To dogmatise on questions of medical practice is to invite controversy
and tempt disaster. The highest wisdom of to-day may be completely
refuted by to-morrow’s discovery. Therefore, for the simple principles
of disease prevention and health protection which I have put into the
mouth of my Health Master, I make no claim of finality. In support of
them I maintain only that they represent the progressive specialized
thought of modern medical science. So far as is practicable I have
avoided questions upon which there is serious difference of belief
among the authorities. Where it has been necessary to touch upon these,
as, for example, in the chapter on methods of isolation in contagious
diseases, a question which arises sooner or later in every household, I
have advocated those measures which have the support of the best
rational probability and statistical support.
Not only has the book been prepared in consultation with the recognized
authorities on public health and preventive medicine, but every chapter
has been submitted to the expert criticism of specialists upon the
particular subject treated. My own ideas and theories I have advanced
only in such passages as deal with the relation of the physician and of
the citizen to the social and ethical phases of public health. To the
large number of medical scientists, both public and private, whose
generous aid and counsel have made my work possible, I gratefully
acknowledge my debt. My thanks are due also for permission to reprint,
to the _Delineator_, in which most of the chapters have appeared
serially; to _Collier’s Weekly_, and to the _Ladies’ Home Journal_.
The Author.
I.
THE CHINESE PLAN PHYSICIAN
THE eleven-o’clock car was just leaving Monument Square when Mr. Thomas
Clyde swung aboard with an ease and agility worthy of a younger and
less portly man. Fortune favored him with an unoccupied seat, into
which he dropped gratefully. Just in front of him sprawled a
heavy-shouldered young man, apparently asleep. Mr. Clyde was
unfavorably impressed both by his appearance and by the manner of his
breathing, which was as excessive as it was unusual. As the car swung
sharply around a curve the young man’s body sagged at the waist, and
lopped over toward the aisle. Before Mr. Clyde’s restraining hand could
close upon his shoulder, he had tumbled outward to the floor, and lay
quiet, with upturned face. There was a stir through the car.
“The horrid drunken creature!” exclaimed a black-clad woman opposite
Mr. Clyde. “Why do they allow such people on the cars?”
The conductor hurried forward, only to find his way blocked by a very
tall, slender man who had quietly stepped, from a seat next the window,
over an intervening messenger boy and the box he was carrying. The new
arrival on the scene of action stooped over the prostrate figure. One
glance apparently satisfied him. With a swift, sharp motion he slapped
the inert man forcefully across the cheek. The sound of the impact was
startlingly loud. The senseless head rolled over upon the left
shoulder, only to be straightened out by another quick blow. A murmur
of indignation and disgust hummed and passed, and the woman in black
called upon the conductor to stop the assault. But Mr. Thomas Clyde,
being a person of decision and action, was before the official. He
caught the assailant’s arm as it swung back again.
“Let him alone! What do you mean by beating a helpless man that way!”
“Do you know more about this affair than I do?” The crisp query was
accompanied by a backward thrust of the tall man’s elbow which broke
Mr. Clyde’s hold, and—smack! smack!—the swift double blow rocked the
victim’s head again. This time the man groaned. The car was in an
uproar. Mr. Clyde instantly and effectively pinned the tall man’s
elbows from behind. Some one pulled the bell, and the brakes ground,
throwing those forward who had pressed into the aisle. Against this
pressure, Mr. Clyde, aided by the conductor, began dragging his man
backward. The stranger was helpless to resist this grip; but as he was
forced away he perpetrated a final atrocity. Shooting out one long leg,
he caught the toe of his boot under the outstretched man’s jawbone and
jerked the chin back. This time, the object of the violence not only
groaned, but opened his eyes.
“I’ll have you in jail for that!” panted Mr. Clyde, his usually placid
temper surging up.
Other passengers began to lift the victim.
“Drop him!” snapped the tall man, with such imperative decisiveness,
that the helping hands involuntarily retracted. “Let him lie, you
fools! Do you want to kill him?”
Misgivings beset and cooled Mr. Thomas Clyde. He had now reached the
rear platform, still holding in his powerful and disabling grasp the
unknown man, when he heard a voice from an automobile which had been
halted by the abrupt stop of the car.
“Can I be of any help?”
“Dr. Magruder!” exclaimed Mr. Clyde, “come in here, will you, and look
at a sick man?”
As the doctor stepped aboard, the captive with a violent wrench freed
himself from Mr. Clyde’s relaxing hold and dropped from the platform
into the darkness. Dr. Magruder forced his way through the crowd, took
one look at the patient, and, right and left, struck him powerfully
across the cheeks time and again, until the leaden-lidded eyes opened
again. There was a quick recourse to the physician’s little satchel;
then—
“All right,” said the doctor cheerfully. “He’ll do now. But, my friend,
with that heart of yours, you want to sign the pledge or make your
will. It was touch and go with you that time.”
Waiting to hear no more, Mr. Thomas Clyde jumped from the rear step and
set off at a rapid pace, looking about him as he ran. He had not gone a
block when he saw, by the radiance of an electric light, a tall figure
leaning against a tree in an attitude of nerveless dejection. The
figure straightened up.
“Don’t try to man-handle me again,” advised the man, “or you may meet
with a disappointment.”
“I’ve come to apologize.”
“Very well,” returned the other coolly; “I appreciate it. Many a fool
wouldn’t go even so far.” Mr. Clyde smiled. “I own to the soft
impeachment. From what Dr. Magruder said I judge you saved that fellow
from the hospital.”
“I judge I did—no thanks to you! You’ve a grip like a vise.”
“Yes; I keep in good training,” said the other pleasantly. “A man of my
age has to, if he is to hold up his work.” He looked concernedly at the
stranger who had involuntarily lapsed against the tree again. “See
here,” he added, “I don’t believe you’re well.”
“No; I don’t believe I am,” answered the tall man in uncompromising
tones; “but I do believe that it is peculiarly my own affair whether I
am or not.”
“Nonsense! Man, your nerves are on the jump. You used yourself up on
that chap in the street car. Come across to my club and take something
to brace you up.”
People usually found it hard to resist Mr. Clyde’s quiet
persuasiveness. The stranger, after a moment of consideration, smiled.
“Begin with a fight and end with a drink?” he asked. “That’s a reversal
of the usual process. If your cuisine runs to a cup of hot milk as late
as this, I’d be glad to have it.”
As they entered the club, Mr. Clyde turned to his guest.
“What name shall I register?”
The stranger hesitated. “Strong,” he said finally.
“Dr. Strong?”
“Well—yes—Dr. Strong if you will.”
“Of what place?”
“Any place—Calcutta, Paris, Mexico City, Philadelphia, Rio. I’ve tried
‘em all. I’m a man without a country, as I am without a profession.” He
spoke with the unguarded bitterness of shaken nerves.
“Without a profession! But you said ‘Doctor.’”
“A title isn’t a profession,” returned the guest shortly.
Turning that over in his mind, Mr. Clyde led the way to a quiet table
in the corner of the diningroom, where he gave his order. Observing
that his new acquaintance was _distrait_, he swung into the easy
conversational flow of a cultured man of the world, at the same time
setting his keen judgment of men to work upon the other. There was much
there to interest a close observer. The face indicated not much over
thirty years; but there were harsh lines in the broad and thoughtful
forehead, and the hair that waved away from it was irregularly blotched
with gray. The eyes, very clear and liquid, were marred by an
expression of restlessness and stress. The mouth was clear-cut, with an
expression of rather sardonic humor. Altogether it was a face to remark
and remember; keen, intellectual, humorous, and worn. Mr. Thomas Clyde
decided that he liked the man.
“You’ve been a traveler, Doctor?” he asked.
“Yes. I’ve seen life in many countries—and death.”
“And traced the relations between them, I suppose?”
“Oh, I’ve flashed my little pin-point lantern at the Great Darkness in
the fond hope of discovering something,” returned the other cynically.
“In a way, I’m interested in those matters,” continued Mr. Clyde.
“They’ve organized a Public Health League here, and made me president
of it. More from finance than fitness,” he added, humorously.
“Finance has its part, too,” said the other. “Give me millions enough
and I’ll rid any city of its worst scourge, tuberculosis.”
“Then I wish to Heaven you had the millions to spend here in
Worthington! We’re in a bad way. Two years ago we elected a reform
administration. The Mayor put in a new Health Officer and we looked for
results. We’ve had them—the wrong kind. The death rate from
tuberculosis has gone up twenty-five per cent, and the number of cases
nearly fifty per cent since he took office.”
“You don’t say so!” said the stranger, showing his first evidence of
animation. “That’s good.” Mr. Clyde stared. “You think so? Then you’ll
undoubtedly be pleased to learn that other diseases are increasing
almost at the same rate: measles, scarlet fever, and so on.”
“Fine!” said Dr. Strong.
“And finally, our general mortality rate has gone up a full point. We
propose to take some action regarding it.”
“Quite right. You certainly ought to.” Something in his guest’s tone
made Mr. Clyde suspicious. “What action would you suggest, then? he
asked.
“A vote of confidence in your Health Officer.”
“You propose that we indorse the man who is responsible for a marked
rise in our mortality figures?”
“Certainly.”
“In the name of all that’s absurd, why?”
“Let me answer that by another question. If disease appears in your
household, do you want your doctor to conceal it or check it?”
Mr. Clyde took that under advisement. “You mean that this city has been
concealing its diseases, and that Dr. Merritt, our new Health Officer,
is only making known a condition which has always existed?” he asked
presently.
“Haven’t you just told me so?”
“When did I tell you anything of the sort?” The younger man smiled.
“That’s five questions in a row,” said he. “Time for an answer. You
said that deaths from tuberculosis had increased twenty-five per cent
since the new man came in.”
“Well?”
“You’re wrong. Tuberculosis doesn’t increase in sudden leaps. It isn’t
an epidemic disease, rising and receding in waves. It’s endemic, a
steady current.”
“But look at the figures. Figures don’t lie, do they?”
“Usually, in vital statistics,” was the imperturbable reply. “In this
case, probably not. That is, they don’t lie to me. I’m afraid they do
to you.” Mr. Clyde looked dubiously at the propounder of this curious
suggestion and shook his head.
“Don’t get it?” queried Dr. Strong. “Perhaps you recall the saying of
Thoreau—I think it the profoundest philosophical thought of the New
World—that it takes two to tell the truth, one to speak and one to hear
it.”
“You mean that we’ve misinterpreted the figures? Why, they’re as plain
as two and two.”
“Truth lies behind figures, not in them,” said Dr. Strong. “Now, you’re
worried because of a startling apparent swelling of the tuberculosis
rate. When you find that sort of a sudden increase, it doesn’t signify
that there’s more tuberculosis. It signifies only that there’s more
knowledge of tuberculosis. You’re getting the disease more honestly
reported; that’s all. Dr. Merritt—did you say his name is?—has stirred
up your physicians to obey the law which requires that all deaths be
promptly and properly reported, and all new cases of certain
communicable diseases, as well. Speaking as a doctor, I should say
that, with the exception of lawyers, there is no profession which
considers itself above the law so widely as the medical profession.
Therefore, your Health Officer has done something rather unusual in
bringing the doctors to a sense of their duty. As for reporting, you
can’t combat a disease until you know where it is established and
whither it is spreading. So, I say, any health officer who succeeds in
spurring up the medical profession, and in dragging the Great White
Plague out of its lurking-places into the light of day ought to have a
medal.”
“What about the other diseases? Is the same true of them?”
“Not to the same extent. No man can tell when or why the epidemic
diseases—scarlet fever, measles, whooping-cough, and diphtheria—come
and go. By the way, what about your diphtheria death rate here?”
“That is the exception to the rule. The rate is decreasing.”
Dr. Strong brought his hand down flat on the table with a force which
made his cup jump in its saucer. “And your misnamed Public Health
League proposes to take some action against the man who is shown, by
every evidence you’ve suggested thus far, to be the right man in the
right place!”
“How does the diphtheria rate show in his favor any more than the other
death rates against him?”
“Because diphtheria is the one important disease which your medical
officer can definitely control, and he seems to be doing it.”
“The only important one? Surely smallpox is controllable?”
“Smallpox is the poisoned arrow of the fool-killer. It is controllable;
but it isn’t important, except to fools and anti-vaccination bigots.”
Mr. Thomas Clyde softly rubbed his cleanshaven chin, a sign and token
with him that his mind was hard at work.
“You’re giving me a new view of a city in which I’ve lived for the
first and last forty-five years of my life,” he said presently. “Are
you familiar with conditions here?”
“Never have been here before, and have no reason to suppose that I
shall ever return. Traveling at night is too much for me, so I stopped
over to have a look at a town which has been rather notorious among
public health officials for years.”
“Notorious!” repeated Mr. Clyde, his local pride up in arms.
“For falsifying its vital statistics. Your low mortality figures are a
joke. Worthington has been more jeered at, criticized, and roasted by
various medical conventions than any other city in the United States.”
“Why, I’ve never seen anything of that sort in the papers.”
Dr. Strong laughed. “Your newspapers print what you want to read; not
what you don’t want to read. They follow the old adage, ‘What you don’t
know won’t hurt you.’ It’s a poor principle in matters of hygiene.”
“So one might suppose,” returned the host dryly. “Still you can
scarcely expect a newspaper to run down its own city. I’ve known
business to suffer for a year from sensational reports of an epidemic.”
The other grunted. “If a pest of poisonous spiders suddenly bred and
spread in Worthington, the newspapers would be full of it, and
everybody would commend the printing of the facts as a necessary
warning and safeguard. But when a pest of poisonous germs breeds and
spreads, Business sets its finger to its lips and says, ‘Hush!’ and the
newspapers obey. You’re a business man, I assume, Mr. Clyde? Frankly, I
haven’t very much sympathy with the business point of view.”
He rose and pushed his chair back.
“Wait a moment,” said the other. “Sit down. I have something that may
be of importance to suggest to you. It occurs to me that Worthington
would be the better for having a man with your ideas as a citizen. Now,
supposing the Public Health League should offer you—”
“I am not at present in medical practice,” broke in the other.
“Even at that, I was thinking that you would be of use as an advisory
physician and scientific lookout.”
For a moment, the other’s face brightened, an indication which Mr.
Clyde was quick to note. But instantly the expression of eagerness died
out.
“Ten hours a day?” said Dr. Strong. “It couldn’t be done properly in
less time. And I’m a mere nervous wreck, bound for the scrap-heap.”
“Would you mind,” said Mr. Clyde very gently, “telling me what’s wrong?
I’m not asking without a purpose.”
Dr. Strong held out his long arms before him. “I’m a surgeon without a
right hand, and a bacteriologist without a left.” The sinewy and pale
hands shook a little. “Neuritis,” he continued. “One of the diseases of
which we doctors have the most fear and the least knowledge.”
“And with the loss of your occupation, general nervous collapse?” asked
Mr. Clyde. Being himself a worker who put his heart into his work, he
could guess the sterile hopelessness of spirit of the man banned from a
chosen activity.
Dr. Strong nodded. “I may still be fit for the lecture platform as a
dispenser of other men’s knowledge. Or perhaps I’ll end up as medical
watchdog to some rich man who can afford that kind of pet. Pleasing
prospect, isn’t it, for a man who once thought himself of use in the
world?”
“Good idea,” said Mr. Clyde quietly. “Will you try the position with my
family?”
The other stared in silence at his questioner.
“Just consider my situation for a moment. As you know, I’m a layman,
interested in, but rather ignorant of, medical subjects. As wealth goes
in a city of one hundred and fifty thousand population, I’m a rich man.
At any rate, I can afford a considerable outlay to guard against
sickness. In the last five years I suppose disease has cost my
household ten thousand dollars in money, and has cost me, in worry and
consequent incapacity for work, ten times that amount. Even at a large
salary you would doubtless prove an economy. Come, what do you say?”
“You know absolutely nothing of me,” suggested the other.
“I know that you are a man of quick and correct judgment, for I saw you
in action.” The other smiled. “You are, for reasons which are your own,
not very expansive, as to your past professional career. I’m content
with that attitude of yours, and I’m quite satisfied to base my offer
on what I have been able to judge from your manner and talk. Without
boasting, I may say that I have built up a great manufacturing plant
largely on my judgment of men. I think I need you in my business of
raising a family.”
“How much of a family?”
“Five children, their mother and their grandmother. I may warn you at
once that you’ll have a jealous rival in Grandma. She’s the household
guardian, and pretty ‘sot’ in her ideas. But the principal thing is for
you to judge me as I’ve judged you, and determine whether we could work
out the plan together.”
Dr. Strong set his chin in one thin, cupped hand and gazed
consideringly upon the profferer of this strange suggestion. He saw a
strong-built, clear-skinned man, whose physical aspect did not suggest
the forty-five years to which he had owned. Mr. Clyde recommended
himself at first sight by a smooth-voiced ease of manner, and that
unostentatious but careful fitness of apparel which is, despite wise
apothegms to the contrary, so often an index of character. Under the
easy charm of address, there was unobtrusively evident a quick
intelligence, a stalwart self-respect, and a powerful will.
Yet, the doctor noted, this man had been both ready and fair in
yielding his judgment, under the suggestion of a new point of view.
Evidently he could take orders as well as give them.
“Well,” said Mr. Clyde, “have you appraised me?”
The weary eyes of the other twinkled a little. “Physically you disclose
some matters plainly enough, if one wishes to show off in the Sherlock
Holmes manner. For instance, you’ve recently been in the tropics; your
eyesight is better than your hearing, you drink lightly if at all, and
don’t use tobacco in any form; you’ve taken up athletics—handball
principally—in recent years, as the result of a bad scare you got from
a threatened paralytic attack; and your only serious illness since then
has been typhoid fever.”
Mr. Clyde laughed outright. “If you had started our acquaintance that
way,” he said, “I’d have thought you a fortune-teller. Part of it I can
follow. You noticed that I kept my left ear turned, of course; and the
fact that my nose shows no eyeglass marks would vouch for my eyesight.
Did you judge me a non-smoker because I forgot to offer you a
cigar—which deficiency I’ll gladly make up now, if it isn’t too late.”
“Partly that—no, thank you. I’m not allowed to smoke—but principally
because I noticed you disliked the odor of my hot milk. It is
offensive, but so faint that no man without a very keen sense of smell
would perceive it across a table; no tobacco-user preserves his sense
of smell to any such degree of delicacy. As for the drink, I judged
that from your eyes and general fitness.”
“And the handball, of course, from my ‘cushioned’ palms.”
“Obviously. A man at the heart of a great business doesn’t take up
violent indoor exercise without some special reason. Such a reason I
saw on the middle finger of your left hand.”
Holding up the telltale member, Mr. Clyde disclosed a small dark area
at the side of the first joint.
“Leaky fountain-pen,” he remarked.
“As you are right-handed naturally, but write with your left hand, it’s
clear that you’ve had an attack of writer’s paralysis—”
“Five years ago,” put in Mr. Clyde.
“And that your doctor made good use of the salutary scare it gave you,
to get you to take up regular exercise.”
“And, incidentally, to cut out my moderate, occasional cocktail. Now,
as to the tropics and the typhoid?”
“The latter is a guess; the former a certainty. Under your somewhat
sparse long hair in front there is an outcropping of very fine hairs.
Some special cause exists for that new growth. The most likely cause,
at your age, is typhoid. As you’ve kept in good training, it isn’t
likely that you’d have had any other serious ailment recently. On that
I took a chance. The small scars at the back of your ears could be
nothing but the marks of that little pest of the tropics, the _bête
rouge_. I’ve had him dug out of my skin and I know something of him.”
“Right on every count,” declared Mr. Clyde. “You’ve given me cumulative
proof of your value to me. I’ll tell you. Forget formalities. Let me
‘phone for a cab; we’ll go to your hotel, get your things, and you come
back with me for the night. In the morning you can look the ground
over, and decide, with the human documents before you, whether you’ll
undertake the campaign.”
The younger man smiled a very pleasant and winning smile. “You go
fast,” said he. “And as in all fast motion, you create a current in
your direction. Certainly, if I’m to consider your remarkable plan I’d
best see the whole family. But there’s one probable and perhaps
insurmountable obstacle. Who is your physician?”
“Haven’t such a thing in the house, at present,” said Mr. Clyde
lightly. Then, in a graver tone, “Our old family physician died six
months ago. He knew us all inside and out as a man knows a familiar
book.”
“A difficult loss to replace. Knowledge of your patient is half the
battle in medicine. You’ve had no one since?”
“Yes. Six weeks ago, my third boy, Charley, showed signs of fever and
we called a distant cousin of mine who has a large practice. He felt
quite sure from the first that it was diphtheria; but he so managed
matters that we had no trouble with the officials. In fact, he didn’t
report it at all, though I believe it was a very light case of the
disease.”
Dr. Strong’s eyes narrowed. “At the outset, I’ll give you two bits of
advice, gratis, Mr. Clyde. First, don’t ever call your doctor-cousin
again. He’s an anarchist.”
“Just what do you mean by that?”
“It’s plain enough, isn’t it? Anarchist, I said: a man who doesn’t
believe in law when it contravenes his convenience.”
Mr. Clyde rubbed his chin again. “Hum,” he remarked. “Well! the second
gift of advice?”
“That you either respect the law yourself or resign the presidency of
the Public Health League.” A distinct spot of red appeared on each of
the elder man’s smooth cheeks. “Are you trying to provoke me to a
quarrel?” he asked brusquely.
Then his expression mollified. “Or are you testing me?”
“Neither. I’m giving you my best and most honest advice. If you expect
me to do as your substitute physician did, to guard your household in
violation of the law which tries to protect the whole public equally,
you’ve got the wrong man, and your boasted judgment has gone askew,”
was the steady reply.
Mr. Clyde turned and left the room. When he returned his hand was
outstretched.
“I’ve taken three swallows of cold air, and sent for a cab,” he said.
“Shake hands. I think you and I will be friends. Only—train me a little
gently at the outset. You’ll come with me?”
“Yes,” said Dr. Strong, and the two men shook hands.
During the drive Mr. Clyde expounded the virtues and characteristics of
his native city to his new acquaintance, who was an excellent listener.
Long afterward he found Dr. Strong acting on remembered and shrewdly
analyzed information given in that first long talk. When they reached
the big, rambling, many-windowed house which afforded the growing Clyde
family opportunity to grow, the head of the household took his guest to
an apartment in one of the wings.
“These two rooms are yours,” he said. “I hope you’ll be like Coleridge
who came to visit with one satchel and stayed five years.”
“That remains to be seen to-morrow,” said Dr. Strong. “By the way, as I
usually read myself to sleep, you might leave me some of your local
health reports. Thus I can be looking the ground over.”
“All I’ve got you’ll find on the shelf over the desk. Good-night!”
Being of that type of man who does his thinking before and not after a
decision, Mr. Thomas Clyde arose in the morning with an untroubled mind
as to his new venture in household economics. Voices from the library
attracted him thither, as he came downstairs, and, entering, he beheld
his guest hedged in a corner by the grandmother of the Clyde household.
“Don’t tell me, young man,” the old lady was saying, in her clear,
determined voice. “You’ve not slept well for ages! I know that kind of
an eye.”
“Mrs. Sharpless has been diagnosing my case, Mr. Clyde,” called the
guest, with a rather wry smile.
“You stay here for a while,” said she vigorously, “and I’ll cocker you
up. I don’t believe you even eat properly. Do you?”
“Maybe not,” admitted the young man. “We doctors are sometimes less
wise for ourselves than for others.”
“Oh! So you’re a doctor?” asked the grandmother with a shrewd,
estimating glance.
“Dr. Strong is, I hope, going to stay with us awhile,” explained her
son-in-law.
“Good!” said Mrs. Sharpless. “And I’ll take care of him.”
“It’s a strong inducement,” said Dr. Strong gracefully. “But I want a
little more material on which to base a decision.”
“Between us Grandma and I ought to be able to answer any questions,”
said Mr. Clyde.
“About sickness, then, in the family. I’ve already introduced myself to
Mrs. Clyde and questioned her; but her information isn’t definite.”
“Myra seldom is,” observed Mr. Clyde. “It’s part of her charm. But
Grandma Sharpless has been keeping a daybook for years. Everything
that’s ever happened, from the cat’s fits to the dressmaker’s misfits,
is in that series. I’ve always thought it might come in handy
sometime.”
“Just the thing!” said Dr. Strong heartily. “Will you bring it, Mrs.
Sharpless? I hope you’ve included your comment on events as well as the
events themselves.”
“My opinions are generally pronounced enough so that I can remember
‘em, young man,” returned Mrs. Sharpless, as she departed for the
desired volumes.
“That last remark of yours sounded a little like making fun of
Grandma,” suggested Mr. Clyde, as the door closed after her.
“Far from it,” retorted Dr. Strong quickly. “Can’t you see that she’s a
born diagnostician? She’s got the sixth sense sticking out all over
her. Women more often have it than men. When a doctor has it, and
sometimes when he’s only able to counterfeit it, he becomes great and
famous.”
“Now that you speak of it, I remember my wife’s saying that when she
was a girl and lived in the country, her mother was always being sent
for in cases of illness.”
Dr. Strong nodded. “Heretical though it is to say so, I would rather
have the diagnosis of such a woman, in an obscure case, than of many a
doctor. She learns in the school of experience.”
Here, Mrs. Sharpless returned, carrying several diaries.
“These go five years back,” said she. “You’ll find ‘em pretty complete.
We’ve had our fair share of trouble; measles, whooping-cough,—I thought
Betsy was going to bark her poor little head off,—mumps, and
chicken-pox. I nursed ‘em through, myself.”
“All of them?”
“All of ‘em didn’t have all the things because Tom Clyde sent the rest
away when one of ‘em came down. All nonsense, I say. Better let ‘em get
it while they’re young, and have done with it.”
“One of the worst of the old superstitions,” said Dr. Strong quietly.
“Don’t tell me, young man! Doctor or no doctor, you can’t teach me
about children’s diseases. There isn’t any of those measly and mumpy
ones that I’m afraid of. Bobs _did_ scare me, though, with that queer
attack of his.”
“Bobs,” explained Mr. Clyde, “is Robin, one of the eight-year-old
twins.”
“Tell me about the attack.”
“When _was_ it?” said the grandmother, running over the leaves of a
selected diary. “Oh, here it is. Last March. It was short and sharp.
Only lasted three days; but the child had a dreadful fever and pretty
bad cramps.”
“Anything else?”
“Why, yes; though that idiot of a cousin of Tom’s snubbed me when I
told him about it. The boy seemed kind of numb and slow with his hands
for some time after.”
“And now?” So sharp came the question that Mr. Clyde glanced at the
speaker, not without apprehension.
“Nothing left of it that I can see.”
“What had you in mind?” asked Mr. Clyde of the doctor, curiously.
“Speaking technically, anterior poliomyelitis.” Grandma Sharpless
laughed comfortably. “I’ve noticed that a very long name like that
usually means a sore toe or a pimple behind your ear. It’s the short
names that bring the undertaker.”
“Shrewdly said, but exception noted,” said Dr. Strong.
“As for Bobs, I remember two cases I saw at Clinton years ago, like
that attack of his. One of ‘em never walked afterward, and the other
has a shriveled hand to this day.”
Dr. Strong nodded. “To come down nearer to English, that’s infantile
paralysis, one of the mysteries of medicine. I’ll tell you some things
about it some day. Your Bobs had a narrow escape.”
“You’re sure it is an escape?” asked the father anxiously.
“If Mrs. Sharpless is satisfied that there’s no trace left, I am.”
“Come in to breakfast,” said Mrs. Clyde, entering the room with a child
attached to either hand. She was a tall, fair woman with the charm of
fresh coloring and regular features, large, intelligent eyes, and a
somewhat restless vigor and vitality. That her husband and children
adored her was obvious. One had to look twice to perceive that she was
over thirty; and even a careful estimate did not suggest her real age
of thirty-seven.
During the introductory meal, Dr. Strong talked mostly to her, but he
kept watching the children. And when it was over, he went to his study
and made an inventory, in the order of age.
GRANDMA SHARPLESS;
_Probably 70; sound and firm as a good apple; ought to live to be 90.
Medical demands, none._
MR. CLYDE;
_45; sturdy, restrained, active, phlegmatic: Tends to
over-concentration; his own best physician._
MRS. CLYDE;
_35; possibly more. Quick-witted, nervously active; eager, perhaps a
little greedy of enjoyment. Somewhat intemperate; probably in eating,
possibly in the use of tea or candy. An invariably loving mother; not
invariably a wise one._
MAYNARD, _otherwise_ “MANNY” CLYDE;
_14 years old; rangy, good-tempered, intelligent boy with a good
physical equipment._ (_Note: watch his eyes._)
ROBIN, _alias_ BOBS _and_ JULIA (_mysteriously_) JUNKUM;
_8-year old twins; Bobs, quick and flashing like his mother; Julia,
demure, thoughtful, a little lethargic, and with much of her father s
winning quality of friendliness._ (_Note: test Bobs for reflexes. Watch
Julia's habits of play._)
CHARLES;
_Aged 7; strong rough-and-tumble urchin, the particular pet of his
grandmother._ (_Note: watch his hand motions._)
BETTINA, _alias variously_ BETSY, TOOTS, TWINKLES, _and the_ CHERUB;
_4 years old; a Duck_ [here the human side of the doctor broke
through], _though a little spoiled by her father._ (_Note: a
mouth-breather; the first case to be considered._)
ADDENDUM;
_Various servants, not yet identified or studied; but none the less
members of our household community._
This catalogue Dr. Strong put away, with Grandma Sharpless’s day books,
for further notation and amplification. Then he made three visits: one
to the Health Bureau, one to the Water Department, and one to the City
Engineer’s office, where he spent much time over sundry maps. It was
close upon dinner-time when he returned, and immediately looked up Mr.
Clyde.
“Well?” said that gentleman.
“Assuming that I accept your offer it should be understood that I’m
only a guardian, not, a physician.”
“Meaning—”
“That I shall expect, in emergency, to call in such physicians or
others as I consider best equipped for the particular task.”
“Very well. But why that phrase ‘or others’?”
“I’ve suggested before that I am a heretic. In certain instances I
might want an osteopath, or, if I were dealing with a sick soul causing
a sick body, I might even send for a Christian Scientist.”
“You have a refreshingly catholic breadth of view.”
“I’m trying to map out for you, a rich man, as good treatment as a very
poor man would have in a hospital—that is, the best technical advice
for every hygienic emergency that may arise—plus some few extensions of
my own. Now we come to what is likely to prove the stumbling-block.”
“Set it up.”
“If I’m to take this job, I must be the autocrat, in so far as my own
department is concerned. As you know, a city health official’s powers
are arbitrary. He can burn your house down; he can imprison you; he can
establish a military régime; he can override or undo the laws which
control the ordinary procedure of life. Hygienic law, like martial law,
supersedes rights in crises. You are asking me to act as health officer
of your house. If I’m to do my work, I must have full sway, and I shall
expect you to see that every member of your household obeys my
orders—except,” he added, with a twinkle, “Grandma Sharpless. I expect
she’s too old to take orders from any one. Diplomacy must be my agent
with her.”
Mr. Clyde pondered. “That’s a pretty wide authority you’re asking.”
“Yes, but I shall use it only in extreme cases. I shall deal
extensively in advice and suggestion, which you may take or leave as
you choose. But an order will mean a life or death matter.”
“Agreed. Now, as to terms—”
“Let the terms go, until we see how much I can save you. Meantime,
don’t overestimate what I undertake to do. Suppose you just run through
the roster of what you consider the danger points, and I’ll tell you
how far I can promise anything.”
“First, then, tuberculosis, of course.”
“Practical immunity from that, as long as you maintain your present
standards of life.”
“Typhoid fever. As I told you, we’ve had one visitation.”
“There’s no reason why you should ever have another if the children
will take ordinary precautions.”
“Diphtheria?”
“We can’t guarantee the youngsters against getting it, though we can do
something to protect them. And if they do get it, we can be pretty
certain of pulling them through.”
“Scarlet fever and measles?”
“Why not add whooping-cough and influenza? The former kills as many
people as either scarlet fever or measles, and the latter twice as
many. They’re all in the same category; medical science is pretty near
helpless against their onset. You and your family may be as rigidly
careful as they will; if the family next door, or a family at the
farthermost end of the town, is careless, we’re as likely as not to
suffer for their sins. All that I can promise, then, is hope against
the occurrence of these diseases, and the constant watchfulness, when
they come, which they call for but don’t always get.”
“Cancer?”
“Eternal vigilance, again; so that, if it does come, we may discover it
in time.”
“Let me see,” mused Mr. Clyde; “what else is there? Oh—nervous and
functional disorders.”
“Functional disorders mean, usually, either a bad start, or the
heritage of some disease like scarlet fever or grippe, or excess or
carelessness in living. I think your household is free from them; and
it should remain free. As for nervous ailments, they commonly mean lack
of self-discipline. It may be overindulgence in work”—he glanced down
at his right hand—“or it may be overindulgence in play.” His glance
wandered significantly to the doorway, through which the voice of Mrs.
Clyde could be heard. “By the way, you’ve left out the greatest
destroyer of all—perhaps because you’re beyond the danger point.”
“Tuberculosis is the greatest destroyer, isn’t it?”
“Not numerically. It is beaten out by the death record of intestinal
poisoning in the very young. Your flock has run the gamut and come
through with undiminished vitality. Two of them, however, are running
life’s race under a handicap”—the father’s eyelids went up—“which I’ll
take up shortly, when I’ve fully determined the causes. They can be
repaired, one readily, the other in time. Finally, I hope to be able to
teach them the gospel of the sound, clean mind in the sound, clean
body. In a desert I might guarantee immunity from most of the ills that
flesh is heir to. Amid the complexities of our civilization, disease
and death are largely social; there is no telling from what friend the
poison may come. No man can safeguard his house. The most he can hope
for is a measure of protection. I can offer you nothing more than that,
under our compact.”
“That is enough,” returned Mr. Clyde. He took from his inner pocket a
folded paper, which he handed over to the young man. “There’s the
contract, duly signed. Come in, Grandma.”
Mrs. Sharpless, entering the door, stopped on seeing the two men.
“Business, Tom?” she asked.
“Business that you’re interested in,” said her son-in-law, and briefly
outlined his plan.
Grandma Sharpless shook a wise gray head. “I’m glad you’re going to
stay, young man,” said she. “You need looking after. But as for the
scheme, I don’t hold much with these new-fangled notions.”
“Perhaps it isn’t as new-fangled as you suppose,” returned the head of
the household. “I’ve just given Dr. Strong a contract, and where do you
suppose I got it?”
“That lawyer man of yours, probably,” said Mrs. Sharpless.
“Well, he looked it over and made sure it was sound in American law.
But essentially it’s a copy of a medical contract in force before
Hippocrates ever rolled a pill. It’s the old logical Chinese form,
whereby the doctor’s duty is prescribed as warding off sickness, not
curing it. Is that old-fashioned enough for you, grandma?”
“Chinese! My land!” said the old lady. “What do they know about
sickness?”
“They know the one most important fact in all medical practice, ma’am,”
said Dr. Strong, “that the time for locking the stable door is before
the horse is stolen, and that an ounce of prevention is worth a pound
of cure.”
II.
IN TIME OF PEACE
“How is the Chinese plan working?” asked Mr. Thomas Clyde, stretching
himself on the lounge in Dr. Strong’s study.
One week before, the doctor had been officially installed, on the
Oriental principle of guarding the Clyde household against intruding
sickness. In that time he had asked few questions. But Mr. Clyde,
himself a close observer, noted the newcomer’s quietly keen observation
of the children, and sometimes of Mrs. Clyde, as they met at mealtime.
He had remarked, too, that the nervous tension of the man was relaxing;
and guessed that he had found, in his new and unique employment,
something of that panacea of the troubled soul, congenial work. Now,
having come to Dr. Strong’s wing of the house by request, he smilingly
put his question, and was as smilingly answered.
“Your Chinese physician has been making what the Chinese call a
‘go-look-see.’ In other but less English terms, a reconnaissance.”
“In what department?”
“Earth, air, and water.” The other waved an inclusive hand.
“Any results?”
“Oh, all kinds. Preliminary report now ready. I’d like to make it a
sort of family conference.”
“Good idea! I’ll send for Mrs. Clyde and Grandma Sharpless.”
“Children out of town?” inquired Dr. Strong suggestively.
“Of course not. Oh, I see. You want us all. Servants, too?”
“The cook certainly. She should be very important to our council of
war. Perhaps we might leave the rest till later.”
They gathered in the spacious study; and Grandma Sharpless glanced
round approvingly.
“It’s like family prayers,” she commented.
“Concerted effort _is_ a sort of prayer, if it’s honest,” said Dr.
Strong gravely. “I’ve never had much of an opinion of the man who gets
up in meeting to beg the Lord for sound health for himself and family
and then goes home and sleeps with all his windows closed.”
“There are no closed windows in this house,” said Grandma Sharpless
emphatically. “I see to that, having been brought up on fresh air
myself.”
“You show it,” returned the doctor pleasantly.
“And I’ve noticed that this house breathes deep at night, through
plenty of open windows. So I can save my own breath on that topic. Just
now I want to talk milk.”
“All our milk comes from my farm,” said the head of the family. “Cows
are my hobby. You ought to see the place, Strong; it’s only ten miles
out.”
“I have seen the place.”
“What do you think of it?”
“I think you’d better get your milk somewhere else for a while.”
“Why, Dr. Strong!” protested Mrs. Clyde. “There isn’t a woman among my
friends who doesn’t envy me our cream. And the milk keeps sweet—oh, for
days, doesn’t it, Katie?”
“Yes’m,” replied the cook. “Three days, or even four, in the ice-box.”
“Doesn’t that show it’s pure?” asked Mrs. Clyde triumphantly.
Dr. Strong shook his head. “Hardly proof,” he said. “Really clean milk
will keep much longer. I have drunk milk from the Rochester municipal
supply that was thirteen days old, and as sweet as possible. And that
was in a hot August.”
“Thirteen days old! I’d be ashamed to tell it!” declared Grandma
Sharpless, with so much asperity that there was a general laugh, in
which the doctor joined.
“I shouldn’t care to try it with your milk. It is rich, but it isn’t by
any means pure. Eternal vigilance is the price of good milk. I don’t
suppose you inspect your farm once a month, do you, Mr. Clyde?”
“No; I leave that to the farmer. He’s an intelligent fellow. What’s
wrong?”
“Scientifically speaking, from 300,000 to 500,000 bacteria per cubic
centimeter.”
“Do we drink all those things when we have a glass of milk, Dr.
Strong?” inquired “Manny” Clyde, the oldest boy.
“Four or five times that many for every teaspoonful,” said the doctor.
“But it isn’t as bad as it sounds, Manny. One hundred thousand is
considered a fairly safe allowance, though _very_ good milk—the kind I
drank when it was thirteen days old—may contain only two or three
thousand. When the count runs up to half a million or so, it shows that
some kind of impurity is getting in. The bacteria in your milk may not
be disease germs at all; they may all be quite harmless varieties. But
sooner or later, if dirt gets into milk, dangerous germs will get in
with it. The high count is a good danger signal.”
“If Bliss, the farmer, has been allowing dirt to get into the milk,
he’ll find himself out of a place,” said Mr. Clyde decisively.
“Don’t be too hard on him,” advised the doctor. “His principal fault is
that he’s getting the milk dirty trying to keep it clean. He is washing
his cans with water from an open well near the barnyard. The water in
the well is badly contaminated from surface drainage. That would
account for the high number of bacteria; that and careless milking.”
“And on that account you advise me to give up the milk?” asked Mr.
Clyde.
“Only temporarily. There are other more immediate considerations. For
one thing, there are both diphtheria and typhoid near by, and the
people on the farm are in contact with them. That’s dangerous. You see,
milk under favorable conditions is one of the best cultures for germs
that is known. They flourish and multiply in it past belief. The merest
touch of contamination may spread through a whole supply, like fire
through flax. One more thing: one of your cows, I fear, is
tuberculous.”
“We might pasteurize, I suppose,” suggested Mrs. Clyde anxiously.
Dr. Strong returned a decisive negative. “Pasteurized milk is better
than poisoned milk,” he said; “but it’s a lot worse than good raw milk.
Pasteurizing simply means the semi-cooking of all the varieties of
germs, good and bad. In the process of cooking, some of the nutritive
quality is lost. To be sure, it kills the bad germs, but it also kills
the good ones.”
“Do you mean that some of the germs are actually useful?” asked Mrs.
Clyde.
“Very useful, in certain rôles. For example, the lactic acid bacteria
would be unpopular with you, Mrs. Clyde, because they are responsible
for the souring of milk. But they also perform a protective work. They
do their best to destroy any bacilli of disease which may invade their
liquid home. Now, when you pasteurize, you kill all these millions of
defenders; and any hostile germs that come along afterward and get into
the milk, through dust or other mediums, can take possession and
multiply without hindrance. Therefore pasteurized milk ought to be
guarded with extra care after the process, which it seldom is. I once
visited a large pasteurizing plant which made great boasts of its
purity of product, and saw flies coming in from garbage pail and manure
heap to contaminate the milk in the vats; milk helpless to protect
itself, because all its army of defense had been boiled to death.”
“If we are allowed neither to use our farm milk raw nor to pasteurize
it, what shall we do with it?” inquired Mr. Clyde.
“Full directions are in there,” answered Dr. Strong, pointing to an
envelope on his desk. “If you’ll look over what I’ve written, and
instruct your farmer to follow it out, you’ll have milk that is
reasonably good. I’ll go further than that; it will be even good enough
to give to the babies of the tenements, if you should have any left
over.”
Mr. Thomas Clyde proceeded to rub his chin, with some degree of
concentration, whereby Dr. Strong knew that his hint had struck in.
“Meantime,” said Mrs. Clyde, with a trace of sarcasm, “do you expect us
to live on condensed milk?”
“Not at all; on certified milk.”
“What’s that mean?” asked Miss Julia, who had a thirst for information.
“What’s a certificate, Junkum?” retorted the doctor.
“That’s what I get when I pass my examinations.”
“Right! Well, milk coming from a farm that passes all its examinations
gets a certificate from the Medical Society, which keeps a pretty
constant watch over it. The society sees that all the cattle are tested
for tuberculosis once in so often; that the cows are brushed off before
milking; that the milking is done through a cloth, through which no
dirt or dust can pass, into a can that has been cleaned by steam—not by
contaminated water—so that no germs will remain alive in it; then
cooled and sealed up and delivered. From the time the milk leaves the
cow until it comes on your table, it hasn’t touched anything that isn’t
germ-proof. That is the system I have outlined in the paper for your
farmer.”
“It sounds expensive,” commented Mrs. Clyde.
“Yes; that is the drawback. Certified milk costs from fifteen to twenty
cents a quart. But when you consider that nearly half the dead babies
were poisoned by bad milk it doesn’t seem so expensive, does it?”
“All very well for us,” said Mr. Clyde thoughtfully. “We can afford it.
But how about the thousands who can’t?”
“There’s the pity of it. Theoretically every city should maintain a
milk standard up to the requirements of the medical certification, and
allow no milk to be sold which falls short of that. It’s feasible, and
it could be done at a moderate price if we could educate the farmer to
it. Copenhagen’s milk supply is as good as the best certified milk in
this country, because the great Danish Milk Company cooperates with the
farmer, and doesn’t try to make huge profits; and its product sells
under five cents a quart. But, to answer your question, Mr. Clyde: even
a family of very moderate means could afford to take enough certified
milk for the baby, and it would pay in doctor’s bills saved. Older
children and grown-ups aren’t so much affected by milk.”
“I’ll go out to the farm to-morrow,” said Mr. Clyde. “What’s next?”
“Water, Mr. Clyde. I’ve found out where you got your typhoid, last
summer.”
“Pooh! I could have told you that,” said Mrs. Sharpless. “There was
sewer-gas in the house. It smelled to heaven the day before he was
taken down.”
“Isn’t it curious how our belief in ghosts sticks to us!” commented the
doctor, chuckling,—“malaria rising from swamps; typhoid and diphtheria
rising in sewer-gas; sheeted specters rising from country
graveyards—all in the same category.” Grandma Sharpless pushed her
spectacles up on her forehead, a signal of battle with her. “Do you
mean to tell me, young man, that there’s no harm in sewer-gas?”
“Far from it! There’s harm enough in sewer-gas, but no germs. The harm
is that the gas reduces vitality, and makes one more liable to disease
attack. It’s just as true of coal-gas as of sewer-gas, and more true of
ordinary illuminating gas than either. I’d much rather have bad
plumbing in the house than even a small leak in a gas-pipe. No, Mrs.
Sharpless, if you waited all day at the mouth of a sewer, you’d never
catch a germ from the gas. Moreover, typhoid doesn’t develop under ten
days, so your odorous outbreak of the day before could have had nothing
to do with Mr. Clyde’s illness.”
“Perhaps you’ll give us _your_ theory,” said the old lady, with an
elaboration of politeness which plainly meant, “And whatever it is, I
don’t propose to believe it.”
“Not mine, but the City Water Commissioner’s. Mr. Clyde’s case was one
of about eighty, all within a few weeks of each other. They were all
due to the criminal negligence of a city official who permitted the
river supply, which isn’t fit to drink and is used only for fire
pressure, to flood into the mains carrying the drinking supply.”
“Then why didn’t the whole city get typhoid?” asked Mr. Clyde.
“Because only a part of the system was flooded by the river water. The
problem of the city’s experts was to find out what part was being
contaminated with this dilute sewage. When the typhoid began to appear,
the Health Department, knowing the Cypress supply to be pure, suspected
milk. Not until a score of cases, showing a distribution distinct from
any milk supply, had appeared, was suspicion directed to the water
supply. Then the officials of the Water Department and Health
Department tried a very simple but highly ingenious test. They dumped a
lot of salt into the intake of the river supply, and tested hydrant
after hydrant of the reservoir supply, until they had a complete
outline of the mixed waters. From that it was easy to ascertain the
point of mixture, and stop it.”
“Our river water is always bad, isn’t it?” said Mr. Clyde. “Last summer
I had to keep Charley away from swimming-school because the tank is
filled from the river, and two children got typhoid from swallowing
some of it.”
“All foolishness, I say,” announced the grandmother. “Better let ‘em
learn to swim.”
“Can’t you swim at all?” asked Dr. Strong, turning to the
seven-year-old.
“I went five strokes once,” said Charley. “Hum-m-m! Any other
swimming-school near by?”
“No.”
“And are the children about water at all?” Dr. Strong asked the mother.
“Well; there are the canal and the river both near us, you know.”
“Then it comes down to this,” said the doctor. “The liability of
typhoid from what water Charley would swallow in the tank isn’t very
great. And if he should get it, the chances are we could pull him
through. With the best care, there should be only one chance in fifty
of a fatal result. But if Charley falls in the canal and, not knowing
how to swim, is drowned, why, that’s the end of it. Medical science is
no good there. Of two dangers choose the lesser. Better let him go on
with the swimming, Mrs. Clyde.”
“Well!” said Grandma Sharpless, “I—I—I—swanny!” This was extreme
profanity for her. “Young man, I’m glad to see for once that you’ve got
sense as well as science!”
“Do you consider the Cypress supply always safe to drink? Several times
it has occurred to me to outfit the house with filters,” said Mr.
Clyde.
“No need, so long as the present Water Department is in office,”
returned Dr. Strong. “I might almost add, no use anyway.”
“Isn’t filtered water good?” asked Manny. “They have it at the
gymnasium.”
“No house filter is absolutely sure. There’s just one way to get a
guaranteeable water: distill it. But I think you can safely use the
city supply.”
“What next, the water problem being cleared up?” asked Mr. Clyde.
“By no means cleared up. Assuming that you are reasonably safeguarded
at home, you’re just as likely—yes, even more likely—to pick up typhoid
somewhere else.”
“Why more likely?”
“For some mysterious reason a man accustomed to a good water supply is
the easiest victim to a bad. Pittsburg, for many years the most
notorious of American cities for filthy drinking, is a case in point.
Some one pointed out that when Pittsburg was prosperous, and wages
high, the typhoid rate went up; and when times were hard, it went down.
Dr. Matson, of the Health Bureau, cleared up that point, by showing
that the increase in Pittsburg’s favorite disease was mainly among the
newcomers who flocked to the city when the mills were running full
time, to fill the demand for labor. An old resident might escape, a new
one might hardly hope to. Dr. Matson made the interesting suggestion
that perhaps those who drank the diluted sewage—for that is what the
river water was—right along, came, in time, to develop a sort of
immunity; whereas the newcomer was defenseless before the bacilli.”
“Then a man, in traveling, ought to know the water supply of every city
he goes to. How is he to find out?”
“In your case, Mr. Clyde, he’s to find out from his Chinese doctor,”
said the other smiling. “I’m collecting data from state and city health
boards, on that and other points. Air will now come in for its share of
attention.”
Young Manny Clyde grinned. “What’s the use, Dr. Strong?” he said.
“Nothing to breathe but air, you know.”
“True enough, youngster; but you can pick your air to some extent, so
it’s worth while to know where it’s good and where it’s bad. Take
Chicago, for instance. It has a very high pneumonia rate, and no
wonder! The air there is a whirling mass of soot. After breathing that
stuff a while, the lungs lose something of their power to resist, and
the pneumococcus bacillus—that’s the little fellow that brings
pneumonia and is always hanging about, looking for an opening in
unprotected breathing apparatus—gets in his deadly work. Somewhere I’ve
seen it stated that one railroad alone which runs through Chicago
deposits more than a ton of cinders per year on every acre of ground
bordering on its track. Now, no man can breathe that kind of an
atmosphere and not feel the evil effects. Pittsburg is as bad, and
Cincinnati and Cleveland aren’t much better. We save on hard coal and
smoke-consumers, and lose in disease and human life, in our soft-coal
cities. When I go to any of them I pick the topmost room in the highest
hotel I can find, and thus get above the worst of it.”
“Don’t tell me that New York is unfit to breathe in!” said Mrs. Clyde,
with a woman’s love for the metropolis.
“Thus far it’s pretty clean. The worst thing about New York is that
they dry-sweep their streets and throw all the dust there is right in
your face. The next worst is the subway. When analysis was made of the
tube’s air, the experimenters were surprised to find very few germs.
But they were shocked to find the atmosphere full of tiny splinters of
steel. It’s even worse to breathe steel than to breathe coal.”
“Any railroad track must be bad, then,” said Mr. Clyde.
“Not necessarily. A steam railroad track runs mostly in the open, and
that great cleaner, the wind, takes care of most of the trouble it
stirs up. By the way, the cheaper you travel, the better you travel.”
“That sounds like one of those maxims of the many that only the few
believe,” remarked Mrs. Clyde.
“You won’t practice it, but you can safely believe it,” retorted the
doctor. “The atmosphere in a day coach is always better than in a
parlor car, because there’s an occasional direct draft through. As for
a sleeping-car,—well, I never get into one without thinking of the
definition in ‘Life’s’ dictionary: ‘Sleeping-Car—An invention for the
purpose of transporting bad air from one city to another.’”
“The poor railroads!” chuckled Mr. Clyde. “They get blamed for
everything, nowadays.”
“It may not be the Pullman Company’s fault that I don’t sleep well in
traveling, but they are certainly to blame for clinging to a type of
conveyance specially constructed for the encouragement of dirt and
disease. Look at the modern sleeping-car: heavy plush seats; soft
hangings; thick carpets; fripperies and fopperies all as gorgeous,
vulgar, expensive, tawdry, and filthy as the mind of man can devise.
Add to that, windows hermetically sealed in the winter months and
you’ve got an ideal contrivance for the encouragement of mortality.
Never do I board a sleeper without a stout hickory stick in my
suit-case. No matter how low the temperature is, I pry the window of my
lower berth open, and push the stick under.”
“And sleep in that cold draft!” cried Mrs Clyde.
“My dear Mrs. Clyde,” replied the doctor suavely, “will you tell me the
difference between a draft and a wind?”
“Is it a conundrum?”
“No; but I’ll answer it for you. A draft is inside a house; a wind
outside. You’re not afraid of wind, are you?”
“Of course not.”
“Then to you an air-current is like a burglar. It’s harmless enough
outside the room, but as soon as it comes through a window and gets
into the room, it’s dangerous.”
“Sound common sense!” put in Granny Sharpless. “Young man, I believe
you’re older than you look.”
“I’m old enough to know that pure air is better than foul warm air,
anyway. Here; I want you youngsters to understand this,” he added,
turning to the children. “When the blood has circulated through the
system, doing all the work, it gets tired out and weak. Then the lungs
bring air to it to freshen it up, and the oxygen in the air makes it
strong to fight against disease and cold. But if the air is bad, the
blood becomes half starved. So the man who breathes stuffy, close air
all night hasn’t given his blood the right supply. His whole system is
weakened, and he ‘catches cold,’ not from too much air, but too
little.”
“It’s often struck me,” said Mr. Clyde, “that I feel better traveling
in Europe than in America. Yet our Pullmans are supposed to be the best
in the world.”
“The worst!” declared Dr. Strong forcefully. “The best in luxuries, the
worst in necessities. The only real good and fairly sanitary cars
operated by the Pullman Company, outside of the high-priced stateroom
variety, are the second class transcontinentals, the tourist cars. They
have straw seats instead of plush; light hangings, and, as a rule, good
ventilation. If I go to the Pacific Coast again, it will be that way.”
There was a pause, in which rose the clear whisper of Bobs, appealing
to his mentor, Julia, for information.
“Say, Junkum, how did we get so far away from home?”
“High time we came back, isn’t it, Bobs?” approved the doctor. “Well,
suppose we return by way of the school-house. All of you go to Number
Three but Betsey, don’t you?”
“And I’m go-un next year,” announced that young lady.
“Perhaps not,” said Mrs. Clyde. “Don’t you think, Doctor, that children
are liable to catch all sorts of things in the public schools?”
“Unquestionably.”
“More so than in private schools, aren’t they?”
“Hum! Well, yes; since they’re brought into contact with a more
miscellaneous lot of comrades.”
“Which is exactly why I have insisted on our sticking to the regular
schools,” put in Mr. Clyde, with the air of quiet decisiveness. “I want
our children to be brought up like other children!” The mother shook
her head dubiously. “I wish I were sure it is the right place for
them.”
“You ought to be sure. I might even say—if you will forgive the implied
criticism—that you ought to be surer than you are.”
Alarmed at his tone, the mother leaned forward. “Is there anything the
matter at Number Three?”
“Several things. Nothing that you need worry about immediately,
however. I’ve been talking with some of the teachers, and found out a
few points. Charley’s teacher, for instance, tells me that she has a
much harder time keeping the children up to their work in the winter
term than at other times.”
“I remember Charley’s tantrums over his arithmetic, last winter,” said
Grandma Sharpless.
“My head felt funny. Kinder thick,” defended Charley.
“That is bad,” said Dr. Strong, “very bad. I’ve reported the teacher in
that grade to Dr. Merritt, the Health Officer.”
“Reported teacher?” said Charley, his eyes assuming a prominence quite
startling. “What for?”
“Starving her grade.”
Mrs. Clyde fairly bounced in her chair. “Our children are not supposed
to eat at school, Dr. Strong.”
“Starving her grade,” continued the doctor, “in the most important need
of the human organism, air.”
“How do you reach that conclusion?”
“Evidence and experience. I remember in my college days that the winter
term was considered to be the most difficult in every year. The
curriculum didn’t seem to show it, but every professor and every
undergraduate knew it. Bad air, that’s all. The recitation rooms were
kept tightly closed. The human brain can’t burn carbon and get a bright
flame of intelligence without a good draft, and the breathing is the
draft. Now, on the evidence of Charley’s teacher, when winter comes
percentages go down, although the lessons are the same. So I asked her
about the ventilation and found that she had a superstitious dread of
cold.”
“I remember Miss Benn’s room,” said Julia thoughtfully. “It used to get
awful hot there. I never liked that grade anyway, and Bobs got such bad
deportment marks.”
“Both of the twins had colds all the winter they were in that room,”
contributed Grandma Sharpless.
Up went Dr. Strong’s hands, the long fingers doubled in, in a curious
gesture which only stress of feeling ever drove him to use.
“‘When will the substitute mothers and fathers who run our schools
learn about air!” he cried. “Air! It’s the first cry of the newly born
baby. Air! It’s the last plea of the man with the death-rattle in his
throat. It’s the one free boon, and we shut it out. If I’m here next
winter, I think I’ll load up with stones and break some windows!”
“Lemme go with you!” cried Charley, with the eagerness of destruction
proper to seven years. “On the whole, Charley,” replied the other,
chuckling a little, “perhaps it’s better to smash traditions. Not
easier, but better.”
“But you wouldn’t have them study with all the windows open on a zero
day!” protested Mrs. Clyde.
“Wouldn’t I! Far rather than choke them in a close room! Why, in
Chicago, the sickly children have special classes on the roof, or in
the yards, all through the cold weather. They study in overcoats and
mittens. And they _learn_. Not only that, but they thrive on it.”
Mr. Clyde was rubbing his chin hard. “Perhaps our school system isn’t
all I bragged,” he observed.
“Not in all respects. You still stick to that relic of barbarism, the
common drinking-cup, after filtering your water. That’s a joke!”
“I don’t see the point,” confessed Mr. Clyde. “Whom is the joke on?”
“All of you who pay for the useless filters and then settle doctors’
bills for the disease spread by the drinking-cups. Don’t you understand
that in the common contagious diseases, the mouth is the danger point?
Now, you may filter water till it’s dry, but if in drinking it you put
your lips to a cup soiled by the touch of diseased lips, you’re in
danger. We think too much of the water and too little of what contains
it. I’ve seen a school in Auburn, New York, and I’ve seen a golf course
at the Country Club in Seattle, where there isn’t a glass or cup to be
found; and they have two of the best water supplies I know. A tiny
fountain spouts up to meet your lips, and your mouth touches nothing
but the running water. The water itself being pure, you can’t possibly
get any infection from it.”
“Can you get me a report on that for the Board of Education?” asked Mr.
Clyde.
“It’s already here,” said Dr. Strong quietly. “That is part of my
Chinese job of watch-dog. One other matter. A teacher in another grade,
at Number Three, with whom I talked, stood with a pencil, which she had
taken from one of her scholars, pressed to her lips. While we talked
she gave it back to the child.”
“Well, land sakes!” said Grandma Sharpless, “where’s the harm? I
suppose the poor girl was clean, wasn’t she?”
“How do I know? How does anybody know? There is a case on record where
a teacher carried the virulent bacilli of diphtheria in her throat for
three months. Suppose she had been careless about putting her lips to
the various belongings of the children. How many of them do you suppose
she would have killed with the deadly poison?”
“Didn’t she know she had diphtheria?” asked Junkum, wide-eyed.
“She hadn’t, dear. She was what we call a ‘carrier’ of disease. For
some reason which we can’t find out, a ‘carrier’ doesn’t fall ill, but
will give the disease to any one else as surely as a very sick person,
if the germs from the throat reach the throat or lips of others.”
“Some lectures on hygiene might not be amiss in Number Three,” said Mr.
Clyde.
“That’s what medical school inspectors are for—to teach the teachers.
The Board of Education should be getting it started.”
“What are you doing over there, Twinkles?” said Mr. Clyde to Bettina,
who had slipped from his knee and was sliding her chubby fist along the
window-pane.
The child looked around. “Thwat that fly,” she explained with perfect
seriousness.
“She has heard the other children talking about the fly-leaflets that
have been scattered around. Where’s the fly, Toodles?”
“Up they-arr,” replied Bettina, pointing to a far corner of the pane
where a big “green-bottle” bumped its head against the glass. “Come
down, buzzy fly.”
“Now, where,” cried Mrs. Clyde, in despair, “do you suppose that
wretched creature came from? I’m so particular always to keep the rooms
screened and darkened.”
“Please’m, it might have come from the kitchen,” suggested Katie.
“There’s a plenty of ‘em there.”
“And before that it came from your next-door neighbor’s manure-heap,”
added Dr. Strong. “That particular kind of fly breeds only in manure.
The fact is that the fly is about the nastiest thing alive. Compared to
it, a hog is a gentleman, and a vulture an epicure. It loves filth, and
unhappily, it also loves clean, household foods. Therefore the path of
its feet is direct between the two—from your neighbor’s stable-yard to
your dinner-table.”
“Disgusting!” cried Mrs. Clyde.
“Worse than disgusting: dangerous,” returned Dr. Strong, unmoved by her
distaste. “A fly’s feet are more than likely to be covered with
disease-bearing matter, which he leaves behind him.”
“Something ought to be done about Freeman’s manure-heap, next door.
I’ll see to it,” announced Mr. Clyde.
“Doubtless you could report him for maintaining a nuisance,” admitted
Dr. Strong; “in which case he might—er—conceivably retort upon you with
your unscreened garbage-pails, which are hatcheries for another variety
of fly.”
“That’s a beam in the eye for you, Tom,” said Grandma Sharpless.
“Meantime I’ll have the kitchen windows and doors screened at once,”
declared Mrs. Clyde.
“That will help,” said Dr. Strong, “though it won’t cure. You can gain
some idea, from this matter of the flies, how intricate a social
problem health really is. No man sins to himself alone, in hygiene, and
no man can thoroughly protect himself against the misdeeds of his
neighbor. It’s true that there is such a thing as individual
self-defense by a sort of personal fortifying of the body—I’ll take
that up some other time—but it’s very limited. You can carry the fight
into the enemy’s country and eradicate the evil conditions that
threaten all, only by identifying yourself with your environment, and
waging war on that basis. Mr. Clyde, do you know anything about the row
of wooden tenements in the adjoining alley?”
“Saddler’s Shacks? Not much, except that a lot of Italians live there.”
“Some live; some die. The whole settlement is a scandal of
overcrowding, dirt, and disease. I’ve made out a little local health
report of the place, for the year. Of course, it’s incomplete; but it’s
significant. Look it over.”