1. Pure air.
2. Pure water.
3. Efficient drainage.
4. Cleanliness.
5. Light.
Without these, no house can be healthy. And it will be unhealthy just in
proportion as they are deficient.
[Sidenote: Pure air.]
1. To have pure air, your house must be so constructed as that the outer
atmosphere shall find its way with ease to every corner of it. House
architects hardly ever consider this. The object in building a house is
to obtain the largest interest for the money, not to save doctors' bills
to the tenants. But, if tenants should ever become so wise as to refuse
to occupy unhealthily constructed houses, and if Insurance Companies
should ever come to understand their interest so thoroughly as to pay a
Sanitary Surveyor to look after the houses where their clients live,
speculative architects would speedily be brought to their senses. As it
is, they build what pays best. And there are always people foolish
enough to take the houses they build. And if in the course of time the
families die off, as is so often the case, nobody ever thinks of blaming
any but Providence[8] for the result. Ill-informed medical men aid in
sustaining the delusion, by laying the blame on "current contagions."
Badly constructed houses do for the healthy what badly constructed
hospitals do for the sick. Once insure that the air in a house is
stagnant, and sickness is certain to follow.
[Sidenote: Pure water.]
2. Pure water is more generally introduced into houses than it used to
be, thanks to the exertions of the sanitary reformers. Within the last
few years, a large part of London was in the daily habit of using water
polluted by the drainage of its sewers and water closets. This has
happily been remedied. But, in many parts of the country, well water of
a very impure kind is used for domestic purposes. And when epidemic
disease shows itself, persons using such water are almost sure to
suffer.
[Sidenote: Drainage.]
3. It would be curious to ascertain by inspection, how many houses in
London are really well drained. Many people would say, surely all or
most of them. But many people have no idea in what good drainage
consists. They think that a sewer in the street, and a pipe leading to
it from the house is good drainage. All the while the sewer may be
nothing but a laboratory from which epidemic disease and ill health is
being distilled into the house. No house with any untrapped drain pipe
communicating immediately with a sewer, whether it be from water closet,
sink, or gully-grate, can ever be healthy. An untrapped sink may at any
time spread fever or pyæmia among the inmates of a palace.
[Sidenote: Sinks.]
The ordinary oblong sink is an abomination. That great surface of stone,
which is always left wet, is always exhaling into the air. I have known
whole houses and hospitals smell of the sink. I have met just as strong
a stream of sewer air coming up the back staircase of a grand London
house from the sink, as I have ever met at Scutari; and I have seen the
rooms in that house all ventilated by the open doors, and the passages
all _un_ventilated by the closed windows, in order that as much of the
sewer air as possible might be conducted into and retained in the
bed-rooms. It is wonderful.
Another great evil in house construction is carrying drains underneath
the house. Such drains are never safe. All house drains should begin and
end outside the walls. Many people will readily admit, as a theory, the
importance of these things. But how few are there who can intelligently
trace disease in their households to such causes! Is it not a fact, that
when scarlet fever, measles, or small-pox appear among the children, the
very first thought which occurs is, "where" the children can have
"caught" the disease? And the parents immediately run over in their
minds all the families with whom they may have been. They never think of
looking at home for the source of the mischief. If a neighbour's child
is seized with small-pox, the first question which occurs is whether it
had been vaccinated. No one would undervalue vaccination; but it becomes
of doubtful benefit to society when it leads people to look abroad for
the source of evils which exist at home.
[Sidenote: Cleanliness.]
4. Without cleanliness, within and without your house, ventilation is
comparatively useless. In certain foul districts of London, poor people
used to object to open their windows and doors because of the foul
smells that came in. Rich people like to have their stables and dunghill
near their houses. But does it ever occur to them that with many
arrangements of this kind it would be safer to keep the windows shut
than open? You cannot have the air of the house pure with dung heaps
under the windows. These are common all over London. And yet people are
surprised that their children, brought up in large "well-aired"
nurseries and bed-rooms suffer from children's epidemics. If they
studied Nature's laws in the matter of children's health, they would not
be so surprised.
There are other ways of having filth inside a house besides having dirt
in heaps. Old papered walls of years' standing, dirty carpets,
uncleansed furniture, are just as ready sources of impurity to the air
as if there were a dung-heap in the basement. People are so unaccustomed
from education and habits to consider how to make a home healthy, that
they either never think of it at all, and take every disease as a matter
of course, to be "resigned to" when it comes "as from the hand of
Providence;" or if they ever entertain the idea of preserving the health
of their household as a duty, they are very apt to commit all kinds of
"negligences and ignorances" in performing it.
[Sidenote: Light.]
5. A dark house is always an unhealthy house, always an ill-aired house,
always a dirty house. Want of light stops growth, and promotes scrofula,
rickets, &c., among the children.
People lose their health in a dark house, and if they get ill they
cannot get well again in it. More will be said about this farther on.
[Sidenote: Three common errors in managing the health of houses.]
Three out of many "negligences and ignorances" in managing the health of
houses generally, I will here mention as specimens--1. That the female
head in charge of any building does not think it necessary to visit
every hole and corner of it every day. How can she expect those who are
under her to be more careful to maintain her house in a healthy
condition than she who is in charge of it?--2. That it is not considered
essential to air, to sun, and to clean rooms while uninhabited; which is
simply ignoring the first elementary notion of sanitary things, and
laying the ground ready for all kinds of diseases.--3. That the window,
and one window, is considered enough to air a room. Have you never
observed that any room without a fire-place is always close? And, if you
have a fire-place, would you cram it up not only with a chimney-board,
but perhaps with a great wisp of brown paper, in the throat of the
chimney--to prevent the soot from coming down, you say? If your chimney
is foul, sweep it; but don't expect that you can ever air a room with
only one aperture; don't suppose that to shut up a room is the way to
keep it clean. It is the best way to foul the room and all that is in
it. Don't imagine that if you, who are in charge, don't look to all
these things yourself, those under you will be more careful than you
are. It appears as if the part of a mistress now is to complain of her
servants, and to accept their excuses--not to show them how there need
be neither complaints made nor excuses.
[Sidenote: Head in charge must see to House Hygiene, not do it herself.]
But again, to look to all these things yourself does not mean to do them
yourself. "I always open the windows," the head in charge often says. If
you do it, it is by so much the better, certainly, than if it were not
done at all. But can you not insure that it is done when not done by
yourself? Can you insure that it is not undone when your back is turned?
This is what being "in charge" means. And a very important meaning it
is, too. The former only implies that just what you can do with your own
hands is done. The latter that what ought to be done is always done.
[Sidenote: Does God think of these things so seriously?]
And now, you think these things trifles, or at least exaggerated. But
what you "think" or what I "think" matters little. Let us see what God
thinks of them. God always justifies His ways. While we are thinking, He
has been teaching. I have known cases of hospital pyæmia quite as severe
in handsome private houses as in any of the worst hospitals, and from
the same cause, viz., foul air. Yet nobody learnt the lesson. Nobody
learnt _anything_ at all from it. They went on _thinking_--thinking that
the sufferer had scratched his thumb, or that it was singular that "all
the servants" had "whitlows," or that something was "much about this
year; there is always sickness in our house." This is a favourite mode
of thought--leading _not_ to inquire what is the uniform cause of these
general "whitlows," but to stifle all inquiry. In what sense is
"sickness" being "always there," a justification of its being "there" at
all?
[Sidenote: How does He carry out His laws?]
[Sidenote: How does He teach His laws?]
I will tell you what was the cause of this hospital pyæmia being in that
large private house. It was that the sewer air from an ill-placed sink
was carefully conducted into all the rooms by sedulously opening all the
doors, and closing all the passage windows. It was that the slops were
emptied into the foot pans;--it was that the utensils were never
properly rinsed;--it was that the chamber crockery was rinsed with
dirty water;--it was that the beds were never properly shaken, aired,
picked to pieces, or changed. It was that the carpets and curtains were
always musty;--it was that the furniture was always dusty; it was that
the papered walls were saturated with dirt;--it was that the floors were
never cleaned;--it was that the uninhabited rooms were never sunned, or
cleaned, or aired;--it was that the cupboards were always reservoirs of
foul air;--it was that the windows were always tight shut up at
night;--it was that no window was ever systematically opened, even in
the day, or that the right window was not opened. A person gasping for
air might open a window for himself. But the servants were not taught to
open the windows, to shut the doors; or they opened the windows upon a
dank well between high walls, not upon the airier court; or they opened
the room doors into the unaired halls and passages, by way of airing the
rooms. Now all this is not fancy, but fact. In that handsome house I
have known in one summer three cases of hospital pyæmia, one of
phlebitis, two of consumptive cough: all the _immediate_ products of
foul air. When, in temperate climates, a house is more unhealthy in
summer than in winter, it is a certain sign of something wrong. Yet
nobody learns the lesson. Yes, God always justifies His ways. He is
teaching while you are not learning. This poor body loses his finger,
that one loses his life. And all from the most easily preventible
causes.[9]
[Sidenote: Physical degeneration in families. Its causes.]
The houses of the grandmothers and great grandmothers of this
generation, at least the country houses, with front door and back door
always standing open, winter and summer, and a thorough draught always
blowing through--with all the scrubbing, and cleaning, and polishing,
and scouring which used to go on, the grandmothers, and still more the
great grandmothers, always out of doors and never with a bonnet on
except to go to church, these things entirely account for the fact so
often seen of a great grandmother, who was a tower of physical vigour
descending into a grandmother perhaps a little less vigorous but still
sound as a bell and healthy to the core, into a mother languid and
confined to her carriage and house, and lastly into a daughter sickly
and confined to her bed. For, remember, even with a general decrease of
mortality you may often find a race thus degenerating and still oftener
a family. You may see poor little feeble washed-out rags, children of a
noble stock, suffering morally and physically, throughout their useless,
degenerate lives, and yet people who are going to marry and to bring
more such into the world, will consult nothing but their own convenience
as to where they are to live, or how they are to live.
[Sidenote: Don't make your sick-room into a ventilating shaft for the
whole house.]
With regard to the health of houses where there is a sick person, it
often happens that the sick room is made a ventilating shaft for the
rest of the house. For while the house is kept as close, unaired, and
dirty as usual, the window of the sick room is kept a little open
always, and the door occasionally. Now, there are certain sacrifices
which a house with one sick person in it does make to that sick person:
it ties up its knocker; it lays straw before it in the street. Why can't
it keep itself thoroughly clean and unusually well aired, in deference
to the sick person?
[Sidenote: Infection.]
We must not forget what, in ordinary language, is called
"Infection;"[10]--a thing of which people are generally so afraid that
they frequently follow the very practice in regard to it which they
ought to avoid. Nothing used to be considered so infectious or
contagious as small pox; and people not very long ago used to cover up
patients with heavy bed clothes, while they kept up large fires and shut
the windows. Small pox, of course, under this _régime_, is very
"infectious." People are somewhat wiser now in their management of this
disease. They have ventured to cover the patients lightly and to keep
the windows open; and we hear much less of the "infection" of small pox
than we used to do. But do people in our days act with more wisdom on
the subject of "infection" in fevers--scarlet fever, measles, &c.--than
their forefathers did with small pox? Does not the popular idea of
"infection" involve that people should take greater care of themselves
than of the patient? that, for instance, it is safer not to be too much
with the patient, not to attend too much to his wants? Perhaps the best
illustration of the utter absurdity of this view of duty in attending on
"infectious" diseases is afforded by what was very recently the
practice, if it is not so even now, in some of the European
lazarets--in which the plague-patient used to be condemned to the
horrors of filth, overcrowding, and want of ventilation, while the
medical attendant was ordered to examine the patient's tongue through an
opera-glass and to toss him a lancet to open his abscesses with!
True nursing ignores infection, except to prevent it. Cleanliness and
fresh air from open windows, with unremitting attention to the patient,
are the only defence a true nurse either asks or needs.
Wise and humane management of the patient is the best safeguard against
infection.
[Sidenote: Why must children have measles, &c.?]
There are not a few popular opinions, in regard to which it is useful at
times to ask a question or two. For example, it is commonly thought that
children must have what are commonly called "children's epidemics,"
"current contagions," &c., in other words, that they are born to have
measles, hooping-cough, perhaps even scarlet fever, just as they are
born to cut their teeth, if they live.
Now, do tell us, why must a child have measles?
Oh because, you say, we cannot keep it from infection--other children
have measles--and it must take them--and it is safer that it should.
But why must other children have measles? And if they have, why must
yours have them too?
If you believed in and observed the laws for preserving the health of
houses which inculcate cleanliness, ventilation, white-washing, and
other means, and which, by the way, _are laws_, as implicitly as you
believe in the popular opinion, for it is nothing more than an opinion,
that your child must have children's epidemics, don't you think that
upon the whole your child would be more likely to escape altogether?