he should be placed in a large, well ventilated room, with the windows and doors well screened, and such preparation should be made from the first day for the thorough and systematic disinfection of all discharges from the bowels and kidneys as will protect other members of the family, the attendants, and the community. 2. A solution of chloride of lime, eight ounces to the gallon of water, should be provided in quantity, and a quart of this should be put in the bed-pan or vessel each time before it receives the discharges, and should be well stirred and allowed to stand in the vessel at least an hour before it is buried. An equivalent solution of creolin, or a thick white-wash made from the fresh quicklime, may be used in the same way when the chloride of lime can not be obtained, but with these at least two hours will be required to complete the disinfection. 3. Soiled bed or body linen should remain in the chloride of lime solution for an hour, and may then be safely put in the family wash. Soiled paper or clothes used about the patient should be immediately burned. Attendants should wash the hands and the lips frequently, and rinse the mouth always before eating. No one should partake of any food which has stood in the sick room. All of these precautions should be continued until the recovery is complete and until all diarrhea has ceased. 4. Typhoid fever is not contagious in the sense commonly understood, and if the precautions above indicated are faithfully and intelligently carried out, a case may be treated in any family or community with perfect safety. If others have the disease, it will be because they were infected from the same source as the patient, or contracted it elsewhere. The same precautions should be observed in dysentery and all other diarrheal diseases, including summer complaint in children. 5. All well water and unfiltered water from rivers draining inhabited areas, where typhoid fever and diarrheal diseases are likely to occur at any time, and milk stored in cans or vessels washed in such water, should be looked upon as suspicious, and should always be boiled before it is drunk by any one not immune from typhoid fever. In the absence of a reliable, filtered, public water supply, carefully collected and properly stored, cistern water is safest. 6. The windows and doors of all dwelling houses, and especially of the kitchen and dining room, should always be well screened, and the flies actually kept out. Unless this is done, a carelessly managed case of typhoid fever, or other diarrheal disease, even a mile or more away, may be a source of danger on account of flies. As mosquitoes are now known to be the carriers of malaria, the same precautions will protect from this poison also. The universal and effectual practice of these precautions would require intelligent care and some expense, but would result in the practical disappearance of one of our most common and fatal domestic pestilences, which is not only a disgrace to our civilization, but an annual scourge and tax upon the people of Kentucky, in comparison with which yellow fever and cholera, plague and other exotic diseases, so feared by our people, sink into insignificance. Copies of this circular, and of others in regard to the prevention of consumption, diphtheria and scarlet fever, may be had by any one for free distribution upon application to the Board at Bowling Green. By order of the Board: J. M. MATHEWS, M. D., President. J. N. MCCORMACK, M. D., Secretary. PREVENTION OF CONSUMPTION. Circular Issued by the State Board of Health of Kentucky. To the Health Officials, Physicians and People of Kentucky: Consumption is the most common and fatal disease with which the people of Kentucky are afflicted. It produces more than twice as many deaths as any other disease, causing one death out of every seven in this State. As it is now definitely known to be a communicable germ disease, a large part of this sickness and mortality can and ought to be pre vented. Careful and extended investigation and observation has demonstrated that the chief source of danger is from the sputum or ex کیجئے Germs of Consumption, magnified, from Photomi- pectorated matter of consumptives, which contains the germs or seed of the disease in countless numbers, and that such sputum is especially dangerous after it has dried. The germs may be constantly found in the air and dust from the carpets, walls and furnishings of rooms occu pied by consumptives, where every precaution is not taken to collect and disinfect such sputum as fast as it is expectorated. Most patients constantly re-infect themselves by failing to destroy their own sputum, and other susceptible persons inhaling the air of such rooms are exposed to constant and serious danger. This is none the less true because the disease may not develop so that it can be recognized for months or even years. These dangers exist to a less extent also in public buildings and rooms frequented and infected by careless consumptives. Being confident that consumption could be practically exterminated, if the medical profession and people could be made to realize the importance of destroying the sputum from every one afflicted with the disease, the following rules have been prepared with care, and should be disseminated, and, as occasion requires, observed by all afflicted persons and families, and all others interested in the public welfare. 1. Every person who has an habitual cough and expectoration should have a microscopical examination of the sputum made to ascertain if it contains the germs of consumption. Until this can be done, or if the germs are found, all of the sputum should be carefully and systematically collected and destroyed or disinfected for his own protection, as well as that of others. 2. Every particle of the sputum should be received upon soft paper and promptly burned, or into cuspidors containing a solution of chloride of lime, four ounces to a gallon of water, or of equivalent strength, and such cuspidors should be washed daily in boiling water. Cuspidors in hotels, cars and other public places, used by consumptives, should have similar care. 3. The room occupied by the afflicted person should be large and well ventilated, with an open fire-place if possible, and no other person should remain or sleep in the room, unless all of the sputum is collected and destroyed with great care. However, if this is carefully and intelligently done, others may share the room in safety. 4. It is important that consumptives should live in the open air and sunlight as much as possible, and that they should be taught to spit upon small pieces of cloth or paper, or use a pocket cuspidor, and destroy the sputum at the first opportunity. They should especially be taught not to spit upon the floor of any public or private building. 5. Weak and broken-down people are especially vulnerable to the germs of consumption. Much may be done to lessen the liability to it by attention to the general health, and by developing the lungs and chest, and keeping them strong and healthy. Exercise in the open air, fresh air in the bed-room, gymnastics, frequent sponge bathing and chest massage, proper clothing, everything in short which will promote physical and mental well-being, are important to all, and especially to those who have inherited or acquired weakness. 6. Sanatoria for the isolation and humane care of consumptives who can not be properly and safely treated at home exist in several States, and are greatly to be desired. Contrary to the popular belief, a large per cent. of those attacked by the disease can and do recover under favorable circumstances. Until the disease can be eradicated, the means of proper treatment should be placed within the reach of all afflicted for their own benefit, as well as for the safety of the public. 7. No person should take a room previously occupied by a consumptive until it has been thoroughly disinfected with formaldehyde or by burning sulphur, three pounds moistened with alcohol for each 1,000 cubic feet of space, with all the flues and other apertures securely closed. Afterwards the room should be re-papered and all woodwork re-painted, or washed in strong soap and rinsed in a disinfecting solution. No amount of disinfection of rooms can lessen the importance of cleanliness, fresh air and sunlight at all times. 8. Milk and meat from animals afflicted with tuberculosis should not be used, or, at least, the former should be boiled and the latter well cooked. This is especially important as to milk for children. 9. With proper precaution, consumptives may safely mingle with their families and the public, but for purposes of information and education in these matters, physicians and heads of families should report all cases suspected to have the disease to the local health authorities and obtain instruction and assistance in preventing its spread. Copies of this circular, and of similar ones in regard to the prevention of typhoid fever, diphtheria and scarlet fever, may be had for free distribution by any one upon application to the Board at Bowling Green. By order of the Board: J. M. MATHEWS, M. D., President. J. N. MCCORMACK, M. D., Secretary. PREVENTION OF DIPHTHERIA. Circular Issued by the State Board of Health of Kentucky. To the Health Officials, Physicians and People of Kentucky: The unusual prevalence of diphtheria in many sections of the State makes it the duty of this Board to again call attention to the best known methods of preventing the occurrence and spread of this disease. 1. Diphtheria is both contagious and infectious, and is distinctly a preventable disease, being easily limited to the first case or cases. When it gets away from the primary cases and makes its escape upon the community, somebody is to blame. The sooner we accept this as a sanitary maxim, the sooner we shall begin to do our duties as individuals and communities. 2. On account of its frequency and fatality, this disease is of far more importance to the people of Kentucky than smallpox, yellow fever or cholera. 3. When a child has sore throat, and especially if diphtheria is in the neighborhood, it should be immediately separated from other children until a competent physician has seen it and decided whether or not it is affected with a contagious disease. 4. If diphtheria, strictly isolate the case at once, in an up-stairs room if possible, and disconnected as far as practicable from the living and sleeping apartments of other children. No one except the physician and nurses should enter the room, and they should take every precaution not to carry the infection to others. 5. The Board urges the use of antitoxin, not less than 3,000 units in every case as soon as the disease is recognized; and recommends that immunizing injections of 500 units be used for all children who have been seriously exposed. Germs of Diphtheria, magnified from Photomicro- 6. Placard the house, and keep all other children, all having the care of children, and all who go where children are, away from it. Notify the health officer of the town or county within twenty-four hours, as the law requires, and he will co-operate with the physician and family to keep the disease from spreading. 7. The discharges from the mouth and nose, which especially contain the germs of the disease, should be received on soft cloths and burned, and other discharges should be disinfected, and all refuse from the sick room burned. All utensils used in feeding the sick should be washed separately from other dishes, and should remain some time in boiling water. 8. Disinfect all bed and body clothing, and other like things, as soon as removed, by immersion for at least six hours in a solution of chloride of lime, four ounces to the gallon of water. They may then |