AMERICANREVOLUTION.ORG

DOMESTIC MEDICINE

CHAP. IX.

OF INFECTION.

MOST diseases are infectious. Every person ought therefore, as far as he can, to avoid all communication with the diseased. The common practice of visiting the sick, though often well meant, has many ill consequences. Far be it from us to discourage any act of charity or benevolence, especially towards those in distress; but we cannot help blaming such as endanger their own or their neighbours lives by a mistaken friendship, or an impertinent curiosity.

THE houses of the sick, especially in the country, are generally crowded from morning till night with idle visitors. it is customary, in such places, for servants and young people to wait upon the sick by turns, and even to sit up with them all night. It would be a miracle indeed should such always escape. Experience teaches us the danger of this conduct. People often catch fevers in this way, and communicate them to others, till at length they become epidemic.

IT would be thought highly improper, for one who had not had the small-pox, to wait upon a patient in that disease; yet many other fevers are almost as infectious as the small-pox, and not less fatal. Some imagine, that fevers prove more fatal in villages than in great towns, for want of proper medical assistance. This may sometimes be the case; but we are inclined to think it oftener proceeds from the cause above mentioned.

WERE a plan to be laid down for communicating infection, it could not be done more effectually than by the common method of visiting the sick. Such visitors not only endanger themselves and their connections, but likewise hurt the sick. By crowding the house, they render the air unwholesome, and by their private whispers and dismal countenances disturb the imagination of the patient, and depress his spirits. Persons who are ill, especially in fevers, ought to be kept as quiet as possible. The sight of strange faces, and every thing that disturbs the mind, hurts them.

THE common practice in country-places of inviting great numbers of people to funerals, and crowding them into the same apartment where the corpse lies, is another way of spreading infection. The infection does not always die with the patient. Every thing that comes into contact with his body, while alive, receives the contagion, and some of the them, as clothes, blankets, &c. will retain it for a long time. Persons who die of infectious disorders ought not to lie long unburied; and people should keep, as much as possible, at a distance from them.

IT would tend greatly to prevent the spreading of infectious diseases, if those in health, were kept at a proper distance from the sick. The Jewish Legislator, among many other wise institutions for preserving health, has been peculiarly attentive to the means of preventing infection, or defilement as it is called, either from a diseased person or a dead body. In many cases the diseased were to be separated from those in health; and it was deemed a crime even to approach their habitations. If a person only touched a diseased or dead body, he was appointed to wash himself in water, and keep for some time at a distance from society.

INFECTIOUS diseases are often communicated by clothes. It is extremely dangerous to wear apparel which has been worn by the deceased, unless it has been well washed and fumigated, as infection may lodge a long time in it, and afterwards produce very tragical effects. This shews the danger of buying at random the clothes which have been used by other people.

INFECTIOUS disorders are frequently imported. Commerce, together with the riches of foreign climes, brings us also their diseases. These do often more than counterbalance all the advantages of that trade by means of which they are introduced. It is to be regretted, that so little care is commonly bestowed, either to prevent the introduction or spreading of infectious diseases. Some attention indeed is generally paid to the plague; but other diseases pass unregarded. Were the tenth part of the care taken to prevent the importation of diseases, that there is to prevent smuggling, it would be attended with many happy consequences. This might easily be done by appointing a physician at every considerable sea-port, to inspect the ship's company, passengers, &c. before they came ashore, and, if any fever or other infectious disorder prevailed, to order the ship to perform a short quarantine, and to send the sick to some hospital or proper place to be cured. He might likewise order all the clothes, bedding, &c. which had been used by the sick during the voyage, to be either destroyed, or thoroughly cleansed by fumigation, &c., before any of it were sent ashore. A scheme of this kind, if properly conducted, would prevent many fevers, and other infectious diseases, from being brought by sailors into sea-port towns, and by this means diffused all over the country.

INFECTION is often spread in cities by jails, hospitals, &c. These are frequently situated in the very middle of populous towns; and when infectious diseases break out in them, it is impossible for the inhabitants to escape. Did magistrates pay any regard to the health of the people, this evil might be easily remedied.

MANY are the causes which tend to diffuse infection through populous cities. The whole atmosphere of a large town is one contaminated mass, abounding with various kinds of infection, and must be pernicious to health. The best advice that we can give to such as are obliged to live in large cities, is, to chuse an open situation; to avoid narrow, dirty, crowded streets; to keep their own houses and offices clean; and to be as much abroad in the open air as their time will permit.

IT would tend greatly to prevent the spreading of infectious diseases, were proper nurses every where employed to take care of the sick. This might often save a family, or even a whole town, from from being infected by one person. We do not mean that people should abandon their friends or relations in distress, but only to put them on their guard against being too much in company with those who are afflicted with diseases of an infectious nature.

SUCH as wait upon the sick in infectious diseases, run very great hazard. They should stuff their noses with tobacco, or some other strong smelling herb, as rue, tansy, or the like. They ought likewise to keep the patient very clean, to sprinkle the room where he lies with vinegar, or other strong acids, frequently to admit a stream of fresh air into it, and to avoid the smell of his breath as much as they can. They ought never to go into company without having changed their clothes and washed their hands; otherwise, if the disease be infectious, they will in all probability carry the contagion along with them. There is reason to believe that infection is often conveyed from one place to another by the carelessness of the faculty themselves. Many physicians affect a familiar way of sitting upon the patient's bedside, and holding his arm for a considerable time. If the patient has the small-pox, or any other infectious disease, there is no doubt but the doctor's hands, clothes, &c. will carry away some of the infection; and, if he goes directly to visit another patient without washing his hands, changing his clothes, or being exposed to the open air, which is not seldom the case, is it any wonder that he should carry the disease along with him? Physicians not only endanger others, but also themselves, by this practice. And, indeed, they sometimes suffer for their want of care.

HOWEVER trifling it may appear to inconsiderate persons, we will venture to affirm, that a due attention to those things which tend to diffuse infection would be of great importance in preventing diseases. As most diseases are in some degree infectious, no one should continue long with the sick, except the necessary attendants. I mean not, however, by this caution, to deter those whose duty or office leads them to wait upon the sick, from such a laudable and necessary employment.

MANY things are in the power of the magistrate which would tend to prevent the spreading of infection; as the promoting of public cleanliness; removing jails, hospitals, burying grounds, and other places where infection may be generated, at a proper distance from great towns; widening the streets; pulling down useless walls; and taking all methods to promote a free circulation of air through every part of the town, &c. The ancients would not suffer even the Temples of their gods, where the sick resorted, to be built within the walls of a city. Public hospitals, or proper places of reception for the sick, provided they were kept clean, well ventilated, and placed in an open situation, would likewise tend to prevent the spreading of infection. Such places of reception would prevent the poor, when sick, from being visited by their idle or officious neighbours. They would likewise render it unnecessary for sick servants to be kept in their masters houses. Masters had better pay for having their servants taken care of in an hospital, than run the hazard of having an infectious disease diffused among a numerous family. Sick servants and poor people, when placed in hospltals, are not only less apt to diffuse infection among their neighbours, but have likewise the advantage of being well attended.

WE are not, however, to learn that hospitals, instead of preventing infection, may become the means of diffusing it. When they are placed in the middle of great towns; when numbers of patients are crowded together into small apartments; when there is a constant communication kept up between the citizens and the patients; and when cleanliness and ventilation are neglected, they become nests for hatching diseases, and every one who goes into them not only runs a risk of receiving infection himself, but likewise of communicating it to others. This, however, is not the fault of the hospitals, but of those who have the management of them. It were to be wished, that they were both more numerous, and upon a more respectable footing, as that would induce people to go into them with less reluctance. This is the more to be desired, because most of the putrid fevers and other infectious disorders break out among the poor, and are by them communicated to the better sort. Were proper attention paid to the first appearances of such disorders, and the patients early conveyed to an hospital, we should seldom see a putrid fever, which is almost as infectious as the plague, become epidemic.

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