HEALTH AND THE HOME
Of all the considerations that determine health, heredity is the one
unalterable factor. Although certain characteristics are obviously
hereditary,--complexion, height, and mental and physical traits in great
variety,--yet in the past heredity has been little understood. In
consequence it has served too often as a scape goat for faults and
failings not beyond an individual's control. Our first clear
understanding of the principles underlying heredity resulted from
experiments made by Mendel, an Austrian monk, during the last century,
and it is now possible to predict with a high degree of accuracy the
inheritance of certain characteristics.
Many diseases, formerly considered hereditary because their actual
causes were unknown, are now known to be communicable. Thus, it is now
understood that tuberculosis is not hereditary, although little children
may be infected by tuberculous parents. No germ diseases are inherited
in the strict sense of the word; but a baby may be infected with
syphilis before birth if his father or his mother has the disease.
It is true, however, that certain tissue weaknesses of the body seem to
be hereditary, and in consequence one family is more susceptible to
digestive disorders, another to diseases of the lungs, a third to
deafness, and so on. Moreover, general low vitality may be inherited. It
should be emphasized, however, that hereditary weakness does not
inevitably lead to disease. Many persons have succeeded in preventing
the development of active disease by guarding against strain in
directions where they are weak by inheritance.
Of all tissue weaknesses that may be inherited, defects of the nervous
system are the most serious. Nervous disorders of every degree of
severity, from slight nervous instability even to insanity, may result
when these tissues are defective; but it is now a recognized fact that
nervous disorders in many cases can be prevented from developing.
Feeblemindedness, another condition due to defective tissue, is known to
be inherited in the majority of cases, and in all cases it is incurable.
HYGIENE OF ENVIRONMENT AND PERSON
By environment is meant everything outside the body that affects it;
taken in its complete meaning the word might include everything that is
or ever was in the whole universe. It is possible to consider here a few
only of the many environmental and personal factors affecting the health
of individuals.
The home constitutes the important part of environment for most persons,
and for children in particular, since they spend the greater part of
their time in or about it, and get there the foundation on which their
health in later years depends. For persons employed away from home,
industrial and occupational hygiene is hardly less important; but those
subjects are too extensive to be considered here.
Most people live where they must, and few have any part in planning the
construction of their own houses. In choosing a house, however, one
should remember that rooms where sunshine never enters are unfit for
continued occupation. For children in particular fresh air and sunshine
are essential, and it may be economy in the end to pay a comparatively
high rent for an apartment having sunshine during at least a part of the
day. Ignorance and carelessness, unfortunately, can spoil the best
living conditions, and sometimes even in the country fresh air and
sunshine are excluded from sleeping and living rooms.
VENTILATION.--Ventilation has a direct bearing on health, although,
contrary to former belief, the actual amount of oxygen in the air is not
ordinarily the most important factor; even badly ventilated rooms
contain more than enough oxygen to support life. The factors of prime
importance in ventilation are temperature, humidity, air movement, and
the number of persons in a given space since the greater the distance
from one another the less is the probability that diseases will be
spread.
Room temperature should not be above 70° F. and, except for the aged or
sick, it is better to be between 60° and 65°. Some moisture in the air
is desirable; the amount needed is from 50% to 55% of the total moisture
that the air can hold at a given temperature. We have no apparatus to
decrease humidity in the air of houses, and in summer we are obliged to
endure humidity, if excessive, no matter how uncomfortable we may be.
But in winter the air in most houses is too dry, so that the mucous
membranes of the nose and throat often become irritated and susceptible
to infection. Most heating systems, particularly in small buildings,
make no provision for supplying moisture. Keeping water in open dishes
on or near radiators is often recommended, and would greatly improve the
condition of the air, if people remembered to keep the dishes filled.
The following is a simple but effective device to increase humidity:
Roll an ordinary desk blotter into a cone about 8 inches in diameter at
the base, and keep it constantly submerged for about one inch in a dish
of water. The water rises to the top of the blotter and a large surface
for evaporation is thus afforded.
[Illustration: FIG. 7.]
Stagnant air is harmful. Air should be in constant though not
necessarily perceptible motion. Air about the body, if motionless, acts
like a warm moist blanket, preventing the passage of heat from the body.
The three factors, heating, humidity, and air motion, must be considered
together. Every person requires each hour about 3000 cubic feet of air,
and the problem of heating and ventilating is that of providing this
amount in gentle motion, at a temperature of about 65° F., and of
humidity from 50-55%. Higher temperatures and stagnant air cause
disinclination to work, headache, nausea, restlessness, or sleepiness,
and if continued are likely to result in loss of appetite, and anemia.
The tuberculosis movement has clearly shown the benefits both for the
sick and the well of living in the open air, and has caused great and
beneficial changes within a generation. The more time spent in the open
air the better; since however most persons who work must spend the
greater part of the day indoors, ventilation is a matter of great
importance.
Although fresh air enthusiasts are still too few, yet some go to the
extreme and think that because cool air in motion is good, the colder
the air and more violent the motion the better. On the contrary,
chilling the whole body or a part of the body lowers resistance.
Draughts of air have no bad effects upon persons in good health,
particularly those accustomed to changes in temperature. But draughts
are likely to be injurious to aged or sick persons and babies, by
diminishing their resistance to such infections as common colds and
pneumonia. It should be remembered that draughts or cold alone cannot
cause colds; the specific germs must be present.
LIGHTING.--Amount and direction of light are physiologically important.
Defects of the eyes, too prolonged use, and insufficient light are the
commonest causes of eye strain. Most eye defects can be relieved by
glasses. Children's eyes should be examined upon entering school, and as
often afterward as the oculist advises. Prolonged use causes fatigue of
the eyes, especially when the illumination is poor; within limits, the
amount of light needed depends on the nature of the work. Light should
come from the left side of right handed people; never from the front.
Light reflected from snow, sand, glazed white paper of books, or other
bright surfaces is fatiguing from its intensity, and from the unusual
angle at which it enters the eyes. Too much light is harmful, and
probably causes some of the effects, such as nausea and headache,
commonly attributed to poor ventilation.
Almost all blindness is preventable, and blindness due to industrial
accidents and processes is no exception to this rule. Surely no
individual precautions or legal measures are too great in order to guard
against this saddest of all physical defects.
CLEANLINESS OF HOUSES.--A clean, well-cared for house is desirable from
every point of view, but certain kinds of cleanliness affect health more
than others.
The most scrupulous care should be exercised wherever food is stored or
prepared. The kitchen is in reality a laboratory; in it either
intelligently or ignorantly are formed chemical compounds which have a
far-reaching effect upon family health. From the standpoint of health no
other room in the house is so important. It should be bright, airy, and
easy to clean. In cleaning kitchen tables and woodwork water should not
be allowed to soak into cracks and dark corners, carrying with it
particles of food for the nourishment of bacteria and insects. Linoleum,
if used to cover the floor, should be well fitted at the edges to
prevent water from running underneath. There should be neither cracks
nor crevices in wall or floor, and no dark corners or out-of-the-way
cupboards in which dust, food particles, and moisture can accumulate.
Such conditions not only attract mice and roaches, but furnish favorable
soil for the development of moulds and fungi which by their growth
affect food deleteriously. Waging a constant warfare against the
development of bacteria constitutes a large part of good housekeeping.
All cooking utensils should be thoroughly washed, scalded, and dried
before they are put away; the use of carelessly washed dishes is bad.
Enameled or agate ware which has begun to chip should be discarded.
Dish-cloths and towels should be washed and boiled after using, and if
possible dried in the sun.
Every place in which food is kept should have constant care. The
refrigerator is particularly important. Its linings should be
water-tight, and the drain freely open at all times; otherwise the
surrounding wood will become foul and saturated with drainings. At least
once a week it should be entirely emptied and cleaned in the following
way: The racks should be thoroughly washed in hot soapsuds to which a
small amount of washing soda has been added, rinsed in boiling water,
dried and placed in the sun and air. All parts of the refrigerator
should be washed in the same manner, especially grooves and projections
where food or dirt may lodge. The drainpipe should be flushed, the whole
interior rinsed again with plain hot water, thoroughly dried with a
clean cloth, and left to air for at least an hour. The drainage pan
should be washed and scalded frequently. Food showing the slightest
evidence of spoiling should be removed from the refrigerator at once.
Even more attention should be paid to the hands of the cook. They should
be washed always before handling food, and always after visiting the
toilet, using the handkerchief, or otherwise coming in contact with
nose, mouth, or other bodily secretions. Theoretically coughing and
sneezing ought not to occur in the neighborhood of food, especially of
food to be eaten raw; and persons with coughs, colds, or other
communicable disease, however slight, ought not to handle food. If this
rule were observed in practice, more persons would go hungry, but fewer
would be sick.
Thorough cleaning of rooms involves soap, water, sunshine, air, and
elbow grease, just as it did before germs were discovered. Cleaning
means actually removing dirt and dust, not merely stirring it up to
settle again; consequently dry sweeping and dusting are ineffectual.
Vacuum cleaning, and sweeping and dusting with damp or "dustless" mops
and dusters are good. Deodorants and disinfectants do not take the place
of ordinary cleanliness.
Dust does not carry living disease germs to an appreciable extent; the
fact is now well established that diseases formerly thought to be
transmitted by dust or even supposed to travel directly through the air,
are carried on tiny particles of moisture and mucus expelled in coughing
and sneezing. This mode of transmission is called droplet or spray
infection; it is one of the most active agents in spreading certain
kinds of communicable diseases.
Nevertheless dust in motion is harmful; it irritates the lining
membranes of the nose, throat, bronchial tubes, and lungs, even causing
tiny wounds through which disease germs enter. Thus tuberculosis is
especially prevalent among stone cutters, felt workers, and others
engaged in dusty trades. Metallic dust is especially harmful, because it
is harder and sharper than dust from organic substances like wool and
cotton. Furthermore, presence of dust indicates a low standard of
cleanliness. People who tolerate it generally tolerate uncleanliness in
other forms, more serious though less apparent.
Cleaning would not be so great a problem if most houses were not
littered with such dust catchers as carpets, so-called ornaments, carved
and upholstered furniture, banners, draperies, and a vast collection of
articles that can only be classified as Christmas presents. In actual
practice things that are difficult or expensive to clean seldom are
cleaned; carpets for example are considered unhygienic, not because they
cannot be cleaned, but because they are not. William Morris' advice to
exclude from houses all articles not known to be useful or believed to
be beautiful would, if followed, add years to the lives of housekeepers.
GARBAGE, has little bearing on health, except in so far as it affords a
breeding place for flies. If it contains disease germs it may be
dangerous, but statistics show that garbage handlers, although they can
hardly be called especially careful, are not more subject to sickness
than other men of their class. Garbage disposal is chiefly a question of
preventing a public nuisance; it is a matter of cleanliness and public
decency.
INSECTS.--Flies, cockroaches, and other scavenging insects may carry
disease germs on their feet and thus infect food on which they walk.
Typhoid, cholera, dysentery, and other diseases have been carried by
flies. Flies are always a menace, and should not be tolerated; moreover,
the thought of their coming to food directly from manure piles and privy
vaults is disgusting. Houses should be thoroughly screened in the fly
season, but it is better to destroy the nuisance at its source. The
chief breeding places of flies are garbage cans and manure piles. If
the garbage can is water tight, closely covered, frequently emptied, and
thoroughly cleaned, flies will not develop in it; about ten days must
elapse from the time when the egg is laid until the insect is ready to
fly. Fly traps to fit on the garbage can are useful. Manure should be
screened and removed frequently, or it can be treated chemically.
Methods for treating it are given in "Preventive Medicine and
Hygiene."--Rosenau, p. 255, and in Bulletin No. 118, of the U. S. Dept.
of Agriculture, July 14, 1914.
[Illustration: FIG. 8.--A FLY WITH GERMS (GREATLY MAGNIFIED) ON ITS
LEGS. (_U. S. Dept. Agri._)]
Other diseases carried by insects are malaria and yellow fever, each by
a special species of mosquito; typhus fever, by lice; and bubonic
plague, by rat fleas. Various diseases less common in this country are
carried by other insects. Even when mosquitoes are not carrying disease
germs their bites may be harmful since they are often rubbed, especially
by children, until the skin is broken, and various infections may enter
through the wounds. Insects of every kind, rats, mice, and vermin should
be excluded from houses.
SEWAGE.--Discharges from the bowels and bladder contain various germs,
and constitute one of the most important routes by which germs of
typhoid fever, cholera and certain other diseases travel from person to
person. Keeping sewage out of the water supply is consequently of great
importance. Where a system of sewage disposal exists, the responsibility
of making the system adequate and thus safeguarding public health rests
upon the community as a whole. Communities ordinarily get just as much,
or just as little typhoid fever as they are willing to endure.
[Illustration: FIG. 9.--HOW A WELL MAY BE POLLUTED. (_From "The Human
Mechanism."_ Copyright by Theodore Hough and William T. Sedgwick. Ginn
and Company, publishers. Used by permission.)]
In places having no system of drainage privies must be used. They can be
made harmless, as army camps prove, but they require scrupulous care.
Fecal matter must be prevented from draining into wells and other water
supplies, and must be screened from flies. The privy should be located
at a distance from the well. The minimum distance that is safe depends
in each case upon the nature of the soil and the direction of the
natural drainage. Even when the privy is situated below the well on
sloping ground, drainage may still occur from the privy to the well;
however, a well-made, properly located pit privy is safe unless it is
near a limestone formation. The dry earth system is satisfactory in
places having an efficient public scavenger system; in this system pails
or cans are used to receive the discharges, which are then covered with
sand, ashes, earth or, preferably, chloride of lime. The buckets are
frequently emptied and the contents buried at least one foot below the
surface of the ground. The objection to this method for more extended
use is that proper care of the cans is a disagreeable duty of which most
households soon tire.
PERSONAL CLEANLINESS.--The main functions of the skin are three: to
protect underlying tissues, to excrete waste matter, and to regulate
bodily heat by checking or allowing the evaporation of perspiration.
After perspiration has evaporated solid matter is left upon the skin,
and oily matter also is deposited on it by the glands that keep the
skin lubricated. Removing these and other materials at least once a day
is desirable to improve the bodily tone and sense of well-being. Real
cleanliness is impossible without frequent use of warm water and soap.
Cold baths are stimulating, though not very efficacious for cleansing
purposes. They are valuable tonics if properly used, but delicate or
elderly persons should use them only by a physician's advice. Chilly
feelings or depression following should be the signal for any person to
discontinue cold bathing or swimming in cold water.
Warm baths are soothing in their effects, and are appropriate at bed
time, particularly for persons inclined to sleeplessness. Very hot
baths, especially if prolonged, may be harmful, and should not be taken
often.
There is no clear connection between general cleanliness and disease.
Frequent bathing does not protect a person from any particular disease,
except in so far as bathing necessarily includes washing the hands. If
typhoid germs for example have actually been swallowed, a clean bodily
exterior is of no avail in preventing typhoid fever or in diminishing
its severity. The same is true of other diseases.
But it is impossible to emphasize unduly the importance of clean hands.
Hands are prime offenders in distributing fresh bodily secretions, and
germs both innocent and harmful. All health authorities agree on this
point.
"Perhaps 90% of all infections are taken into the body
through the mouth. They reach the mouth in water, food,
fingers, dust, and upon the innumerable objects that are
sometimes placed in the mouth. The fact that the great
majority of infections are taken by way of the mouth gives
scientific direction to personal hygiene. Sanitary habits
demand that the hands should be washed after defecation and
again before eating, and fingers should be kept away from
the mouth and nose, and that no unnecessary objects should
be mouthed. All food and drink should be clean or
thoroughly cooked. These simple precautions alone would
prevent many a case of infection."--(Rosenau: Preventive
Medicine and Hygiene, p. 366.)
As Dr. Chapin says:
"Probably the chief vehicle for the conveyance of nasal and
oral secretion from one to another is the fingers. If one
takes the trouble to watch for a short time his neighbors,
or even himself, unless he has been particularly trained in
such matters, he will be surprised to note the number of
times that the fingers go to the mouth and the nose. Not
only is the saliva made use of for a great variety of
purposes, and numberless articles are for one reason or
another placed in the mouth, but for no reason whatever,
and all unconsciously, the fingers are with great frequency
raised to the lips or the nose. Who can doubt that if the
salivary glands secreted indigo the fingers would
continually be stained a deep blue, and who can doubt that
if the nasal and oral secretions contain the germs of
disease these germs will be almost as constantly found upon
the fingers? All successful commerce is reciprocal, and in
this universal trade in human saliva the fingers not only
bring foreign secretions to the mouth of their owner, but
there exchanging them for his own, distribute the latter to
everything that the hand touches. This happens not once,
but scores and hundreds of times during the day's round of
the individual. The cook spreads his saliva on the muffins
and rolls, the waitress infects the glasses and spoons, the
moistened fingers of the peddler arrange his fruit, the
thumb of the milkman is in his measure, the reader moistens
the pages of his book, the conductor his transfer tickets,
the "lady" the fingers of her glove. Every one is busily
engaged in this distribution of saliva, so that the end of
each day finds this secretion freely distributed on the
doors, window sills, furniture and playthings in the home,
the straps of trolley cars, the rails and counter and desks
of shops and public buildings, and indeed upon everything
that the hands of man touch. What avails it if the
pathogens do die quickly? A fresh supply is furnished each
day."--(Chapin: The Sources and Modes of Infection, p.
188.)
ORAL HYGIENE.--Cleanliness and proper care of the mouth and teeth can
hardly be over emphasized. Their bearing upon health is direct. Long ago
it was recognized that persons with decayed or missing teeth frequently
suffered from dyspepsia, a natural result of inability to masticate
properly, but only within recent years has it been realized that decayed
teeth give rise to many other diseased conditions. Bacteria are
constantly present in the mouth. If the mucus of the mouth is not
removed, it forms a sticky coat upon the surfaces of the teeth and gums.
In this bacteria collect, and pus or matter may also be formed, which,
if carried by the blood to other parts of the body, may cause digestive
troubles, rheumatism, and diseases of heart and kidneys. (See Dr. T. B.
Hartzell, Health News, Oct., 1915, "The Importance of Mouth Hygiene and
How to Practise it.")
To keep the mouth and teeth healthy they must have:
1. Proper use.
2. Proper care.
3. Proper treatment.
1. Teeth, like other parts of the body, need exercise. Foods that
require a considerable amount of chewing should be included in the diet.
Such food is needed by children as soon as their first teeth have come,
but care must be exercised to see that the food is actually chewed
before it is swallowed.
2. A good brush should be provided. The stiffness of the bristles should
be regulated according to the individual. The brush should be
thoroughly rinsed after using, and discarded as soon as it is worn.
Dental floss is generally needed to remove particles that have lodged
between the teeth.
Brushing the teeth by passing the bristles across them is not
efficacious. They should be brushed not across but with the cracks, as a
good housewife sweeps a floor.
"In the light of recent investigation conducted by some of
the leading students of mouth hygiene, the most effective
way to use the toothbrush is to place the bristles of the
brush firmly against the teeth, applying firm pressure, as
though trying to force the bristles between the teeth,
using a slight rotary or scrubbing motion.... After a
little practice the user of this method will be surprised
at the results obtained. Care should be used to go over all
the surfaces of the teeth in this manner."--(See Dr. W. G.
Ebersole. "The Importance of Mouth Hygiene and How to
Practice it," Health News, Oct., 1915.)
After brushing the teeth, the mouth should be rinsed by forcing lukewarm
water about the teeth, using all the force that can be brought to bear
by the cheeks, lips, and tongue.
3. TREATMENT.--The teeth, including the first teeth of children, should
be inspected by a competent dentist at least twice a year. Periodic
cleansing by a dentist, and early attention to small cavities, may
prevent serious ill health and impairment of the body, as well as the
acute suffering generally accompanying treatment of advanced dental
defects.
CLOTHING.--Clothing was originally used for purposes of ornament. Desire
for protection from cold and dampness came later. The amount of clothing
required varies greatly according to individual needs and habits, but it
is increasingly recognized that light clothing is best, provided that
the wearer is really protected from cold. Clothing should be porous in
order to allow ventilation of the body, supported so far as possible
from the shoulders, and clean and well aired. Dampness favors the growth
of germs which may cause irritation of the skin.
Clothing should not constrict the body or hamper its movements. Perhaps
the worst health menace for which clothing is to blame comes from the
high heeled shoes on which many women prefer to limp through life. From
the health standpoint shoes are of great importance. Bad shoes are
responsible for many cases of flat feet, whose muscles have degenerated
through non-use, and for much so-called "rheumatism," which is merely
the protest of abused muscles. Bad shoes also, by distorting the feet,
prevent comfortable walking, which is the only out-of-door exercise
readily available for the vast majority of people; and still worse, the
resulting unnatural position of the body sometimes has serious
consequences by bringing injurious strains on other muscles and organs.
FOOD.--Two distinct problems are encountered here: the problem of
nutrition, and the problem of preventing sickness. Nutrition, or proper
feeding, is a subject beyond the scope of this book; it is nevertheless
one of the most important, if not the most important, factor in
maintaining health. Food preparation and care of children, the two most
important functions of the home, are unfortunately relegated to the
least intelligent and least interested members of most households in
which servants are employed.
Most American families eat too much protein food, such as meat and eggs.
Excess of protein probably leads to degeneration of tissues, and plays a
part in causing the degenerative diseases already mentioned. Habit is
important here as in other ways of living, but cereals and vegetables
should in large measure make up the diet of sedentary persons and indeed
of everyone in warm weather.
The amount of food required in 24 hours depends on many factors: age,
height, weight, occupation, season, and habit. Underweight and
overweight are both abnormal conditions; probably the latter is the more
easily remedied. Both require the advice of a physician. Rapid reduction
of weight involves certain dangers, especially for persons with weak
hearts.
Food may cause sickness either because it is in itself harmful, or
because it carries disease germs. Meat from diseased animals should be
destroyed before it reaches the market, but bacterial activities in food
originally wholesome may form in it poisonous substances.
The chief diseases known to be carried by food, water, or milk are
typhoid fever, paratyphoid, dysentery and other diarrhœal diseases,
scarlet fever, diphtheria, septic sore throat, and tuberculosis. The
sole problem here is to keep human and animal excretions out of food,
water, and milk. Since thorough cooking kills disease germs, danger
arises chiefly from raw foods. All fruits and vegetables eaten raw
should first be thoroughly washed.
Water is essential to health. At least three pints should be taken
daily, the amount varying somewhat according to diet, exercise,
temperature, and so forth. Most persons drink too little water.
Cities and towns should of course have public supplies of pure water.
Contamination of water, when it occurs, is caused chiefly by sewage
from cesspools, privies, and drains. All well or spring water must be
constantly watched and Boards of Health are always ready to examine
samples of water and to report whether it is safe to drink. At the
present time a porcelain filter is the only satisfactory kind for a
household, but many domestic filters are so badly cared for that in
actual practice they are worse than none. Danger from a filter
containing an accumulation of impurities is greater than the danger from
most ordinary water supplies. Boiling water for ten minutes kills all
pathogenic germs, but this method is inconvenient on a large scale and
is not practical for continued family use.
Every effort should be made to insure a regular supply of pure water in
every house. It is not satisfactory to have two kinds, one for drinking
and one for other purposes, since mistakes are sure to be made,
especially by children. Some families who use only bottled or filtered
water for drinking purposes habitually run the risk involved in using
impure water from the tap for cleaning the teeth.
Freezing destroys most germs, but ice is not necessarily free from
bacterial life, and should be used in drinking water only when known to
be free from impurities. Neither does freezing milk or cream
necessarily kill germs that may be contained in it.
Raw milk plays so important a part in the spread of disease that its
fitness for human consumption is open to serious question. Certified
milk, where obtainable, is safe but expensive. Boiled milk is safe, but
changed in taste and to some extent in quality. If milk is heated to
142°-145° F. and kept at that temperature for 30 minutes all disease
germs in it are killed. This process, called pasteurization, renders
milk safe. The objection is sometimes made that continued use of
pasteurized milk for infants causes scurvy, but in New York City where
over 90 per cent. of the milk is pasteurized no increase in scurvy has
been noticed, while a large diminution in deaths of infants from
diarrhœal diseases has resulted, as in all cities where pasteurization
is required.
The following is a simple method for pasteurizing a quart bottle of
milk. If the directions are exactly followed the milk will be
pasteurized at the end of the process; no thermometer need be used. To
prevent the bottle from breaking, it is first warmed by placing it for a
few minutes in a pail of warm water.
"From the results of the experiments it was concluded that
any housewife can pasteurize a one quart bottle of milk by:
1. Boiling 2½ quarts of water in a large agate saucepan; or
better
2. Boiling 2 quarts of water in a 10 pound tin lard pail,
placing the slightly warmed bottle from the ice chest in
it, covering with a cloth and setting in a warm place. At
the end of one hour the bottle of milk should be removed
and chilled promptly. The water must be boiled in the
container in which the pasteurization is to be
done."--(Ruth Vories, in "Health News," Sept., 1916.)
ELIMINATION.--Careful attention should be paid to elimination through
the bowels and kidneys. Constipation is responsible for many common
ailments; among them are headache, disinclination to work, irritable
temper, and lowered resistance. If long continued, constipation becomes
serious both from congestion and displacement of pelvic organs, and from
absorption over a considerable time of even small amounts of the
poisonous substances resulting from decomposition of food in the large
intestine. The bowels can best be regulated by diet, water, exercise,
and habit. The habitual use of cathartic and laxative drugs is most
unwise, because they tend to aggravate the trouble. Moreover the
habitual and continued use of injections and "internal baths" is
harmful, and would not be considered necessary if bran and coarse flour
and vegetables were substituted for concentrated foods. Greed, laziness,
and lack of intelligence lead most persons suffering with constipation
to prefer pills to the restraints demanded by hygienic living. The habit
of evacuating the bowels at a regular time, if established in early
childhood and rigidly adhered to, will prevent constipation among most
healthy people. Any person who thinks drugs necessary should consult a
physician, and be prepared to follow the régime he advises over a
considerable period of time and at the cost of some self-denial.
For healthy people, voiding urine presents no difficulty if a sufficient
amount of water is taken; but some persons reduce the amount of liquid
taken in order to escape the inconvenience of urination. This practice
is harmful, and may involve insufficient cleansing of the entire system.
If frequent urination disturbs sleep, liquids may be withheld during the
evening; but the total amount of water taken in 24 hours should not be
diminished.
REST AND FATIGUE.--A fatigued person is a poisoned person. Muscular
exertion burns the fuel constituents of the body, as we recognize by the
greater heat generated within us during muscular exertion. Waste
products, resulting from this burning process, accumulate if not
removed, and clog the body in somewhat the same way that ashes and
cinders clog a furnace. The fatigued person remains fatigued,
consequently, until the accumulations of waste matter are removed by the
normal action of the lungs, skin, and kidneys.
Fatigue is caused by both mental and physical work, and when excessive,
affects the nervous system most disastrously. The body can and should
respond to occasional extra drafts on strength and endurance; its
flexibility and power of adjusting to varying conditions may even be
stimulated thereby. But even slight fatigue, if continued and especially
if associated with anxiety or worry, has caused many nervous and mental
breakdowns.
Work carried beyond the point of normal fatigue requires a
proportionately longer time for recovery. For example, if the point of
fatigue has been reached by a certain finger muscle after 15
contractions, and if half an hour is required to rest it completely, one
might suppose that one hour would rest it after 30 contractions. This is
not so, however; after 30 contractions 2 hours are required, or 4 times
as much rest for twice the amount of work, if continued beyond the point
of fatigue. Laboratory experiments and experience alike show that this
principle holds true in other forms of fatigue. Thus the output of
factories has been shown in many instances to be greater, other things
being equal, when operatives work 8 hours a day than when they work
longer. Excessive hours in any kind of work are the poorest economy.
Fatigue is increased in direct proportion not only to muscular exertion
but also to the amount of speed, complexity, responsibility, monotony,
noise, and confusion involved in an occupation. Ability to bear fatigue
differs greatly with different people, as ability varies to bear other
kinds of strain. Rest at night and on Sunday, and the annual vacation
should be enough to keep a person in good condition. If not, there is
probably something wrong with the worker's health, the nature of his
work, or his adaptation to his particular kind of work. This statement
is not only true of persons regularly employed, but of those living at
home, including children in school, women in "society," and especially
mothers of families.
SLEEP.--A sufficient amount of sleep is essential to health, but
individual requirements vary widely. Each person should know and regard
his own need, and children and young people should be obliged to go to
bed early. Ability to sleep is largely habit; good habits should be
formed and continued. Sleep-producing drugs should never be taken,
except by a doctor's prescription.
RECREATION.--Owing to the speed, complexity, and worry of modern life
among all classes, and to the monotony of work in industry, recreation
has become a matter of vital importance for everyone. Some muscular
activity, preferably in the open air, is needed by every healthy person.
Recreation should be as unlike the regular occupation as possible: going
to the theatre, for example, is not the best exercise for sedentary
workers employed all day in artificially lighted offices. The element of
pleasure is essential. Hoisting dumb-bells purely from conscientious
motives is seldom beneficial, and is generally soon abandoned.
The part played by habit in matters of health is often overlooked.
Although the body adjusts itself to widely varying conditions and even
to unfavorable ones, the importance of forming desirable habits cannot
be overemphasized. Sudden or radical changes in living, however,
particularly among people no longer young, may play havoc. New and
violent systems of exercise, weight reduction, and food fads forced on
families by enthusiastic discoverers involve considerable risk.
Many elements enter into health; in no single one is found hygienic
salvation. Temptation always exists to emphasize one element at the
expense of others. For instance, people who insist upon overventilating
rooms regardless of others' comfort may themselves be utterly careless
in regard to necessary sleep, and more than one fastidiously clean
person has disregarded the highly unclean condition of constipation. To
maintain sound health only a rational program will suffice: properly
balanced work and play, sleep and food and all other elements must be
included in due proportion. And over-anxious health seekers might well
remember that health is not so much an end in itself, as a means to a
happy and productive life; even in concern over health, it is possible
for him that saveth his life to lose it.
EXERCISES
1. Explain the difference between an hereditary disease and hereditary
susceptibility to a disease. How may hereditary susceptibility to a
disease be combatted?
2. What are the essentials of good ventilation?
3. What is the proper temperature for a living room? What are the
effects of higher temperatures? Of lower temperatures?
4. Describe methods for maintaining household cleanliness.
5. Discuss the importance from the point of view of health, of dust; of
insects; of garbage; of sewage.
6. What principles should guide one in deciding whether a certain water
supply is safe to use for drinking purposes? What are the dangers of
impure water? How can impure water be rendered safe?
7. What diseases may be carried by milk? How can milk be rendered safe?
8. Explain the health aspects of personal cleanliness.
9. What care should be given the teeth and mouth? Why?
10. What bad results frequently follow constipation? How should
constipation be remedied?
11. Name seven factors that are important in causing fatigue. Why is it
uneconomical to continue work, either physical or mental, beyond the
point of fatigue?
12. What facilities for recreation, especially in the open air, does
your community provide for little children? For school children? For
working boys and girls? For grown people?
FOR FURTHER READING
Health and Disease--Roger I. Lee, Introduction and Chapters I, III-V,
VII-IX.
How to Live--Fisher and Fisk, Chapters I, III-V.
The Human Mechanism--Hough and Sedgwick, Chapters V, XXII-XXIX.
Disease and Its Causes--Councilman, Chapters X, XII.
Fatigue and Efficiency--Goldmark, Chapters II, III.
Preventive Medicine and Hygiene--Rosenau.
A Manual of Personal Hygiene--6th Edition, Edited by Walter L. Pyle.
Four Epochs of a Woman's Life--Galbraith.
Hygiene and Physical Culture for Women--Galbraith.
The Home and Its Management--Kittredge.
Exercise and Health--F. C. Smith, Supplement 24 to the Public Health
Reports, Government Printing Office, Washington.
The Sanitary Privy--Farmers' Bulletin 463, United States Department of
Agriculture, Government Printing Office, Washington.
Safe Disposal of Human Excreta at Unsewered Homes--Lumsden, Stiles and
Freeman, Bulletin 68, Public Health Reports, Government Printing Office,
Washington.
The Disposal of Human Excreta and Sewage of the Country Home--New York
State Department of Health, Albany.
Milk and Its Relation to Public Health--Bulletin 56, Hygienic
Laboratory, Government Printing Office, Washington.
Milk and Its Relation to Health--New York State Department of Health,
Albany.
Other Publications of the United States Public Health Service and of the
Departments of Health of the different states and cities.