CATCHING DISEASES, COLDS, DISEASED GLANDS
Deadly fevers, the plague, black death, cholera, malaria, smallpox,
taught mankind invaluable lessons. Millions of human beings died before
the mind of man devoted itself to preventing the diseases for which no
sure cure had been found. Efforts to conquer these diseases were tardy
because men were taught that some unseen power was punishing men and
governments for their sins. The difference between the old and the new
way is shown powerfully by a painting in the Liverpool Gallery entitled
"The Plague." A mediæval village is strewn with the dead and dying.
Bloated, spotted faces look into the eyes of ghouls as laces and
jewelry are torn from bodies not yet cold. In the foreground a muscular
giant, paragon of conscious virtue, clad like John the Baptist and
Bible in hand, finds his way among his plague-stricken fellow-townsmen,
urging them to turn from their sins. Modern efficiency learns of the
first outbreak of the plague, isolates the patient, kills rats and
their fleas which spread the disease, thoroughly cleanses or destroys,
if necessary, all infected clothing, bedding, floors, and walls, and
makes it possible for us to go on living for each other with a better
chance of "bringing forth fruits worthy for repentance."
Where boards of health make it compulsory to report cases of sickness
due to contagion, health records are a reliable index to "catching"
diseases. But now that the chief infection is the kind that afflicts
children, we can read the index before the outbreak that calls in a
physician to diagnose the case. School examination shows which
children have defects that welcome and encourage disease germs. It
points to homes that cultivate germs, and consequently menace other
homes. To locate children who have enlarged tonsils may prevent a
diphtheria epidemic. To detect in September those who are
undernourished, who have bad teeth, and who breathe through the mouth
will help forecast winter's outbreaks of scarlet fever and measles. One
dollar spent at this season in examination for soil hospitable to
disease germs may save fifty dollars otherwise necessary for inspection
and cure of contagious diseases.
It is harder at first to interest a community in medical examination
than in medical inspection, because we are all afraid of "catching"
diseases, while few of us know how they originate and how they can be
prevented by correcting the unfavorable conditions which physical
examination of school children will bring to light.
Courses in germ sociology are therefore of prime necessity. How do
germs act? On what do they live? Why do they move from place to place?
What causes them to become extinct? With few exceptions, germs migrate
for the same reason as man,--search for food, love of conquest, and
love of adventure. When there is plenty of food they multiply rapidly.
Full of life, overflowing with vitality, they move out for new worlds
to conquer. Like human beings, they will do their best to get away from
a country that provides a scanty food supply. Like men and women, they
starve if they cannot eat. Like boys and girls, they avoid enemies; the
weak give way to the strong, the slow to the swift, the devitalized to
the vitalized.
Human sociology imprisons, puts to death, deprives of opportunity to do
evil, or reforms those who murder, steal, or slander. Germ sociology
teaches us to do the same with injurious germs. We imprison them, we
take away their food supply, we kill them outright, or we starve them
slowly. They have a peculiar diet, being especially partial to
decomposing vegetable and animal matter and to what human beings call
dirt. By putting this diet out of their reach we make it impossible for
them to propagate their kind. By placing poison within their reach or
by forcing it upon them we can successfully eliminate them as enemies.
As the president of Mexico restored order "by setting a thief to catch
a thief," so modern science is setting germs to kill germs that harm
crops and human stock. Of utmost consequence is it that the body's germ
consumer--its pretorian guard--be always armed with vitality ready to
vanquish every intruding hostile germ. If we are false to our guard, it
will turn traitor and join invaders in attacking us. But here, as in
dealing with evils that originate with human beings, an ounce of
prevention is worth a ton of cure. The most effectual way to eliminate
germ diseases is to remove the cause--the food supply of disease germs.
The fact that many germs are plants, not animals, does not weaken the
analogy, for weeds do not get a chance in well-tilled soil.
Perhaps the most notable recent example of government germ
extermination is the triumph over the yellow-fever and malaria mosquito
in Panama. When the French started to build a canal in Panama, the
first thing they did was to build a hospital. The hospital was always
full and the canal was given up. At the time the United States proposed
to re-attempt the work, it was thought that it could not be done
without great loss of life and without great labor difficulties.
Instead of taking the sickness for granted and enlarging the French
hospital, the chief medical inspector, Gorgas, took for granted that
there need be no unusual sickness if proper preventive measures were
taken. He knew what the French had not known, that the yellow-fever
scourge depends for its terrors upon mosquitoes. Accordingly, with the
aid of six thousand men and five million dollars he set about to
starve out the few infected and infectious kinds of mosquito,--the
yellow-fever or house mosquito and the malaria or meadow mosquito. He
introduced waterworks and hydrants, paved the streets, drained the
swamps and pools in which they breed, and instituted a weekly
house-to-house inspection to prevent even so much as a pail of stagnant
water offering harbor to these enemies. The grass of the meadows where
the malaria mosquito breeds was cut short and kept short within three
hundred feet of dwellers,--as far as the mosquito can fly. All ditches
were disinfected with paraffin, and the natives were forced to observe
sanitary laws. President Roosevelt, in his special message to Congress
on the Panama Canal in 1906, stated that in the weekly house-to-house
visit of the inspectors at the time he was in Panama but two mosquitoes
were found. These were not of the dangerous type. As a consequence of
this sanitary engineering there is very little sickness in Panama, the
hospital is seldom one third full, and the canal is progressing very
much faster than was expected. Panama, like Havana, is now safer than
many American cities, because cleaner and less hospitable to disease
germs.
Any place where numbers of people are accustomed to assemble favors the
propagation of germs,--whether it be the meetinghouse, the townhall,
the theater, or the school. Every teacher can be the sanitary engineer
of her own schoolroom, school, or community by coöperating with the
school doctor, the town board of health, family physicians, and
mothers. Every teacher can exterminate disease by applying the very
same principles to her schoolroom as Chief Medical Inspector Gorgas
applied to Panama. Knowledge, disinfection, absolute cleanliness,
education, and inspection are the essential steps. First she must know
that "children's diseases" are not necessary. She should discountenance
the old superstition that every child must run the gamut of children's
diseases, that every child must sooner or later have whooping cough,
measles, chicken pox, mumps, scarlet fever, just as they used to think
yellow fever and cholera inevitable. The price of this terrible
ignorance has been not only expense, loss of time, acquisition of
permanent physical defects, and loss of vitality, but, for the majority
of children, death before reaching five years of age. All these
"catching" diseases are germ diseases, which disinfection can
eliminate. The free use of strong yellow soap and disinfectants on the
school floor, windows, benches, desks, blackboards, pencils, in the
coat closets and toilets, plus the natural disinfectants, hot sun and
oxygen, will prevent the schoolroom from being a source of danger. One
or more of these germ-killing remedies must be constantly applied;
cleansing deserves a larger part in every school budget.
Often country towns are as ignorant of the existence of germs and of
the means of preventing the spread of disease as the woman in a small
country town who used daily to astound the neighbors by the "shower of
snow" she produced by shaking the bedding of her sick child out of the
window. Their astonishment was soon changed to panic when that shower
of snow resulted in a deadly epidemic of scarlet fever. Medical
inspection of New York City's schools was begun after an epidemic of
scarlet fever was traced to a popular boy who passed around among his
schoolmates long rolls of skin from his fingers.
Much of the care exercised at school to prevent children's diseases is
counteracted because children are exposed at home and in public places
to contagion, where ignorance more often than carelessness is the cause
of uncleanliness. By hygiene lessons, illustrating practically the
proper methods of cleaning a room, much may be done to enlist school
children in the battle against germs. Through the enthusiasm of the
children as well as through visits to the homes parents may be
instructed as to the danger of letting well children sleep with sick
children; the wisdom of vaccination to prevent smallpox, of antitoxin
to prevent serious diphtheria, of tuberculin tests to settle the
question whether tuberculosis is present; why anything that gathers
dust is dangerous unless cleansed and aired properly; and why bedding,
furniture, floor coverings, and curtains that can be cleansed and aired
are more beautiful and more safe than carpets, feather beds,
upholstery, and curtains that are spoiled by water and sunshine; how to
care for the tuberculous member of the family, etc. Anti-social acts
may be prevented, such as carrying an infected child to the doctor in a
public conveyance, thereby infecting numberless other people; sending
infected linen to a common laundry; mailing a letter written by an
infected person without first disinfecting it; sending a child with
diphtheria to the store; returning to the dairy unscalded milk bottles
from a sick room.
The daily inspection of school children for contagious diseases by the
school physician has, where tried, been found to reduce considerably
the amount of sickness in a town. Such inspection should be universally
adopted. Moreover, the teacher should be conversant with the early
symptoms of these diseases so that on the slightest suspicion the child
may be sent home without waiting for the physician's call. Like the
little girl who never stuttered except when she talked, school children
and school-teachers are rarely frightened until too late to prevent
trouble. The "easy" diseases such as measles, whooping cough, etc.,
cost our communities more than the more terrible diseases like typhoid
and smallpox. During one typical week ending May 18, 630 new cases of
measles were reported to one department of health. Obviously the
nineteen deaths reported give no conception of the suffering, the cost,
the anxiety caused by this preventable disease. The same may be said
of diphtheria and croup, of which only thirty-two deaths are reported,
but 306 cases of sickness. Yet no one to-day will send a child to sleep
with a playmate so as to catch diphtheria and "be done with it."
The most strategic point of attack is almost universally unrecognized.
That is the child's mouth. Here the germs find lodgment, here they find
a culture medium--at the gateway of the human system. The mouth is
never out of service and is almost never in a state of true
cleanliness. Solid particles from the breath, saliva, food between the
teeth, and other débris form a deposit on the teeth and decompose in a
constant temperature of ninety-eight degrees Fahrenheit. In the normal
mouth from eight to twenty years of age the teeth present from twenty
to thirty square inches of dentate surface, constantly exposed to
ever-changing, often inimical, conditions. This bacterially infected
surface makes a fairly large garden plot. Every cavity adds to the
germ-nourishing soil. Dental caries--tooth decay--is a disease hitherto
almost universal from birth to death. Thus the air taken in through the
mouth becomes a purveyor of its poisonous emanations and affects the
lung tissues and the blood. Food and water carry hostile germs down
into the stomach. Thence they may be carried into any organ or tissue,
just as nourishment or poison is carried.
Moreover, the child with an unclean mouth not only infects and
reinfects himself but scatters germs in the air whenever he sneezes or
coughs. In a cold apartment where there is no appreciable current of
air a person can scatter germs for a distance of more than twenty-two
feet. Germs are also scattered through the air by means of salivary or
mucous droplets. It is this fact that makes colds so dangerous.
TABLE VIII
=City of Manchester Education Committee=
=INFECTIOUS OR CONTAGIOUS DISEASES IN SCHOOLS INFORMATION FOR TEACHERS=
Four columns are omitted: (1) Interval between Exposure to
Infection and the First Signs of the Disease; (2) Day from Onset
of Illness on which Rash appears; (3) Period of Exclusion from
School after Exposure to Infection; (4) Period of Exclusion from
School of Person suffering from the Disease
-----------+------------------------------+------------+------------------
DISEASE | PRINCIPAL SIGNS AND SYMPTOMS | Method of | REMARKS
| | Infection |
-----------+------------------------------+------------+------------------
Measles |_Begins like cold in the | |After effects
|head_, with _feverishness, | |often severe.
|running nose, inflamed and | |Period of greatest
|watery eyes, and sneezing_; | |risk of infection
|small crescentic groups of | Breath and |first three or
|_mulberry-tinted spots_ appear| discharges |four days, before
|about the third day; _rash | from nose |the rash appears.
|first seen on forehead and | and mouth. |May have repeated
|face_. The rash varies with | |attacks. Great
|heat; may almost disappear if | |variation in type
|the air is cold, and come out | |of disease.
|again with warmth. | |
-----------+------------------------------+------------+------------------
German |Illness usually slight. Onset | |
Measles |sudden. _Rash often first | |
|thing noticed;_ no cold in | Breath and |
|head. Usually have | discharges |After effects
|_feverishness_ and _sore | from nose |slight.
|throat_, and the _eyes may | and mouth |
|be inflamed. Rash_ something | |
|between Measles and Scarlet | |
|Fever, variable. | |
-----------+------------------------------+------------+------------------
Chicken |Sometimes begins with | |When children
Pox |feverishness, but is _usually | |return, examine
|very mild_ and without sign | |head for
|of fever. _Rash_ appears on | |overlooked spots.
|second day as _small pimples_,| |All spots should
|which in about a day become | |have disappeared
|filled with _clear fluid_. | Breath and |before child
|This fluid then becomes | crust of |returns. A mild
|_matter_, and then the _spot | spots. |disease and
|dries up_and _the crust falls | |seldom any after
|off_. | |effects.
| | |
|May have _successive crops of | |
|of rash_ until tenth day. | |
-----------+------------------------------+------------+------------------
Whooping |_Begins like cold in the | |After effects
Cough |head_, with _bronchitis_ and | |often very severe
|_sore throat_, and a _cough_ | |and the disease
|which is _worse at night_. | Breath and |causes great
|Symptoms may at first be very | discharges |debility. Relapses
|mild. Characteristic | from nose |are apt to occur.
|_"whooping" cough_ develops | and mouth. |Second attack
|in about a fortnight, and the | |rare. Specially
|spasm of coughing often ends | |infectious for
|with _vomiting_. | |first week or two.
| | |If a child is sick
| | |after a bout of
| | |coughing, it is
| | |most probably
| | |suffering from
| | |whooping cough.
| | |
| | |Great variation in
| | |type of disease.
-----------+------------------------------+------------+------------------
Mumps |Onset may be sudden, beginning| |
|with sickness and fever, and | |
|_pain about the angle of the | Breath and |Seldom leaves
|jaw_. The _glands become | discharges |after effects.
|swollen and tender_, and the | from nose |Very infectious.
|_jaws stiff_, and the _saliva | and mouth. |
|sticky_. | |
-----------+------------------------------+------------+------------------
Scarlet |The _onset is usually sudden_,| Breath, |Dangerous both
Fever or |with _headache, languor, | discharges |during attack and
Scarlatina |feverishness, sore throat_, | from nose |from after effects.
|and often the child is _sick_.| and mouth, |Great variation
|Usually within twenty-four | particles |in type of disease.
|hours the _rash_ appears, and | of skin, |Slight attacks
|is _finely spotted, evenly | and |as infectious as
|diffused_, and _bright red_. | discharges |severe ones. Many
|The _rash_ is seen first on | from |mild cases not
|the _neck and upper part of | suppuratory|diagnosed and many
|chest_, and lasts three to | glands or |concealed. The
|ten days, when it fades and | ears. Milk |peeling may last
|the _skin peels in scales, | specially |six to eight weeks.
|flakes_, or even _large | apt to |A second attack is
|pieces_. The _tongue_ becomes | convey |rare. When scarlet
|whitish, with bright red | infection. |fever is occurring
|spots. The eyes are not watery| |in a school, all
|or congested. | |cases of sore
| | |throat should be
| | |sent home.
-----------+------------------------------+------------+-------------------
Diphtheria |Onset insidious, may be rapid | Breath and |Very dangerous
|or gradual. Typically _sore | discharges |both during attack
|throat_, great weakness, and | from nose, |and from after
|swelling of glands in the | mouth, and |effects. When
|neck, about the angle of the | ears. |diphtheria is
|jaw. The back of the throat, | |occurring in a
|tonsils, or palate may show | |school all children
|_patches_ like pieces of | |suffering from sore
|yellowish-white kid. The most | |throat should be
|pronounced symptom is great | |excluded. There is
|debility and lassitude, and | |great variation of
|there may be little else | |type, and mild
|noticeable. There may be | |cases are often not
|hardly any symptoms at all. | |recognized but are
| | |as infectious as
| | |severe cases. There
| | |is no immunity from
| | |further attacks.
| | |Fact of existence
| | |of disease
| | |sometimes
| | |concealed.
-----------+------------------------------+------------+-------------------
Influenza |_Begins with feverishness, | Breath and |Excessively
|pain in head, back_, and | discharges |infectious. After
|_limbs_, and usually _cold in | from nose |effects often very
|the head_. | and mouth. |serious and
| | |accompanied with
| | |great prostration
| | |and nervous
| | |debility.
-----------+------------------------------+------------+--------------
Smallpox |The illness is usually well | Breath, |Peculiarly
|marked and the onset rather | all |infectious. When
|sudden, with _feverishness, | discharges,|smallpox occurs in
|severe backache, and | and |connection with a
|sickness_. About third day | particles |school or with any
|a _red rash_ of _shotlike | of skin |of the children's
|pimples_, felt below the skin,| or scabs. |homes, an endeavor
|and seen first about the | |should be made to
|_face_ and _wrists. Spots | |have all persons
|develop_ in _two days_, then | |over seven years
|form _little blisters_, and | |of age
|in other two days become | |revaccinated.
|_yellowish_ and filled with | |
|matter. _Scabs_ then form, | |Cases of modified
|and these fall off about | |smallpox--in
|the fourteenth day. | |vaccinated
| | |persons--may be,
| | |and often are, so
| | |slight as to
| | |escape detection.
| | |Fact of existence
| | |of disease may be
| | |concealed. Mild
| | |or modified
| | |smallpox as
| | |infectious as
| | |severe type.
-----------+------------------------------+------------+-----------------
=In the following diseases only the affected child is excluded=
=Erysipelas.= Child should not | =Ringworm on Scalp.= Child should
return till all swelling and | be excluded till cured. Very
peeling of skin has disappeared. | difficult to cure and often takes
| a very long time.
=Ophthalmia.= Child should not |
return till all traces have | =Phthisis= (=Consumption=). If in
disappeared. | advanced stage and coughing much
| _or spitting_, child should be
=Scabies or Itch.= Child should be | excluded. (Infection from breath
excluded until cured. | and dried spit floating in the air
| as dust.)
=Ringworm on Skin.= Child should be |
excluded till cured. This takes | =Impetigo= (=Contagious Sore=).
only a few days if properly | Child should be excluded until
treated. | cured. A week or ten days should
| suffice.
=A. BROWN RITCHIE=, _Medical Officer to Education Committee_.
Most people still think that colds are due to cold air or draughts
rather than to a cold germ, which finds a body unequipped with
resisting power, with its germ police off guard, exhausted from
overwork, or disaffected and ready to turn traitor if the enemy seems
stronger than our vitality. Sometimes it seems as if we contracted it
from a sneezing fellow-passenger, sometimes from a draught from an open
car window. An uninformed opponent of the theory that colds are a germ
disease wrote the following letter last winter to a New York newspaper:
In addition to the Society for the Suppression of Noises there
should be in this town a Society for the Suppression of
"Fresh-Air" Fiends. The newspapers report an epidemic of
pneumonia, grippe, and colds. It is almost entirely due to the
fact that the average New Yorker is compelled to live, move, and
have his being from daylight to midnight in a succession of
draughts of cold air caused by the insanity of overfed male and
female hogs, who, with blood almost bursting through their skins,
demand "fresh air" in order to keep from suffocating. Everywhere a
man goes, day or night, he is in a draught caused by the crazy
ideas about fresh air.
Our wise ancestors, who as a rule lived much longer than we do,
and had much better health, said:
"If the wind should blow through a hole,
God have mercy on your soul."
After the correspondent has learned that our ancestors had more colds
than we, had poorer health, and died twenty years younger, perhaps he
will listen to proof that his unclean warm air weakens the body and
makes it an easy prey to cold germs.
Many physicians preach and practice this fallacy as to fresh air and
colds, but few physicians now deny that influenza is a germ disease or
that a nose so irritated and so neglected as to secrete large
quantities of mucus is a better place for breeding disease germs than a
nose whose membranes are clean and not thus irritated.
Until medical specialists are agreed, and until they have definitely
located the cold germ, we laymen must choose for ourselves a working
theory. The weight of opinion at the present time declares that colds
are due to germs. Strong membranes with good circulation and drainage
provide poor food for germs. Congested membranes furnish proper
conditions for propagation. The germ theory explains the spread of
germs from the nose to the passages of the head, and from head to
arteries and lungs.
A cold can always be charged to some one else. How many can be laid to
our account? There is one right that is universally not recognized, and
that is the right of protection from the germs showered in the air we
breathe, over the food we eat, by the sneezes of our unfortunate
neighbor at school, in the street car, at the restaurant. The chief
danger of a cold is to our neighbor, not to ourselves. A cold which a
strong person may throw off in a day or two may mean death to his
tuberculous neighbor. Though for our own health "lying up for a mere
cold" is an unnecessary bore, the failure to do so may deprive our
neighbor of a right greater than the right to protection against
scarlet fever or smallpox. Though formerly this statement would not
have been true, rights change with conditions, and the fact that to-day
the three most deadly diseases are pneumonia, tuberculosis, and
diphtheria,--all diseases of the respiratory organs,--justifies the
assertion that we have a right to protection against colds. The
prevalence of colds, sore throats, irritated vocal cords, bad voices,
catarrh, bronchitis, laryngitis, and asthma in America to-day demands
summary measures. One can learn to sneeze into a handkerchief, not into
a companion's face or into a room. School children can be taught to
avoid handkerchiefs on which mucus has dried. In the far distant future
we may be willing to use cheesecloth, and boil it or throw it away, or,
like the Japanese, use soft paper handkerchiefs and burn them after
using.
TABLE IX
DEATH RATE PER 10,000 POPULATION, PNEUMONIA AND BRONCHITIS FIVE-YEAR
PERIOD, 1896-1900
England and Wales 22.70
Scotland 27.40
Stockholm 26.70
London 31.20
Berlin 16.10
Vienna 39.70
Christiania 21.30
Boston 30.60
Chicago 24.20
Philadelphia 25.10
New York City 36.60
One child with a cold can infect a whole class or family, thus
depriving the class and family of the top of their vitality and
efficiency without their consent. Because a person is thought a
weakling who lies up for a "mere cold," one is inclined to wish that
colds were as prostrating as typhoid, in which case there would be some
hope of their extermination.
The exclusion of children with colds from school deserves trial as a
check to children's diseases. Many of these "catching" diseases start
with a cold in the head, as, for instance, measles, influenza, and
whooping cough. The first symptom of mumps, diphtheria, and scarlet
fever is a sore throat or swollen glands, which, because they commonly
accompany a cold, are not at first distinguished from it.
The first step for the teacher or mother in reading the index for colds
is to look into the coat closet for evidence of warm clothing and
overshoes, then to note whether the children put them on when they go
out for lunch or recess. Whether "cold" settles in the nasal passages,
ear, or stomach depends upon which is the weak spot. Draughts, thin
soles, wet soles, exposure when perspiring, may be the immediate cause
of the nutritional or respiratory disturbances that give cold germs a
foothold. Adenoids, diseased teeth, inflamed ears, may furnish the food
supply. "There is no use treating children and sending them on
fresh-air trips as long as they have nutritional and digestive
disturbances due to bad teeth, or colds due to adenoids," said a
physician when examining a party of children for a summer outing. The
great preventive measure to be taken for catching diseases, colds,
diseased glands,--in fact all germ diseases,--is the repeated cleansing
of those portions of the human body in which germs may find
lodgment,--the mouth, the nose, the eyes, and the ears.
In caring for young infants great pains is taken to cleanse all the
orifices daily, but as soon as the child washes himself this practice
is usually abandoned. Washing these gateways is far more important than
washing the surface of the body through which germs could not possibly
gain entrance into the system except through wounds. Oftentimes the
douching of the nostrils with salt water will stop a cold at once. The
mouth is the most important place of all, and the teacher should take
care of her pupils' mouths first and foremost. As bad teeth, enlarged
tonsils, and adenoids harbor germs and putrescent matter that vitiate
every incoming and outgoing breath, these defects should be immediately
corrected. Are we coming to a time when a thorough house-cleaning in
the mouth of every child will take place before he enters the
schoolroom, preferably in the presence of the teacher?
Two other "catching" diseases cause city schools a great deal of
trouble,--trachoma and pediculosis (head lice). There are probably no
two diseases more quickly transmitted from one person to another.
Almost before their presence is known, all children of a school or all
persons of a group have contracted them. When at college twenty men of
my fraternity discovered almost at the same time that they had an
infectious eye trouble; yet we thought we were using different towels
and otherwise taking sanitary precautions. Last summer a Vassar
graduate took a party of tenement children for a country picnic. She
returned with head lice that required constant attention for weeks.
What then may we expect of children who live in homes where there is
neither water, time, nor privacy for bathing, where one towel must
serve a family of six, where mothers work for wages away from home and
see their children only before seven and after six?
Unfortunately for thousands of children, many parents still believe
these troubles will be outgrown. Last summer a fresh-air agency in New
York City arranged for several hundred school girls to go to a certain
camp for ten days each. The only condition was that the heads should be
free from lice and nits (eggs). From the list furnished by
school-teachers--girls supposed to have been cured by school
nurses--not one in five was accepted. A baby two weeks old, brought to
Caroline Rest, had already begun to suffer from this easily preventable
scourge. Of 1219 children examined in Edinburgh, Scotland, 909, or 69
per cent, had some skin disease, and 60 per cent had sores due to head
lice. Even when neglect has caused the loss of hair and ugly sores on
the head, mothers deceive themselves into believing that some other
cause is responsible.
Trachoma, if neglected, not only impairs the health of the eye, but may
cause blindness. Tears carry the germs from the eye to the face, where
they are taken up on handkerchiefs, towels, and fingers and infect
other eyes. Of late, thanks to school nurses and physicians and hygiene
instruction, American cities have found relatively little trachoma
except among recent immigrants. So dangerous is the germ and so
insidious its methods of propagation, that a physician should be
summoned at once at the first sign of inflammation. Conjunctivitis is
due to a germ, and will spread unless checked. Since the board of
health of New York City has instituted the systematic examination of
the eyes of the children in the public schools, it has found fully one
third affected with some form of conjunctivitis. Many of these cases
are out-and-out trachoma, others acute conjunctivitis, and a larger
proportion are "mild trachoma." This last form of the disease is found
to a great extent among children who have adenoids. The adenoids should
be regarded as a predisposing factor rather than a direct cause.
Therefore sore eyes are given as one of the indexes of adenoids. When
we consider that adenoids are made up of lymphoid material, and that
trachoma follicles are made up of the same sort of tissue, it is not
surprising that the two conditions are found in the same child. The
catarrhal inflammation produced by adenoids in the nasal mucous
membrane travels up the lachrymal duct and thus infects the conjunctiva
by contiguity.
In preventing pediculosis and infection of the eye vigilance and
cleanliness are indispensable. After the diseases are advanced, after
the germ colonies have taken title, some antiseptic or germ killer more
violent than water is needed,--kerosene for the hair or strong green
oil soap; for the eye, only what a physician prescribes.