latter purpose may be used a solution of sulphate of zinc and common salt, four ounces of the sulphate and two of the salt to a gallon of hot water. Soak the clothes in this for two hours, and then boil them with soda or borax.

Condy's fluid (solution of permanganate of potash) is often recommended, but it can hardly be used strong

enough to do any good without staining. The sulphate of iron (copperas) should remove such stains, but itself discolors. Stains from copperas can be taken out by oxalic acid or lemon juice. Carbolic also decomposes Condy's fluid, and is incompatible with chlorine, so that it must not be used in combination with either of them. Chlorine and sulphurous acid mutually destroy each other. Chlorine is soluble in water to the extent of two and a half volumes; the solution can be used as a disinfectant for clothing, etc. It is decomposed by the action of light.

Copperas or chloride of lime may be thrown dry into water-closets and drains with good effect. They should afterward be thoroughly flushed. A little disinfectant should be kept standing in all sputa-cups, urinals, and bed-pans, ready for use. For this purpose the tincture of iodine, or Condy's fluid, is excellent. The latter may be known to have lost its efficiency when it has lost its color.

With disease which is only indirectly infectious-as typhoid and cholera-isolation of the patient is not necessary; but the greatest care is essential in disinfecting those discharges from the body which contain the germs of contagion. All excrementitious matter must be disinfected and disposed of thoroughly and promptly. For stools, cover the bottom of the receiving vessel with a layer of copperas, or chloride of lime, before use. After use, add crude hydrochloric, or sulphuric acid. in quantity equal to half the bulk of the discharge, cover closely, and carry at once from the room. These stools must not be emptied into the common closet. Trenches may be dug to receive them, so situated as not to drain into any source of water supply, or they may be mixed with sawdust and burned. All

clothing and bedding, soiled even in the slightest degree with the discharges, must be disinfected with equal care, and boiled. These measures, rigidly taken, will prevent the spread of such disease, unless there is some local cause for it.

When a patient has died from any infectious disease, the body should be washed with some disinfectant, and wrapped in a sheet wet with the same. Labarraque's solution is commonly used. Saturate a large wad of cotton with it, and leave it under the hips. The burial should be as soon as possible, and strictly private.

After a case is ended, whether by death or recovery, the room must be subjected to a thorough process of cleaning and fumigation. Everything that can be so treated should be boiled, or baked in a disinfecting oven at a temperature of not less than 220° F. The floor, woodwork, and, if possible, the walls, should be scrubbed with bichloride of mercury, the mattresses taken to pieces for fumigation, and the bedding washed. Rubber sheets and aprons are best cleaned with Labarraque's solution; they, of course, can not be baked. Everything that can not be otherwise thoroughly disinfected should be hung up in the room while it is being fumigated. All drawers and closets should be left wide open, that the gas may penetrate to every corner. Either sulphurous-acid gas or chlorine may be used for fumigation; the former is usually preferred. They are both powerful bleaching agents, and will discolor metals, so that all metallic surfaces should be first covered with a coating of grease to protect them.

To fumigate a room or ward with sulphur, close the doors, windows, and fireplace, and paste strips of paper closely over all the cracks. Put the sulphur in iron