Page:Tropical Diseases.djvu/397

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XX]
PROPHYLAXIS
355

Personal prophylaxis.— As regards the individual, all unnecessary visits either to plague patients or to plague neighbourhoods should be avoided and, if possible, prevented. The attendants on the sick ought especially to take care that the ventilation of the sick-room is thorough, that cubic space is abundant, and that the utmost cleanliness is practised. Nurses must not hang over patients unnecessarily; they must also be careful to seal up and cover any wounds, no matter how trifling, they may have on their hands; they must go into the open air frequently, and not remain in the wards too many hours at a stretch; they must employ disinfectants freely on themselves and on the excreta of their patients, and use a disinfectant mouth-wash from time to time; they must be careful to wash hands and face before eating, and they must never partake of food or drink in the ward or sick-room. By carefully observing these common-sense precautions, the risk in nursing plague patients is very much reduced, and is certainly very much less than that attending the nursing of cases of typhus or diphtheria. To obviate risk from wounds and to prevent the access of fleas and similar suctorial insects, those engaged on plague duties should wear boots and have the legs protected by trousers tied tightly round the ankles or, better, by putties. Leather gloves are advisable if there is much handling of furniture or of anything likely to abrade the skin. Hospital work is only dangerous when patients are allowed to lie in their dirty flea-, louse-, or bug-infested clothing, when disinfectants are not properly used, and when attendants are careless, stupid, or rash, or where the wards, in the matter of light and ventilation, are by their construction ill adapted for plague cases, and where a number of pneumonic cases are crowded into a single apartment. Cats or dogs should not be allowed near plague patients.

The attendants on pneumonic cases should provide themselves with masks of muslin, three or four fold, and changed when at all damp, and also with goggles to protect the eyes. In Mukden a mask of absorbent