[Reprinted from The Medical News, December 17, 1892.] 
SOME PRECAUTIONS AGAINST THE SPREAD 
OF CONTAGIOUS DISEASES, ESPECIALLY 
IN CHILDREN. 
By JOHN GRAHAM, M.D., 
OF PHlTADELPHIA. 
The surgeon and the obstetrician utilize the 
means that experiment and observation have proved, 
necessary to render their work aseptic. In case of 
the entrance of diseased germs, they take prompt 
means to destroy them, or to neutralize their effects. 
It behooves us, who practise among children suffer- 
ing from contagious diseases, to inquire if we are 
equally careful. 
The surgeon about to open an abdominal cavity 
removes all possible sources of infection from his 
patient's person and environment, and goes to his 
work with clean linen and clean hands. Do we do 
likewise ? 
Some time ago a prominent operator sent me an 
invitation to witness an abdominal section, adding 
in his note, " Provided you have not visited a case 
of scarlet fever or other contagious disease during 
the last twenty-four hours." I could not but think, 
If such precaution is necessary to insure the safety 
of this patient, what are the risks to the little 
children that I shall visit after seeing the case of 2 
scarlet fever or other contagious disease, and whose 
systems are fertile soils for the poison to develop 
in ? 
The danger of such conveyance is great, as physi- 
cians with large family practice know, and many, 
like myself, have been taught the lesson by sad ex- 
perience. I can recall several instances in which the 
children of physicians have fallen victims to scarlet 
fever and diphtheria, the cause being clearly traced 
to disease brought home by their fathers. 
Let me illustrate this danger by a description of 
a physician's visit to a case of diphtheria. The 
doctor enters the house, removes his hat, overcoat, 
and gloves, and is shown into the room containing 
the patient, and comes into direct contact with the 
atmosphere loaded with the germs of the disease. 
His hair, woollen clothing, hands, etc., must more 
or less absorb the poison, in his stay of about fifteen 
minutes. What does he then do ? He replaces his 
overcoat, carefully buttoning it up, as if to keep as 
many of the germs as possible warm and well pro- 
tected. He puts on his hat as he crosses the thresh- 
hold, jumps into his carriage, covers himself with 
robes, and drives to his next patient; enters, takes 
off his hat and coat, and woe to any little ones who 
live in that house ! The doctor has probably that 
with him which will more likely kill than cure. 
What should be done to diminish this danger? 
Stay no longer in a house containing a contagious 
disease than is absolutely necessary. Do not remove 
your hat or unbutton yout coat in that house. After 
examining the patient go down stairs, preferably at 
an open door or window, and give directions for 3 
treatment. The family of the patient will respect you 
for the care you exercise, when you explain the 
reason. Drive without covering with robes to your 
next patient, and be sure that patient is not a child. 
Never allow a messenger from a case of contagious 
disease to call or wait for you in your office. In- 
struct him to bring written messages and leave them 
at your door. If the messenger wishes to speak to 
you, tell him to wait outside your office and ask the 
servant to call you to the door. 
I have more than once been startled on entering 
my office to see a man or woman whom I knew had 
been constantly for days and nights nursing a bad 
case of diphtheria, sitting complacently alongside 
of two or three little children, all waiting to see me. 
On several occasions mothershave brought children, 
suffering from severe attacks of diphtheria, to my 
office and waited to see me. 
When you come home from a case of contagious 
disease, besides washing your hands, face, and head 
with soap and water, hang up your hat and coat in 
the air, and put on a fresh coat. 
I did this some time ago and forgot to bring them 
in when I went to bed. It rained hard all night- 
but better lose a hat and coat than a patient! 
If you return late at night from a case of conta- 
gious disease, besides washing, undress before going 
into the room where your children are. Keep your 
own children out of your office, and do not take 
them in the carriage with you when visiting patients. 
How do you know but some of your calls may be 
upon those with contagious diseases ? 
Our Board of Health instructs us, in cases of 4 
contagious disease, to forbid the children of the 
household to attend school or other places of public 
resort. This is a wise precaution, and the doctor, 
when he has been in contact with contagious dis- 
ease, should, as far as possible, follow the advice 
given to the children. 
We are told that familiarity with crime leads us 
to endure it. Likewise familiarity with contagious 
disease is likely to make us at times careless in using 
the means necessary to prevent its spread. Physi- 
cians are but mortals, and while as a body they are 
conscientious in the discharge of their duties, candor 
compels me to confess that they are not at all times 
as careful as they should be. 
326 S. Fifteenth Street.