Page:Tropical Diseases.djvu/473

From Wikisource
Jump to navigation Jump to search
This page has been proofread, but needs to be validated.
XXV]
PRECAUTIONS
431

have been thoroughly cleansed, disinfected, ventilated, and dried. Overcrowding must be strictly avoided. Ventilation must be effective. The dietary should be revised and, if necessary, rice should be eliminated; it may be replaced by meat, flour, or beans. All the inmates should be obliged to pass the larger part of every day in the open air; their knee-jerks should be tested, and their legs examined for numbness, œdema, and muscular hyperæsthesia from time to time. Any suspicious case should be removed at once.

Should beriberi appear on board ship, besides the precautions already indicated, on the assumption that there may be an infective as well as a dietetic element at the bottom of the disease, special means of disinfection must be employed. Rotten planking and bilge- water must be removed from the neighbourhood of the quarters of the crew; the sound woodwork should be scraped and painted; disinfectants should be freely and frequently employed, clothes and sea-chests washed and disinfected, and every means necessary to destroy lurking germs vigorously adopted.

In beriberi countries low-lying, damp situations should be avoided as building sites. The sleeping quarters, especially, should be raised well off the ground, and located, if possible, in an upper storey; all rooms should be so arranged as to be easily flushed with fresh air and flooded with sunlight.

As yet we know little of the virus of beriberi, if such there be, nor is our knowledge of the way in which it is acquired by any means complete. It may be communicable, and until we have more precise knowledge it is unjustifiable not to recognize the subjects of the disease as being possible sources of danger to others. Therefore, in the endemic zone, beriberics should be treated as infective and isolated. In gaols and similar institutions new-comers, whether manifestly suffering from beriberi or not, should be isolated and kept under special observation for a time, their clothes disinfected and body vermin scrupulously destroyed. Prison clothes and prison blankets especially should always be disinfected before being