Excerpt from Bulletin of the North Carolina Board of Health, Vol. 17: April, 1902

The measures recommended for safeguarding the health of others in time of sickness comprise isolation, prevention of dissemination of infectious material, and disinfection, and these, I predict, will be enforced at no distant day by all intelligent communities not alone in the so-called contagious diseases, but in all diseases of a serious nature spread directly or indirectly by any of the excretory products of the body. Out of deference to the controversy over the right of the two words infectious and contagious to have separate and distinct meanings, I will here declare the sense in which I employ them. Infectious diseases include all those which depend upon the presence of micro-organisms in the tissues, while the contagious class of infections diseases includes those transmissible from man to man by direct contact or close proximity. We do not commonly reckon typhoid fever, for instance, as a contagious disease, but when we read that of 206 cases of that disease investigated by Dr. Herbert Peck, 28, or 13.6 percent., were traced to direct infection in the sick-room, we must agree with him that the danger is more common than is generally supposed, and that it has not received the attention that it deserves. Lobar pneumonia and pulmonary tuberculosis are also not included in the contagious class, and yet we are not insensible of the fact that house epidemics of the former are not uncommon, and that the latter is largely spread by overcrowding and lack of ventilation.

It is not my intention to enter here upon any discussion of the important question of the advisability of enforcing what may be regarded as unnecessarily harsh measures for the suppression of tuberculosis, nor to touch upon the extension of supervision by public authority of the handling of the sick, but rather to consider the efficiency of preventive measures already practised.

Isolation. - The object of isolation is to remove the patient as completely as possible from all chance of acting as a menace to the health of others, whether dwelling beneath the same roof or not. In the dwellings of the poor it is usually most difficult and frequently impossible to isolate the patient in a proper manner because, primarily, of lack of space, in the homes of the well-to-do and of the rich, where plenty of room is available, it is not uncommonly the case that isolation is a mere farce because of failure on the part of the family to grasp the full importance of thoroughness, in spite of instruction by the attending physician and by the representative of the local authority. In the minds of many, isolation is complete when the patient is in a room by himself, with the door leading therefrom into the hall open or shut according to no particular rule, but according as accident has left it. To such minds the air of a sick-room is a deadly contagion to which the doorway, not the door, opposes itself as a most efficient barrier. We all have met and know the person well who says, "I was very careful not to enter the room, but talked with him from the doorway." Often the door is left open, and its place is taken by a sheet wetted occasionally by some disinfectant solution.

About the Publisher

Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com