Jkpailnunt of gealtft. 
Office of the Board of Health, 
Brooklyn. 
187 
To 
During the year 18?7 there were reported to this office 5,529 
cases of contagious diseases, of which 1,598 were fatal. 
The alarming prevalence of Scarlet Fever and Diphtheria at this 
time renders it imperative that every precaution should be taken 
by the members of those families in which they exist to prevent 
their spread. 
The Board of Health has directed the Sanitary Superintendent 
to take the following action : 
First.-To send a list of persons sick with Diphtheria and Scarlet 
Fever, and their residences, to the Principals of the Public Schools, 
daily. 
Second.-To notify the families of those sick with either Diph- 
theria or Scarlet Fever that, during the period of liability to the 
spread of these diseases,* no child in the house where such sickness 
is shall be allowed to attend any school. 
Whenever any child in your family is taken sick with Diph- 
theria or Scarlet Fever, such chjld, and all other children residing 
in the house, must be kept from school from the commencement 
of the disease until all possible danger of communicating it to 
others has passed. There is danger in Scarlet Fever so long as 
there is any roughness or peeling off of the skin,* and in Diph- 
theria until the physician states the patient to be free from the 
disease. After each case of either disease, the room occupied and 
the clothes and bedding used by the child should be fumigated* 
before it, or any one in the house, should be allowed to attend 
school or mingle with others. 
Very respectfully, 
y. Jd. Raymond, p., 
Sanitary Superintendent. 
*See " Circular of Recommendations " annexed. CIRCULAR of RECOMMENDATIONS 
FOR THE 
Sanitary Treatment of Scarlet Fever 
and Diphtheria. 
The Board of Health issues the following circular of recommendations, 
with the hope that those not familiar with the care of Scarlet Fever and Diph- 
theria may be benefited thereby. 
Scarlet Fever and Diphtheria are like Small Pox in their power to spread 
rapidly from person to person ; they are highly contagious. Scarlet Fever and 
Scarlatina are one and the same thing ; Scarlatina being the technical name 
for the disease, and not, as many think, a "tiny" form of Scarlet Fever; 
Canker-Rash and Rash Fever are other names for the same disease. 
When Scarlet Fever or Diphtheria occurs, the sick person, child or adult, 
should be placed in a room apart from the other inmates of the house, and 
should be nursed by as few persons as possible. 
The sick room should be comfortably warm, exposed to sunlight and well 
aired; at the commencement of the sickness only such furniture, bedding, 
clothes, etc., as are absolutely necessary should be left in the room ; carpets 
and window curtains should especially be removed, as the germs of disease 
find a lodgment in them and are difficult to displace. The family should 
not mingle with other people. Visitors should be warned of the presence of 
a dangerous disease in the house, and no one should be admitted. 
The clothing and bedding of nurse and patient should be frequently 
changed, and after being moistened with a solution of Carbolic Acid placed 
in boiling water for one hour. No other clothing or bedding should be washed 
at the same time with that which is infected. 
The clothing and bedding while in use, and the carpets, floors, walls and 
ceilings and the halls of the house should be sprinkled once or twice a day 
during sickness and convalescence with a solution of Carbolic Acid. A solu- 
tion of Carbolic Acid, well adapted to all such uses, is sold by most pharma- 
cists, and may be easily made by shaking together in a bottle the impure Car- 
bolic Acid and water in the proportion of a teaspoonful of the Carbolic Acid 
to a pint of water. This is best applied with a sprinkler, but may be well 
applied by dipping the end of a common dust brush into the solution con- 
tained in a dinner plate, and throwing it off the brush on bedding, carpets, 
walls, etc. 
On recovery from Scarlet Fever the sick person should not mingle with 
others until all roughness of the skin shall have disappeared, as the scales 
from the skin carry the disease ; at least six weeks is considered a proper 
period during which such isolation is necessary. In Diphtheria the patient 
should remain isolated until the physician states him to be free from the 
disease. When the patient has recovered, the walls of the room should be rubbed 
with a dry cloth, and the cloth burned at once without shaking. The ceiling 
should be scraped and whitened. The floor should be washed with soap and 
hot water, and Carbolic Acid added to the water (one pint to three gallons). 
For the purpose of fumigation the windows and doors of the room and 
the fire place should be tightly closed. Everything that was in the room dur- 
ing the sickness should be left in it. If the carpet was not removed it should 
be taken up and raised as far as possible from the floor on chairs or in any 
other manner ; one board of the floor should be taken up. 
An iron kettle should then be raised from the floor on bricks, and five 
pounds of sulphur placed therein ; upon this four ounces of alcohol are to be 
poured and set on fire. Every one must withdraw from the room, as the 
fumes are poisonous. 
The precautions taken with the carpet and the removal of the board from 
the floor allow the fumes of the burning sulphur to pass beneath the floor 
and between the walls, and to destroy any germs of disease which may be 
there. At the expiration of ten hours, not before, the room may be opened. 
All the windows, doors, and the fire-place should remain open for twenty four 
hours, that everything may be well-aired ; the room is then ready for 
occupation. 
In the cleansing of clothing and the fumigation every article which could 
possibly have been infected should be included, as even soiled handkerchiefs 
may communicate the disease. Shouil a second case occur, the entire house 
should be fumigated as above directed. 
The ocurrence of Diphtheria or Scarlet Fever in a house should lead to 
an immediate inspection of all possible sources of contagion. 
JFiY/un. the house : Trace to its source every foul smell, whether from ob- 
structed or leaking soil pipes, from water-closets and waste-pipes imperfectly 
trapped or defective at the joints ; from cellar-air tainted by forgotten and 
decomposing " rubbish," or from apartments filthy, overcrowded and poorly 
ventilated. 
In the yard: Remove all filth and decomposing substances ; clean and dis- 
infect foul-smelling privies, cesspools and cisterns ; clean and fill disused 
cesspools and privies. The latter are very numerous in this city and an es- 
pecial source of danger. 
Privies, Water-Closets, Drains, Sewers, Gutters, Collections of Decompos- 
ing Matters, etc., may be disinfected by the following solution: To ten gallons 
of boiling water, add ten pounds of Sulphate of Iron (Copperas) and one pint 
of Crude or impure Carbolic Acid, and mix thoroughly. This solution will 
cost eight to ten cents a gallon-less per barrel. 
To prevent infection of water-closets and privies, and to destroy odor, pour 
the solution into the pan or vault three or four times a day, at the rate of one 
pint for every four persons. Keep a little of this solution in the chamber 
vessel used by the sick. 
The officers of the Board of Health will cheerfully make examinations or 
fumigations of premises when desired.