PRACTICAL PHASES OF LABORATORY WORK. DR. C. F. DALTON, BURLINGTON, VT. I have envied you gentlement during the last four days as you have been up here on a sort of vacation, while I have been doing my regular routine work, and it has been a very busy time. Just to show you what Burlington can turn out in the line of health officer's duties, we have had five sudden deaths during the last four days. Burlington is getting to be quite metropolitan. At the beginning of this discussion I think it is my privilege and my duty to again voice the sentiments expressed by State's Attorney Gates in regard to the men who constitute the Laboratory staff. I believe that the most practical phase of the Laboratory of Hygiene is the character of the men who work there and I want to say to you, gentlemen, that possibly I, more than any one else, appreciate the uniform courtesy extended by every member of that staff. And I am sure the more you come in contact with Dr. Stone and his assistants, the more you will appreciate what I have said. We have more diphtheria here in Burlington than anywhere else in the state. So far this year we have had sixty cases; it seems to be endemic, but by constant vigilance we hope we are getting it under better control. I believe we should insist on having two consecutive negative cultures before the release of a case of diphtheria. I have talked this matter over very thoroughly with the physicians in my locality, and also with the families, and have told them plainly the reasons for asking for two such negative cultures. Sometimes I have had quite a bit of dispute with the physicians on the subject, but it had been demonstrated at the Laboratory that a positive culture quite frequently follows one negative culture, so it is plain that we should allow two, or better still, three days' interval before the second negative culture is taken. The length of time the bacilli are found in the throat varies. Dr. Stone tells me that the time average in a long series of cases at the Laboratory is fourteen days, that is from the date of the first positive culture. In the March number of Progressive Medicine several series of cases are reported in which the time ranges from eight to fifty-two days. I have attended these health officers' meetings for the last two or three years unofficially and have failed to ever hear a paper upon the subject of fumigation. I wish we might have instruction on this subject. Personally I use permanganate and formaldehyde. I should not feel safe in using candles. I find also that the solutions of formaldehyde vary greatly in strength. At the present time I have some formaldehyde which I think registers up to 40 per cent, but I have used formaldehyde which I am quite positive did not come up to that mark. I wish it might be possible for the Laboratory of Hygiene to examine the different fumigators and disinfectants and tells us what are the best to use; tell us whether the candles are effective and tell us whether the formaldehyde grades up to the 40 per cent or not. Dr. B. H. Stone. CLOSING DISCUSSION. I think it really makes very little difference what form of formaldehyde you use. The manner in which you generate the gas is only a matter of expense and convenience. If you want to pay a little more for some method that is a little more convenient to handle, you probably will get about the same results. From the small amount of work which we have done along the line of disinfectants, I feel that it is not safe to use less than a pint of 40 per cent formaldehyde or its equivalent for 1000 cubic feet of space. Dr. Dalton spoke about asking the Laboratory to make tests of standard formaldehyde solutions. I wish to say that is strictly within our duty under the Pure Food and Drug Law to make these tests whenever application is made. Any preparation sold for any prescribed standard of strength must be that strength, and it is our duty to examine specimens submitted at any and all times. If a solution is sold for 40 per cent formaldehyde solution, it is our duty to examine the same whenever we are asked so to do. You should send it in a sealed bottle so that no one can tamper with it while it is in transit. Dr. H. D. Holton. Do you know anything at all about how the candles stand? Dr. H. B. Stone. The required number as stated on the label is usually not sufficient. In most of these cases we have had to use two or three times the number of candles which they claim will do the work, to do it. If you use candles, you should know the amount of formaldehyde in each and you should use a number equivalent to sixteen ounces of the 40 per cent solution. They have a statement of the fact that we tried a certain number of candles in a room of a certain size with certain results. I do not remember in this particular case whether or not the number of candles required was the number of candles which they claim will do the work. My impression is that we used double the number which they recommended. Any results which we have ever published have stated the facts that so many candles have been used in such a sized room and the results were so and so. Any facts which we have ever submitted or published are reliable. |