Disinfection of the vacated room, then, consists in the destruction of all infectious particles which remain attached to surfaces, or lodged in crevices, in interstices of textile fabrics, etc. The object in view may be accomplished by thorough washing with one of the disinfecting solutions heretofore recommended; but most sanitarians think it advisable to disinfect the room" with a gaseous disinfectant, such as formaldehyd or sulphur dioxid. If the "fumigation" with sulphur dioxid is resorted to, the directions given by the Committee on Disinfectants of the American Public Health Association should be followed, i. e., three pounds of sulphur should be burned for every 1,000 cubic feet of air-space. But, as already stated, disinfection with formaldehyd gas is to be preferred (see page 15).

At the end of from twelve to twenty-four hours, doors and windows should be opened, and the room freely ventilated. After this fumigation, all surfaces should be washed with a disinfecting solution (chloride of lime two per cent, carbolic acid two per cent, or mercuric chlorid 1:1000), and afterwards thoroughly scrubbed with soap and hot water. Plastered walls should be white-washed.

Disinfection of Privy Vaults, Cesspools, etc. The contents of privy vaults and cesspools should never be allowed to accumulate unduly, or to become offensive. By frequent removal, and by the liberal use of antiseptics, such necessary receptacles of filth should be kept in a sanitary condition. The absorbent deodorants, such as dry earth or pounded charcoal,-or the chemical deodorants and antiseptics, such as chloride of zinc, sulphate of iron, etc.,-will, under ordinary circumstances, prevent such places from becoming offensive. Disinfection will only be required when it is known, or suspected, that infectious material, such as the dejections of patients with cholera, yellow fever, or typhoid fever, has been thrown into the receptacles. In the Manual for the Medical Department of the United States Army the following directions are given:

92. When accumulations of organic material undergoing decomposition cannot be removed or buried, they may be treated with an antiseptic solution, or with freshly burned quicklime. Quicklime is also a valuable disinfectant, and may be substituted for the more expensive chlorid of lime for disinfection of typhoid and cholera excreta, etc. For this purpose freshly prepared milk of lime should be used, containing about one part, by weight, of hydrate of lime, to eight of water.

93. During the prevalence of an epidemic, or when there is reason to believe that infectious material has been introduced from any source, latrines and cesspools may be treated with milk of lime, in the proportion of 5 parts to 100 parts of the contents of the vault, and the daily addition of 10 parts for 100 parts of daily increment of feces.

Hospitals The directions already given in regard to disinfection of the sick-room and its contents apply as well to hospital wards in which patients with infectious diseases are treated. In addition to this, it will be necessary in hospitals to guard against such infectious diseases as erysipelas, septicæmia, puerperal fever, and hospital gangrene. The antiseptic treatment of wounds, in connection with a proper regard for cleanliness and ventilation, has practically banished these diseases from well regulated hospitals. Of the first importance in effecting this are the precautions now taken with reference to the disinfection of sponges, instruments, the hands of attendants, etc.

Instruments of silver, such as probes and catheters, may be disinfected by passing them through the flame of an alcohol lamp. Instruments of steel, gum catheters, etc., may be disinfected by immersion in a five per cent solution of carbolic acid, or in a 1:1000 solution of mercuric chloride. For instruments and vessels of copper, brass, and tin, boiling water, or the carbolic acid solution, may be used. Vessels of porcelain or glass may be disinfected by heat, or by either of the disinfecting solutions mentioned. Sponges should be kept permanently in one of the disinfecting solutions, or, what is better, may be dispensed with entirely for the cleansing of wounds. In place of them, irrigation with a disinfectant solution may be resorted to, or the discharges may be wiped away with some cheap absorbent material which can be burned after having been once used.

Patients in hospitals, with infectious diseases, will of course be kept in isolated wards. Everything which comes from such a ward should be disinfected, and the immediate attendants of the sick should not be allowed to visit other parts of the hospital without first changing their outer clothing for a recently disinfected suit, and washing their hands in a disinfecting solution. When relieved from duty their underclothing should also be disinfected; and they should take a complete bath with one of the weak disinfecting solutions heretofore recommended.

Disinfection of Water and Articles of Food The disinfection of drinking water on a large scale, in reservoirs, wells, etc., is impracticable. But it is a very simple matter to disinfect water which is suspected of being contaminated with the germs of cholera, typhoid fever, or any other disease transmissible in this way. This is readily accomplished by boiling. As already stated, all known disease germs are destroyed by the boiling temperature maintained for half an hour. The importance of this precaution during the prevalence of an epidemic of cholera or typhoid fever cannot be over-estimated, when the water used for drinking purposes comes from an impure source, or is liable to contamination by discharges of patients suffering from these diseases. Those articles of food, and especially milk, animal broths, etc., which might serve as pabulum for disease germs, should, during the prevalence of an epidemic, be cooked but a short time before they are eaten. And such food, if put aside for hours after it has been prepared, should always be again subjected to a boiling temperature shortly before it is served. Food which gives evidence of commencing putrefaction is unfit for use, and in time of epidemics is especially dangerous.

Disinfection of Ships It should be the aim of a physician attached to a passenger ship, or of the master of a vessel having no physician on board, to prevent the vessel from becoming infected when in an infected port, or when cases of infectious disease occur on board. This is to be accomplished by keeping the ship clean; by disinfecting suspected articles, and especially the soiled clothing of passengers, before they are received on board; by the isolation of cases of infectious disease which occur on board; and by the thorough execution of those measures of disinfection recommended for the sick-room. When a case of cholera or of yellow fever occurs upon a ship at sea, it cannot be taken as evidence that the vessel is infected unless at least five days have elapsed since the person attacked came on board. For he may have contracted the disease from exposure at the port of departure, or in some other locality on shore. When, however, a longer time than this

has elapsed, or when several cases develop in a particular locality on shipboard, either simultaneously or successively, the vessel must be considered infected, unless it is shown that the cases are directly due to the opening of baggage containing infected clothing.

In practice, the sanitary officials at the port of arrival usually treat a vessel as infected if any case of infectious disease has occurred upon her during the voyage. This is a safe general rule, which should not be departed from unless a considerable time-five or seven days-has elapsed since the cases occurred, and they can be clearly traced to exposure before coming on board. In this case, if the ship is clean and the precautions relating to disinfection and isolation of the sick have been faithfully executed, the health officer may be justified in dispensing with the general measures of disinfection which are required for an infected ship.

These measures do not differ from those heretofore recommended for the disinfection of the sick-room and its contents; but the special conditions on shipboard, and the great interests at stake, make it essential that the execution of these measures should be in the hands of sanitary experts.

In the disinfection of ships, fumigation with sulphurous acid gas has been largely practiced by those in charge of quarantine establishments. The fact that the ship may be almost hermetically closed, and the escape of gas to a great extent prevented, makes this method of disinfection more trustworthy than in the case of dwellings and hospitals. The further fact, that certain parts of the ship are inaccessible for the application of disinfecting solutions, seems to make the use of a gaseous disinfectant imperative.

Disinfection by means of steam, especially of an iron vessel, would no doubt be a difficult matter on account of the condensation which would occur from contact with the cool walls of the vessel below the water-line. But it will be well to fill the vessel with steam before introducing the sulphur dioxid; for as already stated, the disinfecting power of this agent is much greater in presence of moisture. A well equipped quarantine establishment should have an apparatus for generating sulphurous acid gas, and injecting it into vessels, as this is the most expeditious and satisfactory method of fumigating a ship.

An essential part of the disinfection of a ship will consist in the thorough cleansing of the bilge. The International Sanitary Conference of Rome prescribed that the bilge water shall be pumped out and replaced by sea water at least twice at each disinfection of the vessel.

Merchandise Article V, of the Report of the Committee on Disinfection of the International Sanitary Conference of Rome, says:

"V. Disinfection of merchandise and of the mails is unnecessary. (Steam under pressure is the only reliable agent for the disinfection of rags-les chiffons en gros.)"

We think this statement too broad, especially so far as merchandise is concerned which has been on board a ship infected with yellow fever. The poison of this disease seems to be capable of self-multiplication on a foul ship in tropical latitudes, quite independently of passengers and crew. And there is ample evidence that even where no case has occurred on an infected ship at sea, those who are engaged in discharging her cargo after arrival in port may be seized with yellow fever from breathing the infected atmosphere of the hold. Evidently merchandise conveyed on such a ship should be dis

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ice. Humanity requires that during an epidemic the sick shall be , the dead buried, and the foul places cleansed. All this calls for and intelligent efforts of persons who have the courage to face and not only of those who by their profession are necessarily brought with the sick-physicians, clergymen, sanitary officials, nurses, also, of volunteers; for, during the prevalence of an epidemic of or of yellow fever, the number of physicians and trained nurses e affected area is commonly insufficient for the care of the sick, istory of epidemics shows that brave men and women are to be every civilized country, who are willing to volunteer for such perils; and also that physicians, and those whose legitimate duty it is to the sick, very rarely desert their post in time of danger; but the y among these brave men and women who stand by their guns, and the volunteers who go to their assistance, is often very great. There videspread notion among people not familiar with the facts, that enjoy a certain immunity from infectious diseases not possessed by eople, and that the absence of fear is a safeguard against infection. supposition is without foundation, and is an insult to the brave men men who fall at their post of duty in every epidemic. Courage is no a protection against disease germs than against bullets. It is true, n epidemics, as in war, the sulkers and cowards often run into danger the men in the ranks escape. The rashness which results from ignoor from thoughtlessness is not courage, any more than the prudence avoids danger when there is no good reason for facing it is cowardice. e who rashly venture within the lines drawn by an epidemic, in the ait or business or pleasure, on the supposition that they will escape the ailing disease because they are “not afraid," often fall victims to their easoning temerity, and not infrequently beat a hasty retreat, with ached face, when they are brought directly into the presence of the sick 1 dying.

Our advice to the brave is, Do not put your trust in your courage, for it no armor against infection. Rely rather upon those precautions which ence and experience indicate as best suited to the special circumstances in aich you may be placed, and do not hesitate to retreat before an invisible e, when you are not required by considerations of duty to remain upon the eld of battle. If your services are not required, you are simply in the way; nd if you fall ill, you add to the labors of those who devote themselves to he care of the sick. And to the timid we would say let not your fear control your actions, but look the circumstances fairly in the face, and be guided by reason and knowledge, or by the advice of those competent to decide for you. A premature flight may bring you into ridicule, or into greater dangers than those you flee from. Do not let your fears exaggerate the facts, and weigh these in the balance of your reason, and not of your apprehensions. The fact that Judge A or Col. B has fallen a victim to cholera or yellow fever is no more reason for deserting your home than is the fact that the humblest citizen of your town has died from the same disease.

If courage is no protection against infection, it cannot be denied that fear, in the presence of the infectious agent, is a predisposing cause which frequently determines an attack, and which may turn the balance in favor of a fatal result. The depressing effect of fear is well known, and all