The prophylaxis and treatment of internal diseases : designed for the use of practitioners and of advanced students of medicine / by F. Forchheimer.

  • Forchheimer, F. (Frederick), 1853-1913.
Date:
1910
Catalogue details

Licence: Public Domain Mark

Credit: The prophylaxis and treatment of internal diseases : designed for the use of practitioners and of advanced students of medicine / by F. Forchheimer. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    wells, or the connection of leaky cisterns or wells with leaky privy vaults, directly or indirectly. I know of one community in which surface wells and cisterns were formerly used, and which was yearly visited, during the autumn montlis, by an epidemic of fever; all this disappeared after the village had grown to the dignity of having a common water supply from artesian wells. In the open country it is the duty of the physician, when in the presence of a case of typhoid fever, to give all directions necessary for preventing the spread of the disease. Milk also requires strict supervision, principally on account of the water from unknown sources that it contains, added either for purely commercial purposes or with laudable, but misdirected, attempts at cleanliness by the dairyman. The modern and humane dairyman sees that his cows get pure water, and that all his utensils are thoroughly sterilized; but if the family milk supply does not come from a milkman who employs for delivery only such persons as know the relation between milk and disease, it is necessary to boil all the milk. In the country, with the precautions before described as to water supply, raw milk may still be looked upon as a permissible luxury. Other articles of food that have been accused of transmitting typhoid fever are butter, ice, oysters, and celery. As to ice, Sedgwick and Winslow show that the risk of contracting tj^phoid from natural ice is infinitesimally small. Both oysters and celery have been known to transmit typhoid; but here again the risk is small, and precautionary measures need only be taken under ex- traordinary circumstances. For oysters this is done by avoiding those that come from places where they have been fattened in impure water. For celery and other vegetables and fruits no precautions can be taken except careful cleanliness. For protection against infection by flies, care in handling all secretions and excretions of the patient is necessary. All vessels in which these are collected or kept should be covered and the disinfectants to be mentioned should be used. All food which is kept in the sick room should be protected against flies. The patient himself is a source of great danger, but reasonable precau- tions, properly carried out, will remove all possibility of this. It is possible to transmit typhoid by direct contact. Leube reports one case in which a thermometer, introduced into the healthy rectum after having been used in a typhoid patient, was the carrier of infection. Cole states that, at the Johns Hopkins Hospital, 1.81 per cent of all cases are of hospital origin, and sug- gests that isolation may become necessary. It is therefore necessary to dis- infect everything that has been in contact with the mucous membranes of a typhoid patient. The typhoid bacilli leave the patient's body by means of the stool and urine, at times also by expectoration, and possibly with other secretions. In order that a community may not suffer by the presence of a typhoid patient it is necessary that all secretions and excretions be dis- infected. Chuonic Typhoid Bacillus Carriers.—^Living typhoid bacilli may be found in the stools for a very long time after convalescence. The celebrated typhoid fever carrier, a cook who, at the time of writing (1909), is confined to the House of Detention in New York City, started small epidemics of typhoid fever in New York City (1900), Dark Harbor, Me. (1902), Sands