RESTRICTION ANI) PREVENTION OF SCARLET 
FEVER, DIPHTHERIA, SMALL POX, AND 
OTHER INFECTIOUS DISEASES. 
FROM THE OFFICE OF THE R. I. STATE BOARD OF HEALTH. 
PUBLIC HEALTH TRACT NO. 2, 
Good personal health, is the foundation of individual enterprise and success. 
Individual health, in the aggregate, is public health. 
Good public health, is the essentially solid basis of national energy and 
prosperity. 
A nation of invalids is already in its decline. A nation of universally able- 
bodied citizens, in the fullness of physical and mental health, may defy adversity. 
How to prevent the occurrence of disease, and acquire, and preserve good 
health, is one of the most important studies of modern times. It is not only en- 
gaging the attention'of the Medical Profession, but also that of advanced and 
thoughtful minds in every community. 
Fortunately it is one, in which every intelligent individual can readily engage, 
and also one, which every person is under imperative moral obligations to pursue. 
No person can rightfully allow himself, his family, or his neighbor to become 
sick, when such sickness can be prevented by reasonable precautions. 
The design of this tract is to show in what way, many cases of contagious 
disease, may be prevented from spreading through a whole community, or light- 
ing up the disease at some future time or in some distant place, by restricting 
the infection to the original cases. 
The directions given will have particular reference to Scarlet Fever. This 
disease is also popularly known under the different other names, of Canker Rash, 
Scarlet Rash, Putrid Sore Throat, Scarlatina, etc., all and singular of which are 
produced by one and the same poison, and are capable of reproducing the same, 
and consequently infecting other persons with the same disease. 
It is not a long time since prominent physicians had doubts of the contagiousness of Scarlet 
Fever. The proofs of communicability, have however so multiplied in a few years of close obser- 
vation and investigation, that the question seems now to he definitely settled. 
Scarlet Fever is caused by the introduction within the body through the 
lungs, stomach or skin, of specific poisonous particles of matter, or organic 
germs. Individuals vary greatly in their readiness to receptivity of the disease 
germs, and their susceptibility to the effects of the inceptive action. But what- 
ever the degree of the disease, the same poisonous germs are reproduced, with 
equal power to produce the disease in other persons. 2 
The excretions or waste material from the bowels, kidneys, skin, lungs, 
mouth and nostrils, contain and carry out of, and away from the body, these 
particles or germs of the disease, which are so exceedingly minute in size, 
that they have never yet been detected by microscopic observation, and so light, 
as to float in the air for long periods of time, and for long distances, without hav- 
ing their poisonous qualities or vitality destroyed, by the moisture or dryness, the 
heat or cold, or the ordinary gases of the atmosphere. 
These germs, by their exceeding lightness, may separate from any of the 
emanations from the body, either after having been thrown out upon the surface 
of the ground, and rising therefrom to be wafted away in the currents of the air, 
to infect some other person or persons, weeks or months afterwards, and scores 
of miles away, or, separating immediately in the sick chamber from the breath, 
perspiration, scaling off, or other discharges from the body, may rise, and float- 
ing about in the room, infect some unwary caller, or find lodgment in some nook 
or crevice, or on some shelf, moulding, sash, ornament, curtain, drapery or other 
clothing, to be again dislodged from their resting places weeks, months or years 
afterwards, to affect some casual visitbr or new occupant, or be carried away in 
articles of furniture, ornament, or wearing apparel, to spread infection and carry 
dismay to other persons, and in other localities. 
Scarlet Fever is one of the most fatal of contagious diseases. 
By the Census of the United States for 1870, the mortality from this disease for the previous 
twenty years, is stated to average about one to every twenty from all other causes. 
But it is needless to go to statistics, to prove the necessity of all reasonable 
attempts to check the progress of the malady. 
When, therefore, it is ascertained, that a member of the family is affected with 
the disease, let the following directions be observed and carried out, as far as cir- 
cumstances will permit, under the supervision, and modification, when needed, 
of the physician in attendance. 
A close observance of them will be attended with considerable labor and incon- 
venience, but it must not be forgotten, that no person has a right to injure his 
own family, his neighbor, or his fellow man anywhere, by willful or indolent 
neglect of known duties. 
1. Entire separation of the sick from all other persons, except such as are 
absolutely required for attendance and nursing. Nothing can compensate for this 
precaution, for the restriction of the disease, and the welfare of the patient. 
2. The patient should betaken to a dry, well ventilated, and properly pre- 
pared apartment. An upper room is dryer,"and safer as well as more airy than one 
near the ground. The temperature should be kept between 68° and 72° F., as 
nearly as possible during the heated stage, and at about 76° thereafter. 
All furniture not really needed, all ornaments, pictures, books and maps, all 
valuable carpets, drapery or other cloth material that might be damaged by fumi- 
gation or disinfection, and all furniture upholstered with cloth, should be entirely 
removed. 
All large furniture not removable except with great difficulty, may, however, be covered with 
paper, and the paper covered with cloth, all which can be carefully removed and destroyed after 
the termination of the sickness. 3 
Pieces of carpet and old rugs may be used to cover the naked floor and disposed 
of as above, or disinfected by fumigation or beat. Fresh air should .have free 
access to the room, special care being taken to protect the patient from currents 
or drafts, or sudden introduction of large volumes of air of lower temperature 
than that of the room. 
3. The bed provided should be elastic and cool. Soft feather beds, or 
any into which the body of the patient sinks, are entirely inadmissible. Rubber 
sheets or other covering of firm material, laid over the bedding, drawn tight, and 
securely fastened to the sides of the bedstead, to prevent sinking down of the 
body, should be used when mattresses cannot be obtained. Rubber sheeting, 
properly applied, is a very effectual protection of the under bedding. 
4. Attention to cleanliness and disinfection is indispensable. The body 
and bed linen, and all larger clothes, should be frequently changed and imme- 
diately on removal, immersed in vesels containing a disinfecting solution, 
(Liquor Sod:e Chlorinat* one quart, water four gallons,) which should be kept in or near 
the room for the purpose of retaining soiled clothes until opportunity occurs for 
thoroughly boiling for at least one hour. 
Heat above the boiling point, whether by boiling or baking, is a powerful 
disinfectant, and effectually destructive of contagion germs. The clothing of 
nurses and attendants should also be disinfected before coming in contact with 
persons liable to infection, and the above precautions should be continued until 
the period of peeling or scaling of crumbled scurf skin has ceased. These fine 
branny or mealy scales are especially dangerous as carriers of the contagium 
of Scarlet Fever. 
Cotton clothing is much better than woolen for use in the sick room, being less likely to entangle 
and hold the scales or germs of contagion, and also more easily disinfected. 
The hands should be washed with Carbolic Acid Soap, or in diluted Chlorine 
Water, (One ounce to half pint of water,) or diluted Bromo Chloralum, (one ounce to half 
pint water,) The last is free from any-odor. The body of the patient should be 
bathed at least once every twenty-four hours in the solution (Liquor Sod* Chlorinatre 
one-half ounce, water one pint,) until cessation of peeling. 
5. All the larger discharges from the ncse or mouth, and all the stools and 
passages of water, should fall into vessels containing at least a half pint of a 
solution of green copperas, (One pound copperas to one gallon of hot water,) and carried 
at once to some distance from the house, and if possible covered with a light 
coating of dry earth. Keep out of streams of water, and away from the vicinity 
of wells. If water closets or privies must be used, let them be frequently and 
thoroughly disinfected. (See Public Health Tract No. 1.) 
Good napkins and handkerchiefs should not be used for the smaller discharges 
from the mouth and nose, but instead small pieces of old cotton cloths, which 
may be burned immediately after use. 
While good ventilation is indispensable in the sick room, some benefit may 
doubtless be derived from the diffusion therein, of some disinfecting gas like 
chlorine or ozone. Saucers partly filled with Chloride of Lime may be set in 
different places in the room, upon each of which a teaspoonfull or two of good 
sharp vinegar may be turned every three or four hours. The Lime should be re- 
newed when it ceases to give off the gas. Cloths may be wet with Liquor Soda; 
Chlorinatfe (One part to three of water,) or if Chlorine gas is very offensive to the 4 
patient or attendants, the cloths may be wet with Bromo Chloralum, which is with- 
out odor, (One part to four of water,) and hung up in different parts of the apartment. 
6. After the complete termination of the disease, all the contents of the sick 
chamber, all the material of every kind whatever, used during the sickness and 
remaining in the room unprotected, and the floor, walls, windows and ceiling of 
the room should be thoroughly disinfected by washing, fumigation or heat. 
Whatever is of small value had better be burned. The rooms should be washed 
thoroughly in every part with the following solution : 
( Sulphate Zinc, half a pound, crude Carbolic Acid dhe ounce, hot water, two gallons.) 
When practicable, the walls and ceilings, should be lime washed or kalsomined. 
To fumigate a room with Sulphurous Acid gas, the contents must be so ar- 
ranged that the fumes may come in contact with the entire surfaces of [all the 
articles to be disinfected, as well as sides of the apartment. 
Across a tub partly filled with water, place a pair of tongs or other support, for an iron basin or 
skillet, or thick earthen pan. Put in the basin or pan, a layer of ashes one inch thick, then a few 
bright live coals, upon which scatter at least one pound of powdered or crushed sulphur. Close 
the apartment tight, and leave for twenty-four hours. Then ventilate freely. 
To disinfect with heat alone, large ovens must be used, and the temperature 
carried up to a degree, at which bread would be rapidly baked, and cont inued 
for one hour. 
In case of death, the body should be wrapped in large cloths, thoroughly 
saturated with a strong solution of Chloride of Lime or Soda and placed in a 
coffin as soon as possible. 
Funerals of persons dying of contagious diseases, had better be held else- 
where, than at the residences of the deceased, and an open coffin should never 
be allowed. 
Whenever a virulent contagious disease occurs in any community, it is the duty 
of all citizens to cooperate with the afflicted family, in repelling the attack of the 
invader, and confining the disease to the first cases. 
To avoid attacks of infectious diseases, the directions suggested in Public 
Health Tract No. I should be strictly observed.. Breathing air containing 
sewer gas, or any gases of decay, or exhalations from any form of filth, in cess- 
pools, water closets, sinks, foul cellars, or uncleansed animal bodies, or repeat- 
re-breatliing one’s own breath, or the breath of others in closed rooms, 
especially in closed bed-rooms through the night, are unfailing sources of 
deterioration of general health, and whatever impairs general health, lessens the 
natural vigor of the individual, lessens the power of resisting the attacks of any 
disease, and especially predisposes to attacks of infectious maladies, like Scarlet 
Fever and Diphtheria, and also greatly increases the liability of death. 
While the above suggestions have particular reference to Scarlet Fever, many 
of them will apply equally well to other forms of contagious diseases. Small Pox 
preeminently, requires the same management. 
Paragraphs numbered one, two and three, are applicable to nearly all forms of 
dangerous maladies, while the first section of paragraph 5 has especial appli- 
cability to typhoid fever, and nearly all will apply equally well to diphtheria. 
Doubtless some will question the necessity of such sweeping precautions, but it may be suggested 
that to the neglect of such precautions, may be due in a great measure, the continued existence of 
infections diseases, whether in isolated or in epidemic visitations, and if preventable diseases are 
ever to be stamped out of existence, it can be accomplished only by such vigorous measures, as 
will effect the destruction of the disease producing germs, in their infancy. 
Let this be preserved for future use in ease of need.