Cooley's Cyclopaedia of Practical Receipts Volume I Part 180

14. LARMANDE'S ANTIMEPHETIC LIQUOR. A solution of the sulphates of zinc and copper.

15. THYMOL. From experiments made with this substance it appears to be a very powerful and valuable antiseptic, and likely, because of its non-poisonous and non-irritant qualities, to supplant carbolic acid in various branches of surgical practice, in which this latter agent has. .h.i.therto been employed; such, for example, as a dressing for wounds, ulcers, and as a topical application for certain skin eruptions, &c. Its difficult solubility and price (spite of its much greater antiseptic power), however, for the present at any rate, preclude it from being made available as an ordinary common disinfectant, as this term is generally understood. See THYMOL.

16. SILICATE OF SODA. It is stated that this salt has considerable anti-putrefactive powers.

17. Aluminised CHARCOAL. This is recommended by Dr Stenhouse as a cheap and very efficient decolorising agent. It is made by dissolving in water 54 parts of the sulphate of alumina of commerce in water, and mix it with 92-1/2 parts of finely powdered wood charcoal. When the charcoal is saturated it is evaporated to dryness, and heated to redness in covered Hessian crucibles till the water and acid are dissipated. The charcoal contains 7-1/2 per cent. of anhydrous alumina.

The natural disinfectants are air and water.

Air, when in violent motion, as is the case during a hurricane, has in many instances been known to arrest the course of certain epidemics; whilst in the form of ordinary ventilation, although inadequate alone to destroy the causes (whatever they may be) of contagion or infection, it is nevertheless found to supplement, to a considerable extent, the application of artificial and specific disinfectants. Hence the paramount necessity of perfect ventilation in all apartments in which the sick are placed, and hence also the measures taken in all hospitals to ensure by this means an increasing supply of fresh air to the wards in which the patients are lying.

The diminution in the amount of sickness prevailing in an army caused by the removal of the soldiers from barracks and placing them in sheds or under canvas is another ill.u.s.tration, tending to show the disinfectant properties possessed by an atmosphere in a state of circulation, when, of course, other hygienic precautions are not neglected.

In Hammond's 'Hygiene' for 1863 the author, who was surgeon-general in the United States army, says that he only met with one instance of hospital gangrene in a wooden pavilion hospital, and not a single one in a tent; and the same result is recorded by Kraus, of the Austrian army in 1859, who says he never discovered that gangrene originated in a tent; that, on the contrary, cases of gangrene at once began to improve when those suffering from the disease were sent from hospital wards into tents. In his work on 'Practical Hygiene' Dr Parkes advises all cases of typhus occurring in barracks, whenever practicable, to be sent to tents or wooden huts having badly-jointed walls.

The great solvent power of water, superadded to its being able to hold matters in suspension, renders it a most important disinfectant, and thus enables it in the form of rain to remove from the atmosphere many noxious and pestilential bodies that would doubtless, if allowed to increase, become a source of disease. The air-current which const.i.tutes the ventilation of the House of Commons, before entering the Commons' chamber, is made to pa.s.s over a fine spray of water, by which means it has any dust or other organisms washed out of it. The beneficial effect of rain also in flushing drains and ca.n.a.ls, and sweetening the superinc.u.mbent air, and of washing out of it many solid as well as gaseous objectionable impurities, is well known. The year 1860 was one of the wettest on record, as it was also one of the healthiest. Dr W. Budd recommends that when a room is to be disinfected, a short time before the process is commenced a tub of boiling water should be placed in the apartment, so that the steam may become condensed on the walls, and diffused throughout the air, as he believes there is a greater chance of ensuring the destruction of the disease germs by the aerial disinfectants than if these latter were allowed to act on the germs in the dry state.

We have already enforced in these pages the importance of the habit of personal cleanliness as being one of the greatest aids to the preservation of health; and although the unstinted use of soap and water will alone fail to effect the removal of any infectious or contagious maladies, their use will be found important auxiliaries in a.s.sisting recovery. But personal ablution is not the _sine qua non_. The frequent cleansing of our dwellings, streets,[259] alleys (more particularly culs-de-sac), lanes, and the sheds and habitations of animals, by soap and water, or water alone, as well as the removal of all decaying or refuse materials from our midst, is of equal importance, and must not be disregarded, if we desire to make our sanitary surroundings such as they ought to be.

[Footnote 259: In streets where there is much traffic the air above has been found to contain large quant.i.ties of dust composed, amongst other matters, of the remains of horse droppings; hence the great importance of a.s.siduously watering and cleansing the thoroughfares of all large cities and towns. A plan for laying the dust of streets has been suggested by Mr Cooper, and consists in watering them with waste chlorides of calcium and magnesium. Carbolic acid has been employed for the same purpose by many urban authorities for some years past.]

We extract the following from Dr Parkes' valuable and standard work--'Practical Hygiene,'

"_Disinfection of Various Diseases._

"EXANTHEMATA, SCARLET FEVER, AND ROTHeLN. The points to attack are the skin and throat. The skin should be rubbed from the very commencement of the rash until complete desquamation, with camphorated oil, or oil with a little weak carbolic acid. The throat should be washed with Condy's fluid, or weak solution of sulphurous acid.

"Clothes to be baked, or to be placed at once in boiling water, as directed further back. The clothes should not be washed at a common laundry. Chlorine or euchlorine should be diffused in the air, the saucer being put some little distance above the head of the patient. Carbolic acid and ether or carbolic-acid spray may be used instead.

"_Smallpox._--In this, as in all cases, there can be no use in employing aerial disinfectants, unless they are constantly in the air, so as to act on any particle of poison which may pa.s.s into the atmosphere.

"The skin and the discharges from the mouth, nose, and eyes are to be attacked. There is much greater difficulty with the skin, as inunction cannot be so well performed. By smearing with oil and a little carbolic acid and glycerin, or, in difficult cases, applying carbolised glycerin to the papules and commencing pustules, might be tried. The permanganate and sulphurious acid solutions should be used for the mouth, nose, and eyes.

The clothing should always be baked before washing, if it can be done.

"The particles which pa.s.s into the air are enclosed in small dry pieces of pus and epithelial scales; and Bakewell, who has lately examined them, expresses great doubts whether any air purifier would touch them. Still it must be proper to use euchlorine or carbolic acid. Iodine has been recommended by Richardson and Hoffmann.

"_Measles._--Oily applications to the skin and air purifiers, and chlorides of zinc and aluminium in the vessels receiving the expectoration, appear to be the proper measures.

"_Typhus (Exanthematicus)._--Two measures seem sufficient to prevent the spread of typhus, viz. most complete ventilation and immediate disinfection and cleansing of clothes. But there is also more evidence of use from air purifiers than in the exanthemata. The nitrous acid fumes were tried very largely towards the close of last century and the beginning of this in the hulks and prisons where Spanish, French, and Russian prisoners of war were confined. At that time so rapidly did the disease spread in the confined s.p.a.ces where so many men were kept, that the efficacy even of ventilation was doubted, though there can be no question that the amount of ventilation which was necessary was very much underrated. Both at Windsor and Sheerness the circ.u.mstances were most difficult. At the latter place (in 1785), in the hulk, 200 men, 150 of whom had typhus, were closely crowded together; 10 attendants and 24 men of the crew were attacked; 3 medical officers had died when the experiments commenced. After the fumigations one attendant only was attacked, and it appeared as if the disease in those already suffering became milder. In 1797 it was again tried with success, and many reports were made on the subject by army and naval surgeons. It was subsequently largely employed on the Continent, and everywhere seems to have been useful.

"These facts lead to the inference that the evolutions of nitrous acid should be practised in typhus-fever wards, proper precautions being taken to diffuse it equally through the room, and in a highly dilute form.

"Hydrochloric acid was employed for the same purpose by Guyton de Morveau in 1773, but it is doubtless much inferior to nitrous acid. Chlorine has also been employed, and apparently with good results.

"In typhus it would seem probable that the contagia pa.s.s off entirely by the skin, at least the effect of ventilation, and the way in which the agent coheres to the body linen seems to show this.

"The agent is not also enclosed in quant.i.ties of dry discharges and epidemics, as in the exanthemata, and is therefore less persistent and more easily destroyed than in those cases. Hence possibly the greater benefit of fumigations, and the reason of the arrest by ventilation. The clothes should be baked, steeped, and washed, as in the exanthemata.

"_Bubo Plague._ The measures would probably be the same as for typhus.

"_Enteric (typhoid fever)._ The bowels' discharges are believed to be the chief, if not the sole agents in spreading the disease; the effluvia from them escape into the air, and will adhere to walls and retain power for some time, or the discharges themselves may get into drinking-water. Every discharge should be at once mixed with a powerful chemical agent; of these, chloride and sulphate of zinc have been chiefly used, but sulphate of copper (which Dougall found so useful in stopping the growth of animalculae), chloride of aluminium, or strong solution of ferrous sulphate (1 ounce to a pint of water), or carbolic acid. After complete mixing the stools must be thrown into sewers in towns; but this should never be done without previous complete disinfection. In country places they should be deeply buried at a place far removed from any water supply; they should never be thrown on to manure heaps or on to middens, nor into earth closets, if it can be possibly avoided. As the bedclothes and beds are so constantly soiled with the discharges, they should be baked, or, if this cannot be done, boiled immediately after removal with sulphate or chloride of zinc. It would be less necessary to employ air purifiers in this case than in others.

"_Cholera._ There can be little doubt that the discharges are here also the active media of the conveyance of the disease, and their complete disinfection is a matter of the highest importance. It is, however, so difficult to do this with the immense discharges of cholera, especially when there are many patients, that the evidence of the use of the plan in the last European epidemic is very disappointing.

"The ferrous sulphate (green vitriol), which has been strongly recommended by Pettenkofer as an addition to the cholera evacuations, was fully tried in 1866 at Frankfurt, Halle, Leipzig, in Germany, and at Pill, near Bristol, and in those cases without any good result. In other places, as at Baden, the benefit was doubtful. It seemed to answer better with Dr Budd and Mr Davies at Bristol; but other substances were also used, viz.

chlorine gas in the rooms, and chloride of lime and Condy's fluid for the linen. On the whole it seems to have been a failure. Ferric sulphate, with or without pota.s.sium permanganate, has been recommended by Kuhne instead of ferrous sulphate, but I am not aware of any evidence on the point.

Carbolic acid was largely used in England in 1866, and appeared in some cases to be of use, as at Pill, near Bristol, and, perhaps, at Southampton. It failed at Erfurt, but, as it is believed the wells were contaminated by soakage, this is perhaps no certain case. Chloride of lime and lime were used at Stettin without any good result, and, on the whole, it may be said that the so-called disinfection of the discharges of cholera does not seem to have been attended with very marked results. At the same time it cannot be for a moment contended that the plan has had a fair trial, and we can easily believe that unless there is a full understanding on the part of both medical men and the public of what is to be accomplished by this system, and a conscientious carrying out of the plan to its minutest details, no safe opinions of its efficacy or otherwise can be arrived at. It would be desirable to try the effect of chromic acid or bichromate of potash.

"With regard to air purifiers little evidence exists. Chlorine gas diffused in the air was tried very largely in Austria and Hungary in 1832, but without any good results. Nitrous-acid gas was used in Malta in 1865, but apparently did not have any decided influences, although Ramon da Luna has a.s.serted that it has a decided preservative effect, and that no one was attacked in Madrid who used fumigations of nitrous acid. But negative evidence of this kind is always doubtful. Charcoal in bulk appears to have no effect. Dr Sutherland saw a ship's crew severely attacked, although the ship was loaded with charcoal.

"Carbolic-acid vapour diffused in the atmosphere was largely used in 1866 in England; the liquid was sprinkled about with water, and sawdust moistened with it was laid on the floors and under the patients. The effect in preventing the spread of the disease was very uncertain.

"_Yellow Fever._ In this case the discharges, especially from the stomach, probably spread the disease, and disinfectants must be mixed with them.

"Fumigations of nitrous acid were employed by Ramon da Luna, and it is a.s.serted that no agent was so effectual in arresting the spread of the disease.

"_Dysentery._ It is well known that dysentery, and especially the putrid dysentery, may spread through an hospital from the practice of the same close stool or latrines being used. As long ago as 1807, fumigations of chlorine were used by Mojon to destroy the emanations from the stools, and with the best effects. The chlorine was diffused in the air, and the stools were not disinfected; but this ought to be done as in enteric fever, and especially in the sloughing form. It is probable that carbolic acid in large quant.i.ty would be efficacious.

"With respect to _Erysipelas_, _Diphtheria_, _Syphilis_, _Gonorrha_, _Glanders_, and _Farcy_, local applications are evidently required, and carbolic acid in various degrees of strength, and the metallic salts, are evidently the best measures.

"_Cattle Plague._ The experiments made by Mr Crookes on the disinfectant treatment of cattle plague with carbolic acid vapour have an important bearing on human disease. Although the observations fall short of demonstration there are grounds for thinking that when the air was kept constantly filled with carbolic acid vapour, the disease did not spread.

"So also euchlorine was employed in Lancashire by Professor Stone of Manchester, with apparent benefit. Dr Moffat employed ozone (developed by exposing phosphorus to the air), and he believes with benefit. As such experiments are very much more easily carried out on the diseases of animals than on those of men, it is much to be wished that the precise effect of the so-called disinfectants should be tested by continuing the experiments commenced by Mr Crookes, not only in cattle plague in the countries where it prevails, but in epizootic diseases generally.

"It may be said, in conclusion, that although positive evidence is so deficient, yet, taking into consideration the decidedly great and known effect of many so-called disinfectants, and air-purifiers on organic matters, and the fact that the infectious organic agencies are certainly easily destroyed in most cases (since free ventilation renders many of them inert, and few of them retain their power very long), it is highly probable that the specific poisons of the so-called zymotic diseases are destroyed by some of these chemical methods, and at any rate the careful and constant use of chemical agents for the destruction of the specific poisons in the excreta and discharges from the body, and when they pa.s.s into the air, is not only warranted, but should be considered comparative.

"_Purification of rooms after infectious diseases._ In addition to thorough cleansing of all woodwork with soft soap and water, to which a little carbolic acid has been added (1 pint of the common liquid to 3 or 4 gallons of water), and to removal and washing of all fabrics which can be removed, the brushing of the walls, the room should be fumigated for 3 hours with either the fumes of sulphurous or nitrous acids. Both of these are believed to be superior to chlorine, especially in smallpox. All doors and windows, and the chimney being closed, and curtains taken down, the sulphur is ignited as directed in our article FUMIGATION.

"In white-washed rooms the walls should be sc.r.a.ped, and then washed with hot lime to which carbolic acid is added.

"Mortuaries and dead-houses are best purified with nitrous acid."

These directions may be supplemented by the following:--The towels, sheets, articles of clothing, &c., should be boiled in water, or plunged in boiling water containing one to two handfuls of soda to the gallon, before being taken from the room, after which treatment they should be steeped in water containing 4 fluid ounces of carbolic acid to a gallon of water.

Fabrics soiled by the discharges, &c., such as rags, bandages, and dressings, if of little value should be immediately consigned to the flames; but if this be not convenient, they may be treated with carbolic acid and water, in the same manner as directed for towels, sheets, &c.

As soon as any infectious disease sets in, the room of the patient should be at once stripped of curtains, carpet, bed-curtains, valances, and all unnecessary garments, whether in a wardrobe or drawers, as well as of all superfluous furniture, especially chairs stuffed with wool or covered with fabric of any kind.

Disinfections of the apartment by fumigations must be postponed until it is vacated; as before such a time thorough disinfection is impossible.

Infected bedding, &c., should be removed in the boxes made for the purpose, and subjected to the heating process. In most towns provision is made by the Board of Guardians, and under the directions of the medical officer of health, for the disinfection process to be efficiently carried out. See DISINFECTING CHAMBERS.

The disinfection of articles of food is accomplished by thorough cooking, boiling in the case of milk, boiling and filtration in the case of water, and complete roasting, stewing, and frying of meat.

The experiments of Mr Crookes (to which reference has been made in the extract taken from Dr Parkes' 'Practical Hygiene') with carbolic acid during the cattle plague possess great practical interest both for the chemist and physiologist.

Of the use of carbolic acid as a disinfectant Mr Crookes, in the Appendix to the Report of the Cattle Plague Commissioners, writes as follows:

"According to the principles laid down, the air must be treated, and where there is no disease there is only a secondary use in treating anything besides the air. Several cowhouses have been treated with carbolic acid with very excellent results. The mode has been, first, to remove from the floor the ma.s.s of manure, which too often adheres to it; secondly, to sprinkle the floor with strong carbolic or cresylic acid; next, to wash the walls, beams, and rafters, and all that is visible in the cowhouse, with lime, in which is put some carbolic acid, 1 to 50 of the water used, or with strong carbolic acid alone. Next, to make a solution containing 1 of carbolic or cresylic acid to 100 of water, or, perhaps still better, 60 of water, and to water the yard and fold until the whole place smells strongly of the acid. Only a few farms have been treated in this way, so far as I know, but in each it has been successful. It may be well to give the cattle a little of the weak solution of carbolic acid, but this has not been so fully tried as the external use. The washing of the mouth and of the entire animal with the weak solution may be attended with good results, especially in the early stage of disease; but I know nothing of cure, and speak only hopefully of prevention.