THE PREVENTION AND CORRECTION OF VITIATED AIR.
The important part which vitiated air enacts in the production of many
forms of disease, has been already fully shewn; and it must be admitted,
that whatever has for its objects the prevention and correction of that
principle, is deserving of attention.
By preventing the production, and by removing vitiated air when already
formed, a vast amount of disease may be arrested, and much of that
benefit will actually be accomplished, which it was boldly but
fallaciously pronounced would revert from many absurd measures which
were adopted, and which are still recommended for the avoidance of
contagion, and would realize almost all the advantages which Quarantine
Regulations, and the most efficient systems of Contagion Police can or
propose to afford; and that, too, at no inconvenience to individuals, no
restraint upon communication, after certain processes of purification
have been undergone, and no ruinous hindrance of commercial
transactions.
The various sources of vitiated air have been already noted. Some of
them are beyond any present remedy, as the unwholesome condition of the
surface of the earth in many regions, within the tropics, for whose
correction or improvement, time, capital, enterprise, labour, and
perhaps new climates, are essential. To that source of vitiated air,
draining, cutting down superabundant wood, embanking rivers, reclaiming
partially inundated land, and cultivation, must be applied before the
emanations which infest these situations can be prevented from arising.
Another source of vitiated air is, men being crowded together in close
and confined apartments, where no attention is paid to the preservation
of cleanliness and the removal of impurities, as in some jails and other
places for the confinement of criminals.
That source of vitiated air is particularly worthy of notice here,
because a very common form of disease which it induces is what is well
known as Jail or Contagious Fever.
The means for the prevention of this form of vitiated air are obvious.
Large, airy, well ventilated and lofty apartments are essential, if many
persons must be put together; and, where that is not necessary, it is
advisable to have them separated in several different chambers, where
due ventilation is strictly maintained, by retaining the windows more or
less open through the day, or by other equally effective means.
By the sleeping of many persons in one apartment, the atmosphere is
deprived to a great extent of its more vital fluid, and becomes unfit to
support respiration in its integrity; and the health of the inmates is
not unfrequently injured in consequence. The sleeping of many persons in
one bed-room, therefore, should be avoided, where it is possible; but,
where that is not practicable, it becomes necessary to lessen the evil
consequences, and this may be done by keeping a door or window partially
open during the night, when the weather is not too inclement to forbid
that procedure.
At all times, exhalations to a great extent are proceeding from the
bodies of men; and, where individuals are much confined to one
apartment, and where that is small, close, and ill ventilated, they
fasten or adhere to the furniture, curtains, carpets, and the very
walls. During sleep, the amount of these exhalations, it would appear,
is increased. It is then that the pores of the entire system, as well
upon the internal as the external surfaces, are most freely laid open,
and that they pour forth their respective fluids most abundantly. The
quantity of watery vapour which issues during sleep from the lungs is
prodigious; and the large quantity of water which is sometimes seen
collected on the panes of windows in the morning, and which is condensed
vapour, affords some idea of the vast quantity of fluid which is exhaled
during sleep. With this watery vapour, other ingredients of a hurtful
nature are conjoined, and, like it, adhere to the furniture and clothes.
When these exhalations are permitted to remain, they impart to the room
a disagreeable odour, cause the bed-clothes to be damp and unwholesome,
which, with the progress of fermentation, at length emit offensive
effluvia. In order to avoid these hurtful consequences, the following
measures should be adopted. When the bed-room is left in the morning,
the window or windows should be opened, and the bed-clothes freely
exposed to the air for some time: the constant passing of fresh air over
the clothes and through the apartment, will shortly carry off the
greater part of the exhalations which may have adhered.
The window should be left open during a part of the day, if the
atmosphere without is not particularly damp, as the removal of
impurities, when they have adhered to solid bodies, is not effected at
once, or so immediately as is generally believed.
Exhalations of a very hurtful nature proceed also from excretions, which
should be removed immediately, certainly before fermentation can have
proceeded to any considerable length.
The furniture of bed-rooms requires special care. The various processes
of rubbing, washing, and scouring, should be frequently repeated; and
articles, such as bed and window curtains, should be oftener in the
washing-tub than is dreamt of by many very careful housekeepers, and
when they are composed of fabrics of a nature to forbid contact with
soap and water, the necessary purification may be effected, at least in
a partial manner, by occasional exposure to the wind in the open air.
In those apartments in which the sick are contained, the atmosphere is
particularly liable to become vitiated from the exhalations of the body,
and from the excretions being in general more disposed to be virulent
than those of persons in health.
The necessity for a constant supply of pure air is, if possible,
increased, and the utmost care and attention is demanded, in order that
this may be duly provided. In large hospitals for the reception of sick,
ventilation becomes a point of the most important nature; and, when
efficiently established, is entitled to be considered one of the most
powerful remedies which can be obtained to check the progress of
disease, and to promote recovery, when that is once established.
Various methods have been devised to promote ventilation in hospitals,
which it is unnecessary to describe here; for this reason, as well as
others, that the importance of ventilation is too well understood by
medical men, for them not to enforce it in establishments of which they
have the management.
During sickness in private houses, ventilation cannot be too much
enforced. When the weather will permit, one window at least should be
partially opened, pulled down, if possible, during the summer. In
winter, the door of the apartment should be left open for a short time
occasionally; and, if the chamber is not very small, a fire may be used,
which will not only remove the cutting dullness of the air, but will
also ensure a constant change of the atmosphere, from the ventilation
which it causes.
In some forms of disease, as in the “Sweating Sickness of England,”—the
typhus fever, the skin is wont to become covered with perspiration,
which is particularly prone to undergo putrefaction. To obviate that
putrefaction, and to prevent the formation of effluvia, it is proper to
wash the skin of the patient, in almost every form of disease, with soap
and warm water, which will purify that important organ, and assist in
rectifying its functions. Where the character of the disease is putrid,
sponging the skin with vinegar and water, either warm or cold, should be
adopted, and is often of the greatest use.
All impurities should be removed from the sick-room, as they are liable
to vitiate the atmosphere; and all clothes and utensils which have been
used by the patient should be immediately put among warm water, and left
there till a convenient season occur for their being thoroughly
cleansed.
When the patient is in a state to bear the fatigue of being removed for
part of the day to another chamber, advantage should be taken of his
absence from his bed-room, to ventilate the apartment, by throwing open
the doors and windows, to expose his bed and body clothes to the free
action of the air, and to cover the sickly smell frequently present in
sick chambers, by the burning or dissemination of some fragrant
substance in the atmosphere.
CORRECTION OF VITIATED AIR.
The effluvia which are wont to arise in sick-rooms, are sometimes so
very strong, especially where little attention is paid to cleanliness
and ventilation, as to fasten most tenaciously to the contents of the
apartments, and to impart to them a most disagreeable and sickly odour,
not immediately removeable upon the establishment of currents of air
obtained by opening the doors and windows.
These effluvia, for the most part, are cognizable to the organ of smell,
and they have long been, and are still, vaguely designated “Contagion,”
“Infection,” and the like.
Where effluvia are not recognised by the organ of smell, there are many
good reasons for believing, notwithstanding that circumstance, that they
may be present in rooms which contain, and which have lately contained,
sick persons.
Well authenticated cases are on record, where persons in health have
inhabited apartments which, at a former period, contained sick persons,
and have been attacked with disease in such a manner as to leave little
doubt of the presence of unwholesome effluvia, and of their having been
the efficient agency in the production of the evil. These instances have
occurred, where it is impossible to suppose that the effluvia could have
been commingled with the atmosphere during the whole interval, often
amounting to years, from the period of the removal of the sick, to that
of the taking up of their abode there by those who have suffered.
The period during which the apartment has been uninhabited has, on many
occasions, been too long to admit of the opinion that the atmosphere has
not been again and again changed. It would therefore appear, that not
only the atmosphere becomes infested, on those occasions, with effluvia,
but that the walls, the furniture, and the floors may likewise become
impregnated with them.
It is consonant with experience to admit, that solid bodies occasionally
combine with, or imbibe, or attract gasiform products, or that aeriform
or vaporic agents adhere to solid substances.
The opinion may be entertained, that the effluvia of sick rooms may
fasten to the furniture, &c., and in that situation, even where
ventilation is maintained, form centres from whence they may be
disengaged, either constantly, for a long period, or only on occasions
which are particularly favourable for their redissemination in the
atmosphere.
It is common to designate these effluvia primarily disseminated in the
atmosphere, and the vitiated air which is formed in old fever and plague
wards, and to which reference has just been made, Contagion, without any
other term to mark the distinction between these principles and those
which are legitimately so called. In a previous part of this work, the
distinction has been carefully made, and it was shewn that the effluvia
under discussion do not form, strictly speaking, a contagious, but only
a vitiated atmosphere.
As it appears that effluvia which arise from the bodies, and the
excretions of the sick, do not only mingle with the atmosphere, but also
adhere to furniture, walls, &c., when concentrated and long exhaled, it
becomes necessary not only to remove that atmosphere in which they are
disseminated, but also to adopt means for the purification of all those
bodies to which they may adhere, in order that the atmosphere may not
become again and again loaded with them, arising, as they may, from the
places to which they are adhering.
The means best calculated to obtain that end, are those processes to
which reference was made above, viz. rubbing, scouring, washing, and
exposing to the free action of the air.
But besides these means of purification, there are others, as
fumigations, which are calculated to be highly useful, and which should
be used on all occasions of severe general disease.
Fumigations are vapours of an elastic nature, permanent and
non-permanent. They are diffused through the atmosphere, and impart to
it their peculiar odours.
They are highly useful. In the _first_ place, there is reason to believe
that they, especially the more active, may decompose the effluvia which
are mingled with the atmosphere, and which are adhering to solid bodies,
all of which they can be made to reach and act upon, and even to
penetrate where the scrubbing-brush and hot water cannot be applied; in
the _second_ place, they insure a change of atmosphere; and, in the
_third_ place, they effectually cover or hide the smell of the
sick-room, which is at all times highly disagreeable, and which is often
regarded with great terror and apprehension, being ever associated with
ideas of contagion and disease;—and in this way, fumigations are found
of very great value, giving, at the same time confidence to the timid,
and affording something different from what contagion is commonly
thought to be, on which the organ of smell may be safely exercised.
Some fumigations are produced by the volatilization of solid bodies, as
camphor and carbonate of ammonia, or sal volatile;—some by the
volatilization of liquids, such as vinegar, pyroligneous acid, and the
various essential oils, as cinnamon, rose, thyme, mint, pennyroyal,
carraway, and turpentine, while others are permanently elastic fluids or
gases, as muriatic acid gas, chlorine, and ammonia.
The first-mentioned substances, viz. camphor and ammonia, are not very
strong, and may be disseminated through the apartment of the patient,
even when he is present, without giving him any uneasiness. Carried
about with those who visit the sick, and who are apprehensive of
contagion, they are useful by affording a grateful odour, which hides
disagreeable taints, and perhaps it is in that way chiefly that they are
useful.
The liquids which have been named above, have been long used for the
purposes of fumigation, and in general, they may be employed even in the
presence of the patient. A few of them may possibly decompose effluvia,
but there is much reason to think that they are useful, for the most
part, by hiding ungrateful odours, and imparting to the atmosphere,
which is liable to be suspected as unwholesome, a delightful fragrance.
Vinegar is much used for the purpose, and with very considerable
benefit, and is therefore to be employed.
The essential oils are capable of being diffused throughout the air, and
with the assistance of heat, are often made available for the purpose of
covering odours. When they are to be used, the oils should be poured
upon a piece of live coal, held in the middle of the apartment; they are
then immediately converted into vapour. In like manner, vinegar and the
other volatile liquids may be disseminated through the atmosphere.
The oils, the vegetable substances in which they are contained, tar and
the like, are occasionally burnt with the same intention, and sometimes
with advantage.
The incense so much used by the ancients, was procured for the most part
by the burning of the vegetable substances in which these essential and
fragrant oils resided, by which part of them is diffused in vapour.
The ostensible and pretended object of the priests, in offering up
incense, while that and other religious rites were performing over the
bodies of deceased persons, was the conciliation and propitiation of the
Deity. But while this was the sole ostensible object of the priests, and
that which was held by the people, as the only and exclusive purpose
proposed, there is good reason to believe that the offering up of
incense, like many other observances of religion, had its temporal, and
worldly, as well as spiritual ends; and that the sweet smelling odours,
which were thought would be so grateful to Heaven, were, on those
occasions, used in no small degree, as so many fumigations, to defend
the pious and resigned priests from the effluvia of the dead body, and
the consequent corruption of the atmosphere.
The use of fumigations, in a disguised form, was perhaps rendered
necessary, as the purpose of purifying the atmosphere, might have seemed
to cast reflections or imputations on the dead, which the vile,
barbarous, and superstitious people, especially relatives, might have
resented with acts of violence, or which might have thrown priest-craft
into contempt and abhorrence.
Perhaps it was in reference to this matter, as it was in many others of
graver import, that the ignorant and superstitious condition of the
people on the one hand, and the cunning, subtlety, despotism, and
superior knowledge of the ministers of religion on the other, in early
times, made it convenient that certain ends, thought to be desirable,
should be accomplished without reasons, explanations, or intentions
being given.
There is, then, reason to believe, that the burning of oils and other
fragrant substances, was used in very early times to purify the
atmosphere from the effluvia of dead bodies.
The products of the combustion of essential oils, tar, pitch, and the
like, are carbonic acid gas and watery vapour, which, there is reason to
think, cannot be useful in purifying the air, or in neutralizing hurtful
effluvia.
The permanently elastic gases which are used as fumigations, are the
most potent agents of the kind, and they are generally used, and with
much propriety and advantage, in all cases where disease is of a putrid
character, and where, in short, the atmosphere is likely to be vitiated
to a great extent. They form also the most useful fumigations for the
purpose of purifying the atmosphere, and the walls and furniture of
apartments lately inhabited by the sick, and their employment, in such
cases, should never be neglected, even when there is no great reason to
apprehend vitiation of the atmosphere, for when advantage is doubtful,
there can exist no possibility of detriment. The agent now most commonly
employed, is chlorine gas, and it is perhaps the most efficient in the
list of fumigations.
Chlorine gas has a greenish colour, and a most disagreeable and
suffocating odour. Water impregnated with it, has the property of
destroying colours, and chlorine is, on that account, much employed in
bleaching, in the forms of “Bleaching Powder” and “Tennant’s Powder.”
When chlorine gas is disseminated through an apartment, any stench,
however strong and intolerable, which may have been present there, is no
longer perceptible, the odour of the chlorine taking its place, or so
completely covering it, as to render it no longer cognisable to the
senses.
Chlorine gas is employed both alone, and in combination with other
bodies, as lime and soda.
In combination with these alkalis, chlorine forms the chlorides of lime
and soda. The former is well known in this country, and the latter, when
dissolved in water, forms the “Liqueur disinfectante” of Monsieur
Labarraque, which is much celebrated on the Continent.
The solutions of these salts in water, are sprinkled occasionally
through the apartments which are to be purified.
When these solutions are sprinkled about, and exposed to the action of
the air, the chlorine escapes in its gaseous form and mingles with the
atmosphere, while the lime and soda, which are now uncombined, attract
and unite with any carbonic acid which may have arisen from the patient,
his clothes, or excretions.
The solution of chloride or chloruret of lime, answers sufficiently
well, but as it is to be obtained in all drug shops, it is unnecessary
to add here a formula for its preparation.
FORMULA FOR THE PREPARATION OF CHLORINE GAS.
Take three parts of common salt, one of black oxide of manganese, and
three of strong oil of vitriol. Mix the salt and the oxide together in a
stoppered retort, pour in the oil of vitriol and apply a gentle heat.
The gas is immediately evolved, and rapidly diffuses itself throughout
the atmosphere. Muriatic acid gas, a combination of chlorine and
hydrogen gases, though considered as inferior to chlorine as a
fumigation, is frequently employed for the purpose of decomposing
effluvia, as the materials for its preparation are almost ever at hand.
FORMULA FOR OBTAINING MURIATIC ACID GAS.
Put a handful of common salt previously made very hot into a saucer, and
pour over it an ounce of strong oil of vitriol. The gas is immediately
extricated.
It has been already said that the fumigations just noticed are on many
occasions highly useful, and their employment is much recommended in all
situations where the atmosphere is liable to be contaminated by effluvia
from sick persons or from dead bodies; but it is not therefore to be
understood that, because the use of these agents has been advocated, it
is for the purpose of destroying atmospheric contagion, of decomposing
the specific animal poisons which have been supposed to be present, and
dissolved in the atmosphere, which is the object, or one of the objects,
held in view by the generality of those who advise the use of
fumigations. These fumigations have been recommended with the view of
correcting what has been treated of as vitiated air, which is distinct
from, but which has long been erroneously regarded as, Atmospheric
Contagion. On some occasions, great fires of wood, coal, pitch,
gunpowder, and the like, have been recommended for the purpose of
destroying contagion and purifying the atmosphere. During the prevalence
of the plague in London, great fires were kindled in the streets, and,
according to some historians, with considerable benefit.
Such great fires produce great agitation of the atmosphere, and it is
possible that in this way they may prove useful in improving the
condition of that fluid, particularly when, as happened occasionally
during the visitations of plague in London, the weather is sultry and
close, and when the atmosphere is confined and little agitated, and
allowed almost to stagnate.
There is much reason to think that the agitation of the ocean, by its
waves and tides, is not more favourable to the preservation of the
purity of its waters, than the movement of the atmosphere, by winds and
currents, is to the maintenance of its wholesome condition, and when
this is lost, to restore it; and in the absence of winds, and when
pestilence is raging, the use of combustion on a large scale may with
advantage be adopted; but in this climate, where the weather is seldom
long calm, the occasions for the employment of that agency can be very
rare indeed.
Heat is much used for the purpose of dissipating effluvia, and purifying
goods, clothes, letters, &c., which are supposed to be impregnated with
contagious matter, or other unwholesome impurities; and there is good
evidence to shew that this agent is perhaps the most powerful instrument
which is ever employed for the purpose in question.
Heat when applied to an atmosphere containing effluvia will rarefy it,
cause it to become lighter, and dissipate it, amid the atmosphere above,
where any opportunity is afforded for its egress; and when the heat is
employed in the sick chamber, much good is effected by the dissipation
of the damp and condensed vapour which cannot fail to be frequently
present in that situation.
In the sick chamber, the presence of a fire for even an hour daily is
highly useful where there is little opportunity for ventilation, and
when the external atmosphere is damp and motionless, for the heat
issuing from it, will dislodge and dissipate any effluvia which may have
become condensed, and have fastened on the furniture of the apartment.
The condensation of effluvia, &c., is thus depicted in the “Mussulman.”
The apartment is that of a prison. —— The pestiferous breath of the
surviving was mingled with the effluvia from the dead, and the
empoisoned exhalation was condensed on the damp walls, and was seen
trickling down in drops of poison to the ground.[10]
Footnote 10:
The Mussulman by Madden.
Heat, when applied to clothes which are impregnated with specific
contagious matter, or merely impurities or condensed effluvia, is
calculated to be highly useful, and where washing cannot be adopted,
should never be neglected. Clothes which are thus tainted will be
deprived in a great measure of their power of doing mischief, by placing
them before a fire for a considerable time, for there is good reason to
think that specific contagious poisons will be decomposed, and it is
ascertained that condensed effluvia may be dissipated by the application
of a smart heat.
The following experiment will at once illustrate the property which some
bodies possess of absorbing effluvia from the atmosphere, and prove the
influence of heat in again expelling and dissipating them. Pure sand,
exposed to a red heat to drive off impurities, was put amidst tainted
air. Put into a glass tube and exposed to a spirit lamp, it yielded
ammonia or hartshorn,—a product of putrefaction which the sand had
undoubtedly absorbed from the tainted atmosphere. Ammonia is a compound
of nitrogen and hydrogen, gases which are evolved during the
putrefaction of animal materials.
The investigation of the means by which persons, merchandize, clothes,
letters, &c., may be most speedily and most effectually freed from
effluvia, contagion, and other unwholesome impurities, is a most
important point, for it relates to the most vital interests of society,
commerce, freedom of intercourse, personal liberty, and the safety and
health of the community. But from the very important considerations with
which the investigation is connected, the merits of the respective means
employed for the purpose will not be treated of here, as they deserve a
more extended consideration than can be given. In the mean time it would
be highly dangerous and impolitic, to adopt any great and rash change in
a system so important as quarantine, until the most full and sound
inquiry has been made upon the subject. Public safety demands the utmost
caution.
There may exist great diversity of opinion respecting the nature of the
impurities with which merchandize and clothes are sometimes impregnated,
on the period during which they retain their activity, and on the means
of purification; but it has been often clearly demonstrated, that
specific contagious matter, or virus, and effluvia, may be conveyed by
these bodies, may be retained for a considerable time, and, on a
favourable opportunity, produce very hurtful effects.
The impurities may be variously designated, yet their unwholesome
tendency is much the same, and it is necessary to adopt provisions to
counteract it.