"All that I know, I owe to my mother."
Abraham Lincoln.
HOW WE CATCH DISEASE
We Catch Disease--How Germs Enter the Lungs--How Germs Work in
the Body--The Function of the White Blood Cell--How an Abscess
Is Formed--The Evil Habit of Spitting in Public
Places--Sunlight and Germs--Why It Is Necessary to Open
Windows--Facts About Tuberculosis--The Tendency to Disease--The
Best Treatment for Tuberculosis--Consumption Is a Preventable
and a Curable Disease--When Delay Is Dangerous--What to Eat and
Wear in Hot Weather--Scientific Dressing--Drink Plenty of
Water--What to Drink When Traveling.
A simple explanation of how we "catch" disease may be interesting and
profitable. Let us take, for example, a case of consumption. In order to
"catch" consumption it is necessary to breathe into our lungs the germ
of consumption.
How do we "catch" these germs?
If a consumptive patient spits or expectorates on the street, or on the
floor of a railroad car, or in a room, or store, or theater, after a
time the spittle becomes dry, and because of the wind or a breeze which
may be caused by opening or shutting a door, or it may be the skirts of
women walking about, the dried sputum in which the germs are becomes
mixed with the dust of the air. If we happen to be around, just at the
particular time when the germs are blown into the air, we may breathe
into our lungs enough of them to produce consumption. If we are in good
health, and if we do not happen to get too large a dose of the bacteria
at one time (and that is only a matter of luck), we can overcome them,
as will be shown shortly. If, however, we are not in good health, if we
are just recovering from some serious or depressing disease, such as
Grippe, the bacteria will overcome our reserve vitality, and consumption
will graft itself on our weakened system.
How do these germs work?
They lodge on some part of the lung tissue and burrow into it. They make
a nest for themselves and begin work immediately. They live on the lung
tissue, they multiply rapidly, they produce--as a result of their
activity--a poisonous substance. Because of their eating up, as it were,
the lung tissue we often find holes (cavities) in the lungs of
consumptives. By breeding rapidly they require more and more room, so
they invade more and more of the lung tissue and destroy it. The
poisonous substance which they produce is absorbed by the blood. Its
effect on the blood is to weaken it, and when the blood becomes weak the
vitality declines, so that the patient loses weight, appetite, and
strength. The poison also produces fever, and so the long, weary fight
goes on till death claims the patient.
WHAT HAPPENS IF WE INHALE THESE BACTERIA, AND CONSUMPTION DOES NOT
DEVELOP.--In order to understand the answer to this question it is
necessary to explain certain facts concerning the white blood cells. The
white blood cells can pass through a blood vessel and back into it again
without leaving any hole in the wall of the blood vessel.
The function of the white blood cells is to wander around and if they
discover any stray bacteria, whose presence is undesirable, it is their
duty to get rid of it as quickly as possible. The white blood cell may
therefore be likened to a detective whose duty it is to arrest any
suspicious character who comes into the city. When a white blood cell
discovers a strange microbe it immediately surrounds and encloses it
within itself, just as your hand can enclose any small object, such as a
cent or a dime. It then promptly goes to the nearest blood vessel,
enters it, and is carried away in the blood stream. If we are in good
health our blood cells are alert, active, and capable of defending us
against any invading foe in the form of a microbe or bacteria. If we are
not in good health the bacteria may overcome the white blood cells. If
we inhale a large number of the consumptive bacteria at one time, and
they succeed in getting into the lung substance, they are immediately
met by an army of blood cells, all bent on capturing them. An actual
battle is fought and the deciding factor of the battle will be the
condition of the patient. If there is plenty of strength and reserve
force, if the patient is in good health, the blood cells will win the
battle; if the condition of the patient is poor, the blood cells will
lose the battle and tuberculosis, or consumption, has its beginning in
that patient from the time the blood cells lose their fight. We know the
battle has been lost because the well-known symptoms of the disease soon
appear. The blood cells do not retreat when defeated; they go on
fighting to the best of their ability. Whether they ever succeed in
overcoming the bacteria, depends upon the treatment the patient gets,
and his personal conduct. We give him a maximum of fresh air and
sunlight because these are the great enemies of all kinds of bacteria.
We force his feeding and try to stimulate his appetite, hoping thereby
to give him strength so that his blood cells will fight actively in his
interest. We take steps to reduce his fever so that his strength may not
be wasted and burned up. If we succeed, with the necessary active
cooeperation of the patient, the blood cells finally overcome the
bacteria and the patient recovers from the disease.
This is the story of the invasion of almost every disease. It is the
story of the white blood cell.
The white blood cell is active in another way and it is a very
interesting way. When you cut yourself the blood cells immediately
surround the entire cut. They line up like an army defending a city.
They form a perfect wall, millions of them, ready to pounce upon all
enemies in the form of bacteria or microbes, that have the temerity to
try to creep into the wound unseen.
This is the reason that so very few of the hundreds of little surface
wounds and scratches which every one gets, ever become infected or go
wrong in any way.
When a microbe does get inside, under the skin, and becomes active, as
they sometimes will, the white blood cell, appreciating that it cannot
defeat the enemy, begins to build a wall around him and locks him in.
This compels the enemy to limit his activity within the wall, which he
does, and so an abscess is formed, which bursts when the bacteria fill
it so full that the wall gives way and empties the poison out on the
surface of the skin, thus saving the body from the poison of the microbe
which would spread all through the body, were it not for the wall formed
by the active, busy little white blood cell.
The foregoing simple explanation of "how we catch disease" will no doubt
be suggestive to the interested and careful reader. The first and most
obvious question that suggests itself is: If we "catch" tuberculosis by
inhaling germs from some other person's dried spittle, why are
consumptives allowed to spit where it will do harm? Consumptives are not
allowed to spit where it will do harm, but they do and they always will.
Every department of health in every civilized corner of the globe has
secured the enactment of laws making spitting unlawful in any public
place. Every sanitary society, every agency whose aim is to work in the
interest of public health, has actively aided, and is aiding, in the
propaganda for a better universal understanding of the principles of
sanitation and hygiene. The individual must be educated to understand
the tragic need of such a law. You cannot legislate virtue into the
public conscience. It is a profound reflection upon human intelligence
to appreciate that the great white plague, for the stamping out of which
so many thousands of lives are annually sacrificed, and so much money is
spent, could be forever stamped out, if the human race would agree
absolutely to stop spitting.
It is the duty of every person to take an active personal interest in
this crusade of education and emancipation. We appreciate and concede
that a large number of those afflicted with consumption do not willfully
spit, knowing that others may be affected as a consequence. They do it
in ignorance. Our aim is to educate the victim to an understanding of
the true condition. The knowledge must be carried into every home, and
the story must be told in a simple, convincing way, to attain results.
The mothers of the country can aid to a very considerable degree, in
this commendable work. Every mother can tell her children the story of
how disease is caught. She can tell them that the danger spots of
infection are where people congregate together, in church, school,
theater, street-cars, and railroad trains. She can teach them to breathe
through their nostrils, especially when in these public places, because
the nostrils are so constructed that they act as a sieve or strainer,
they clean the air we breathe, and when we blow the nose after being in
one of these places we blow out thousands of germs and other impurities
which would have gone straight into the lungs if we had breathed through
the mouth. She can teach them the value of deep breathing when in the
open air, and of standing and walking erect so as to get all the lung
space possible. By constantly reminding children of these little points
you will be amazed at the progressive improvement which goes on both in
their bodies and in their minds. They will become little missionaries,
they will tell the story to others, and a real good can be accomplished
in this simple way, that will grow in strength and vigor as the years
roll round.
The next suggestive feature in the reading of "How we catch disease," is
the significant emphasis which is put upon sunlight and fresh air in the
treatment of consumption. Sunlight, as already stated, is the great
enemy of microbes and germs of all kinds. Where sunlight is, germs do
not want to be. How wrong, therefore, is the habit of lowering the
shades, when the sun shines into your home, because it "spoils the
carpet." Let it spoil the carpet; it is much cheaper to buy a new carpet
than to pay for a funeral. Let the sunlight stream into your rooms for
the few hours it can every day. Germs love the dark, sunless corners
where the dust is. Housewives should, therefore, go into the dark
corners with a moist duster, and wipe them clean, then boil the duster
and hang it in the sunlight to dry until needed again. If you choose to
use a feather duster instead, as the lazy woman does, you only chase the
dust and the germs from one corner to another, and in doing so you
afford yourself the opportunity of swallowing a few germs in the
passing. One may, therefore, be punished in an unexpected way for being
lazy.
For the very excellent reason that corners and angles are unsanitary,
there are to be no more of them in the construction of houses and office
buildings of the better class. They are being built with "round"
corners; even the ceiling and walls, and floor and walls, meet in a
curve,--no square crevice or corner where dust or germs can gather.
If we add moisture to a sunless spot, we have the ideal environment for
germs to breed and flourish in. There is always moisture or humidity in
the air if the altitude is low, and if it is near the ocean, or any
large body of water, the moisture is relatively greater. For this reason
we send patients with pulmonary disease to the mountains, where the
altitude is much higher, where there is no moisture, and consequently
where there are practically no germs. We cannot move our homes to the
mountains, however, so what must we do to get rid of the moisture and
the germs where we are compelled to live? What do we do with the family
wash when it is wet? We hang it up in the yard, in the sun and in the
breeze, because we know from experience that the wind and the sun soon
dry anything wet. They do more; they freshen everything, so that
anything exposed to the sun and air smells fresh and sweet and is fresh
and sweet and pure. So to make our homes sweet and fresh and dry we must
chase the stale air away, and the moisture with it, by opening our
windows and letting in the sunlight and the breeze, every day, and for
as long as possible every day. Open windows and sunlight and fresh
air,--all you can get,--this is the song of health, the joy of life, the
only agents that will keep the eager, busy, little white blood cell
healthy and willing and alert. This is the reason you must keep the
windows of your bedrooms open at night, as well as by day, so you and
your children will get fresh, pure, sweet air, and not stale, moist,
germ-laden air to breathe.
FACTS ABOUT TUBERCULOSIS
Tuberculosis, or consumption, is a disease of poor air, dusty quarters,
insufficient nourishment, and, above all, of ignorance with regard to
its dangers and what we now know of the possibilities of its cure. The
more we know about it the better chance there is to cure it, and better
still, prevent it.
Not very long ago the death rate from consumption was one in six, that
is, every sixth person who died in this country died as a result of
tuberculosis in some form. It is now about one in eight. This is a
remarkable decrease--about one-third of its former ratio of victims are
now spared. Not so very long ago the disease was regarded as practically
fatal; now it is classified as one of the eminently curable diseases.
The universal dissemination of this knowledge will do much to rob the
"Great White Plague" of its terrors.
Investigation and observation have demonstrated that there is in the
great majority of people a definite tendency successfully to throw off
the disease. It is a curious and astonishing fact, which we have learned
from the study of the results of autopsies; we find, in nearly every
instance, that every person in whom death occurred after thirty had had
consumption at one time and resisted it and died of some other disease.
We mean by this that at some time, in all likelihood during one of the
"colds" of childhood, every one of us contracted consumption, but
because of our vitality we successfully resisted and conquered it. In
other words, the white blood cells won their fight.
This knowledge is of great value; it taught the scientists who were
studying the characteristics of the disease that there were conditions,
possible of attainment, under which the human organism could definitely
and victoriously defeat the invasion of the tubercle bacilli.
The public mind, until recently, was imbued with the fallacy that the
disease was hereditary. It was thought that if it "ran in the family"
the victims of it were almost certain to die. We know definitely now
that consumption is not hereditary, and that, instead of death being
certain in a patient in whose family it has been, this fact alone
ensures the victim a much better prospect of cure than if it had never
existed in the family. The explanation of this seeming paradox is quite
logical from a medical standpoint. The theory of the vaccine treatment
of disease is that if you infuse into the blood the products of the
germs of certain diseases, the individual in whose blood the vaccine has
been put, will wholly resist that particular disease, or if he acquires
it, it will be in a mild and more modified form. If a family for a
number of generations has had various members die of tuberculosis, the
blood stream of the family will have become so impregnated with the
toxins, or poisons, of the disease, that, in time, a certain immunity
will have been established. Consequently, tuberculosis in an individual,
the blood of whose ancestors has been accustomed or habituated to the
poison of the disease, will run a milder course, be more modified in its
type, and will respond to treatment easier than in an individual whose
family history is free from the taint of tuberculosis.
In proof of this principle, it is a well-known fact that consumption
runs a rapid, fatal course among those nations which have not hitherto
been exposed to it. The death rate among our American Indians when it
was first introduced among them was enormous.
The same truth applies to syphilis. The blood of the civilized race has
become so thoroughly syphilized, that it is no longer so susceptible to
the disease as it once was: and the disease as we know it to-day does
not manifest the same virulency as it did years ago, or as it does in a
race in whom it is grafted for the first time.
These ideas of the curability of the disease and of its non-heredity are
extremely important and supremely suggestive. Tuberculosis takes only
the quitters and the supine. Anyone who will fight bravely against the
disease can always resist its ravages for many years, if not to the
extent of living out a normal life.
THE TENDENCY TO DISEASE.--Mothers should understand just what is meant
by "the tendency to disease." We assert that consumption is not
hereditary, but we know that certain individuals are born with the
tendency to tuberculosis. Just what does this mean?
Let us suppose a tubercular mother gives birth to a child. It would be
foolish to assume that this child comes into the world with a normal
standard of resistance; but it is certain he is not tubercular and
doomed at the moment of his birth. He may be what is ordinarily termed
a weak, puny, sickly infant, but the germ of disease is not implanted in
his constitution. If he is taken from his mother, taken away from the
tubercular environment, and brought up under the best hygienic and
sanitary surroundings, it is possible for him to become a robust,
healthy, normal man.
The tendency to disease in this case will not materialize. If, however,
we permit him to remain with his tubercular mother, to nurse her milk,
to live in what necessarily is an unhygienic and unsalutary
environment--the presence of the consumptive mother renders it so--the
probability is that the tendency to disease, which in his case is the
tendency to weak lungs, will materialize, because of his weak
resistance, poor nourishment, and unfavorable surroundings. If,
therefore, his method of living does not contribute to building up and
strengthening what is in the first place a weak structure, the structure
itself will, during the first strain put upon it, give way, and
naturally the weak spot will be the point of election for the invasion
of disease. This strain may be one of the infantile diseases,--scarlet
fever, or measles, or whooping cough, or it may be bronchitis. Instead
of convalescing from these conditions, as a normally constituted child
will, this child, whose potential resistance is below standard, will
fail to reach the rallying point, will afford a fertile field for germ
invasion, and will develop tuberculosis,--not directly, however, as a
result of having had a tubercular mother, but because he was not removed
from the tubercular environment and given a fair chance. The high infant
mortality is, to a very large extent, caused directly by this "tendency
to disease," plus unfavorable environment, and this is wherein the
eugenic propaganda has found its field of promise and is unassailable
reason for active existence.
Let us take another illustration, so that mother may have a full
understanding of the far-reaching effect of the "tendency to disease."
We cannot justly assume a child to have outlived its hereditary
tendencies until it has reached the period of its full growth,
physically, mentally, and morally. We know that this period is about
the twenty-third year. Now a young girl of eighteen, or even twenty, who
is successfully resisting an inherited tendency, is likely to reach her
full physical and mental growth, providing she does not subject her
vitality to a serious physical strain, or providing she is not the
victim of a serious illness. Suppose this young girl marries and becomes
pregnant; this condition immediately changes the fighting or resisting
equation; she is no longer conserving her strength and energy; she is
spending it out, wasting it so far as it applies to her own upbuilding.
The percentage in favor of a successful fight against the inherited
tendencies is greatly reduced, and as a matter of fact, statistics
show--as is fully explained in the article on "The Evils of Early
Marriage"--that many of these young mothers succumb to disease as a
result of pregnancies at this period of immaturity, when they could have
otherwise lived. The "tendency to disease" has therefore an economic
value and the state should build along the line of the conservation of
health in its broadest sense.
THE BEST TREATMENT FOR TUBERCULOSIS.--The most important factor in the
present-day treatment of consumption is the right kind of nourishment.
This cannot be emphasized too strongly. In the first edition of this
work, it was stated that the most important factor in the treatment of
this disease was fresh air. The author has had very good reasons to
change his opinion radically in this respect.
So emphatically may this truth be asserted that it is now not at all
necessary to seek a change of climate in the hope that such a change may
aid the patient. It must not, however, be understood that this reasoning
applies to charitable cases. If the patient is so situated that it is
not possible to provide a proper environment, a change may do good. It
is not the change of air that is responsible for the improvement,
however, though it no doubt contributes in these cases; it is the
altered environment.
Patients who in their own homes enjoy sanitary and hygienic care; who
may have a room of ample size for their exclusive use, which is
thoroughly aired, day and night; who are provided with the "right kind
of nourishment," and who will obey implicitly the rules which the
physician, who is conversant with this particular method of treatment,
will lay down, may be assured that a prompt response will ensue. The
intelligent reader will understand that this statement does not apply to
patients in the last stages of the disease. The assertion, however, must
rightly be regarded as revolutionary. It is not what we were taught--it
emphasizes, nevertheless, what every physician already knows, that,
theoretically, consumption is a disease that should respond to
treatment. That we have not had greater success with it in the past,
must be attributed to our method of treatment. The fact that most of us
have had the disease, and have recovered, conclusively demonstrates its
curability. Those individuals who fail to recover promptly do not
possess the vitality to throw it off spontaneously. If at this time--the
real beginning of the disease--it is discovered, and the right treatment
instituted, we immediately supply the organism with the ingredients it
is deficient in and we are justified in looking for favorable results if
the patient adheres to the instructions.
The second essential in the treatment of consumption is an abundance of
fresh, pure air. We therefore direct the patient to remain in the open
as much as is possible. If circumstances permit him to sleep
out-of-doors, so much the better; if not, he must sleep in a room with
the windows open to the fullest extent, winter and summer. There are no
exceptions to this rule. If it storms, the outside blinds may be closed,
but the windows must remain open. The city air is just as efficient for
our purpose as is the air of any other vicinity--the point is, to get
enough of it from a mechanical standpoint. The advantages from sending
patients away, even under the old belief, were more than discounted by
conditions incident to the new environment that were detrimental to
their progress. Now that we know it is not necessary or essential to
procure any other kind or quality of air than exists in any city, all
our efforts may be concentrated in the interest of the patient in
directing the "right kind of nourishment" and in supervising his
conduct. In few instances is it necessary to prescribe any medicine.
In exceptional cases the cough may require some sedative remedy,
especially if it disturbs the patient at night. Experience has taught
us, however, that to live twelve hours in the open air and to sleep with
the windows wide open, will do more for the cough than any medicine we
possess.
Pleuritic complications may cause pain, but this feature is best aided
and permanently relieved by fresh air also. Very recently there were
made exhaustive experiments in this connection in St. Thomas' Hospital,
London, England. It was decided to subject patients to open-air tests
for pleuritic pains in the course of consumption. This particular
hospital is situated on the River Thames, in a notoriously damp and
foggy part of the city; despite this drawback it was conclusively shown
that the patients who lived night and day on the balconies breathing
this heavy, murky, damp atmosphere, were relieved of their pains
quicker, and more permanently, than those who were shielded in the wards
of the hospital.
Inasmuch as the patient must be adequately nourished, his cure depends
upon the condition of the stomach. It is known that the germ works more
actively in a patient who is losing weight. When the germ is very
active, its poisons, circulating in the blood, cause fever and fever
results in tissue waste. We must therefore bend every effort toward
overcoming this tendency. If we can get the patient to take sufficient
food and if he digests it thoroughly, the weight will increase, the
fever will subside, and the tissue waste will stop. Patients must be
extremely careful, therefore, what they put into their stomachs. Only
simple, tasty, highly nutritious food should be taken, and digestive
energy should not be wasted on less nutritious materials. For this
reason incalculable harm has been done by indiscriminate
medicine-taking. Medicines exert a bad influence on the stomach and
those patients who take them lose their appetites. Drugs should never be
taken except for a definite purpose and only on the advice of a
physician. These patients should particularly be guarded against the use
of advertised patent medicines. They are always bad, and never under any
circumstances are they of any advantage, as is clearly shown in the
chapter on "Patent Medicines." Thousands of persons die of consumption
every year who would have lived had they not taken such remedies.
The following article is sent out by the New York Department of Health
as a Circular of Instruction regarding Tuberculosis.
INFORMATION FOR CONSUMPTIVES AND THOSE LIVING WITH THEM
CONSUMPTION IS CHIEFLY CAUSED BY THE FILTHY HABIT OF
SPITTING.--Consumption is a disease of the lungs, which is
taken from others, and is not simply caused by colds, although
a cold may make it easier to take the disease. It is caused by
very minute germs, which usually enter the body with the air
breathed. The matter which consumptives cough or spit up
contains these germs in great numbers--frequently millions are
discharged in a single day. This matter, spit upon the floor,
wall or elsewhere, dries and is apt to become powdered and
float in the air as dust. The dust contains the germs, and thus
they enter the body with the air breathed. This dust is
especially likely to be dangerous within doors. The breath of a
consumptive, except when he is coughing or sneezing, does not
contain the germs and will not produce the disease. A well
person catches the disease from a consumptive only by in some
way taking in the matter coughed up by the consumptive.
Consumption can often be cured if its nature be recognized
early and if proper means be taken for its treatment. In a
majority of cases it is not a fatal disease.
It is not dangerous to live with a consumptive, if the matter
coughed up by him be promptly destroyed. This matter should not
be spit upon the floor, carpet, stove, wall, or sidewalk, but
always, if possible, in a cup kept for that purpose. The cup
should contain water so that the matter will not dry, or
better, carbolic acid in five per cent. watery solution (six
teaspoonfuls in a pint of water). This solution kills the
germs. The cup should be emptied into the water closet at least
twice a day, and carefully washed with boiling water.
Great care should be taken by consumptives to prevent their
hands, face, and clothing from becoming soiled with the matter
coughed up. If they do become thus soiled, they should be at
once washed with soap and hot water. Men with consumption
should wear no beards at all, or only closely cut mustaches.
When consumptives are away from home, the matter coughed up
should be received in a pocket flask made for this purpose. If
cloths must be used, they should be immediately burned on
returning home. If handkerchiefs be used (worthless cloths,
which can be at once burned, are far better), they should be
boiled at least half an hour in water by themselves before
being washed. When coughing or sneezing small particles of
spittle containing germs are expelled, so that consumptives
should always hold a handkerchief or cloth before the mouth
during these acts; otherwise the use of cloths and
handkerchiefs to receive the matter coughed up should be
avoided as much as possible, because it readily dries on these
and becomes separated and scattered into the air. Hence, when
possible, the matter should be received into cups or flasks.
Paper cups are better than ordinary cups, as the former with
their contents may be burned after being used. A pocket flask
of glass, metal, or pasteboard is also a most convenient
receptacle to spit in when away from home. Cheap and convenient
forms of flasks and cups may be purchased at many drug stores.
Patients too weak to use a cup should use moist rags, which
should at once be burned. If cloths are used they should not be
carried loose in the pocket, but in a waterproof receptacle
(tobacco pouch), which should be frequently boiled. A
consumptive should never swallow his expectoration.
A consumptive should have his own bed, and, if possible, his
own room. The room should always have an abundance of fresh
air--the window should be open day and night. The patient's
soiled wash-cloths and bed linen should be handled as little as
possible when dry, but should be placed in water until ready
for washing.
Rooms should be cleaned daily, but in order to prevent the
raising of dust, all floors must be well sprinkled before
sweeping, and all dusting, etc., done with damp cloths.
If the matter coughed up be rendered harmless, a consumptive
may frequently not only do his usual work without giving the
disease to others, but may also thus improve his own condition
and increase his chances of getting well.
Rooms which have been occupied by consumptives should be
thoroughly cleaned, scrubbed, and whitewashed, painted, or
papered before they are again occupied. Carpets, rugs, bedding,
etc., from rooms which have been occupied by consumptives,
should be disinfected. Such articles, if the Department of
Health be notified, will be sent for, disinfected, and returned
to the owner free of charge, or, if he so desires, they will be
destroyed.
When consumptives move they should notify the department of
health. Consumptives are warned against the many widely
advertised cures, specifics, and special methods of treating
consumption. No cure can be expected from any kind of medicine
or method except the regularly accepted treatment, which
depends upon pure air, an out-of-door life, and nourishing
food.
Consumptives having an opportunity of entering a sanatorium,
should do so at once.
WHEN DELAY IS DANGEROUS.--Inasmuch as it is mother's duty to watch over
the health and the efficiency of all members of the household, she would
do well to establish a rule to err on the safe side in every case of
sickness. That rule should be never to delay too long in obtaining
medical aid.
In nearly twenty years of active general practice I have had hundreds of
"hurry" calls to "come at once." In not over a dozen of these calls did
any of the cases demand immediate attention from a medical standpoint.
Most of them, however, should have had earlier aid. People wait too long
in the hope of spontaneous recovery, and when, instead of recovery, they
realize that the patient is quite sick, they become conscience-stricken
and send a "rush" call for the doctor. After delaying from day to day
they decide to get professional advice and send a messenger for a
physician with instructions to "go for another if he can't come at
once." It is imperative he should come instantly, though they have
delayed for a week in requesting his services. Every physician has these
calls every week of his life. If an individual has survived a week's
neglect, it is quite within reason to assume that he will survive
another hour,--and during that hour the physician may have time to
complete whatever he may be doing when the call comes.
If you have been guilty of bad judgment in not sending earlier for aid,
don't add discourtesy to your sins. The world demands of us, and every
person has the right to expect, a certain degree of consideration and
courtesy. If we do not give it, we only harm ourselves because the lack
of cultivation is a detriment which limits growth and happiness. The
degree of attainable happiness is limited by the degree of "goodness"
that is in us. If you are not considerate, depend upon it, there is an
element of happiness which escapes you, and you cannot attain it till
you are considerate.
It is inconsiderate and it is discourteous to send an immediate demand
for a physician "to come at once" if there is no urgent need for his
services, and if you have just been inspired for aid after a week's
blindness, there is no urgency in the matter. A call in an hour would
do just as well.
Take the following case: A mother discovers a small quantity of blood in
the diaper of her two months old baby. There is a larger quantity in the
afternoon and she decides to give the baby a dose of castor oil. During
the night it slept fitfully and in the morning it has a large stool as a
result of the castor oil and there is a large quantity of blood in the
stool. She sends a "rush" call for a physician. The physician discovers
the following facts: The baby is being artificially fed; it has been
vomiting its food for a week; its stools have been green, foul and
contained mucus; it had a fever for a number of days; it has lost much
weight and looked pale and sickly. The physician obtained this history
from the mother--she therefore knew the baby's condition. Why did she
delay sending for a physician? How sick did she want the child to be
before the need for aid seemed justifiable to her? Why didn't the sight
of blood in the stool suggest the need of assistance? What do the public
expect of physicians in such cases? But why ask questions? Many mothers
will doubt the existence of such a mother as is described above. They
need not; she was one of my own patients. I do not understand such
women; I only know that such mothers exist in quite large numbers. This
particular mother has other children; she is a good housekeeper, is
personally attractive, and is thought well of in the community. If such
seemingly heartless conduct can spring from such a source is it not
evidence of the fact that the average mother needs instruction, needs
education, and does it not bespeak the need of eugenics being sown
broadcast throughout the land?
Delays are dangerous in all sicknesses that last, despite a thorough
cleaning out of the bowels. To wait, hoping that "things will change,"
is bad practice. It is unjust to the medical profession, and it is
infinitely more unjust to the victim.
There are two kinds of surgical operations--those of choice and those of
necessity.
Every one knows about the operations of necessity, most of which must
be performed as a result of accident, but few people understand the
dangers of delaying what are termed "operations of choice." These are
for such conditions as appendicitis, cancer, and stomach and bowel
troubles.
Delaying an operation of choice lessens the chances of living, and
really makes an operation of necessity with fewer chances of recovery
than from the operations that must promptly follow injuries.
When we feel that an operation is needed, or are in doubt about it, the
wise thing to do is to consult medical authority. Then, if it is found
there should be an operation, there is plenty of time to make every
arrangement. We can begin to diet, which is generally necessary and
there is every chance for speedy recovery.
If a man breaks a leg and it has been set badly, the surgeons do not
rebreak it at once, but allow it to heal and the patient to regain his
strength, when it is again broken and reset properly. This is an
operation of choice.
But if a terrible fracture of the leg results from a fall, with the
shattered bone protruding, an operation of necessity must follow to mend
torn arteries.
It has been learned through recently gathered statistics that about
thirty per cent. of the people operated on for appendicitis die simply
because they delay the operation. This should have been an operation of
choice, when every arrangement could have been made long beforehand; the
delay makes it an operation of necessity, with the victim in such poor
physical condition that he has not half the strength to recover that he
would have had if he had been wise enough to consult a physician when he
first suspected that something was wrong.
These same statistics go to show that fully 99 per cent. of the
appendicitis cases, when taken in time, are cured by means of the
operation, thus affording the strongest proof of the folly of delaying
such things.
The total number of deaths from appendicitis each year, due to delay in
operating, is greater than the number of deaths during the
Spanish-American War. There are instances where the doctors do not
advise operations soon enough.
Above all things, when a reputable physician advises operation, do not
think you know more than the physician, but have the operation performed
at once. Nine times out of ten this will be the means of saving your
life.
WHAT TO EAT AND WEAR IN HOT WEATHER
No faith should be placed in the so-called "hot-weather" foods. The
cereals and other manufactured foods advertised as possessing marvelous
qualities, have in reality no advantage. Some of them have more or less
value as ordinary food, but they certainly possess no unusual
superiority. Home cooking is the best in summer or any other time.
Great care should be taken to keep the system in the best possible
condition. This will prove the most effectual safeguard against the
heat. Some foods do not agree with certain individuals, and these should
be carefully avoided in summer. Every person will have to judge for
himself in this matter. Otherwise the diet should be balanced carefully
so that enough, and yet not too much, is eaten. As much fruit as
possible should be eaten, and meat never more than once a day. It is not
well, however, to omit it entirely.
Food sustains the body through the heat it generates chemically, and it
is therefore impossible to eliminate a certain heating effect. If the
system is kept normal, however, and the diet properly balanced, this
should not be felt. Work is performed by the body and energy expended.
This must be replaced with the heat value of food. A certain amount of
fat, starch, and the other constituents of a well-balanced diet is
essential.
Fat meats and other forms of fat are the most heating of all foods and
may be minimized in summer. The amount of food necessary is, of course,
largely governed by the nature of the work performed by the individual.
Brain workers can eat very little in the morning and during the day,
reserving until evening the single heavy meal. If they have been doing
this the year around they probably will be cooler during the morning and
afternoon if a light breakfast and luncheon are eaten. It is not well,
however, to make any radical change from one's regular habits.
Manual workers require more food, and the heavy meal had best be eaten
in the middle of the day. All three meals should be substantial. There
is no danger of eating too much if the system is not overburdened.
Not only is pork rich and fat, and therefore very heating, but it is the
quickest of all meats to spoil. Veal also spoils very quickly if not
kept at the proper temperature. Of all meats mutton has the best keeping
qualities. Beef also keeps well and is a safe meat to eat in summer.
Flies are dangerous under any conditions, but particularly should they
be avoided where meat is kept. The bacteria they carry thrive
particularly on meat, and therefore are apt more rapidly to multiply
than if deposited on some other food. Care should be taken to buy meat
only from places where adequate protection is provided against flies.
It is of the greatest importance to keep the meat at a uniform cold
temperature. It should not be allowed to become heated, and then cooled
again. Some meat shops still keep the meat on open counters or hooks and
replace it in the refrigerators at the close of the day. These shops
should be carefully avoided. Modern methods provide glass-covered
refrigerating counters which keep the meat cool while it is on display.
Meat should be kept at as low a temperature as possible. The ordinary
refrigerator is at a little above freezing and temperatures at or below
zero are preferable.
SCIENTIFIC DRESSING.--By dressing scientifically it is possible to
minimize the effect of the heat. The heat from the sun must be kept away
from the body and the heat generated by the body permitted to escape.
These results can best be accomplished by having the clothes very loose
fitting, so as to leave ample air space, and by having the outer clothes
of a good non-conductor of heat. The cloth, of course, should be as
light in weight as possible, but it is more important to have it a good
non-conductor of heat and of porous weave.
Not enough attention is paid to the selection of colors for resisting
the heat. Two cloths identical except in color will show a great
difference in the comparative amount of heat they let through. Light
shades should be chosen, but care should be taken to see that they are
not glaring, so as to irritate the eye and increase the mental effect of
heat.
Linen and silk are better non-conductors than wool. And the weave of a
cloth has a great deal to do with the amount of heat it lets through.
Smooth, hard weaves absorb much less heat than fuzzy weaves. For this
reason, serge is much cooler than worsted of the same shade and weight.
A mistake is often made, however, in getting serge of a dark blue. It
should be of as light a color as possible; gray is much cooler than
blue. A white serge is much cooler than white flannel, because it is
less fuzzy.
Linen is much cooler than woolens, because it is a better non-conductor
and is of more porous weave. The linen thread is rough, which causes
inequalities in the weave, permitting a more thorough circulation of
air. Cotton is a still better non-conductor than linen, and would be
preferable for summer clothes but for the fact that it neither wears nor
holds its shape so well.
Mohair is very light in weight and cool looking. As a matter of fact,
however, it is a fairly good conductor of heat, is closely woven, and
usually comes in dark shades. It is a woolen cloth, and any woolen has
its threads woven more closely on account of the process of manufacture
than linens, cotton, and silk cloths. Linen is perhaps the best material
for summer wear. It is porous in weave, light in color, and of fairly
light weight.
It is well to remember that the safety valve of the body in hot weather
is the evaporation of perspiration, not the act of perspiring. If the
hand is put in a glove, for instance, it will perspire much more than if
in the open air, but it will not be as cool. It is the evaporation that
is a cooling process. If the perspiration is absorbed it cannot
evaporate. That is why loose fitting undergarments are cooler than tight
ones. It is also the reason why cotton is cooler next to the skin than
linen or silk; it absorbs moisture less freely.
DRINK PLENTY OF WATER.--Water, and a great deal of it, is desirable at
any time during the summer. It should be drunk freely during the day.
Lemonade also is good, the slight acid being an aid to digestion. It is
best to have beverages cooled only to a moderate temperature. Ice water
is not bad, but it would be preferable if it were not at so extreme a
temperature. Ice is resorted to only as a convenient means of securing a
palatable temperature; the system does not crave extreme cold. Water at
the temperature of the air is nauseating, so ice is put into it and the
other extreme secured. Sixty degrees is the ideal temperature for
drinking water. If this could be conveniently obtained it would be
preferred to a greater degree of cold. Not only is it less harmful to
the system, but it is more satisfying and thirst-quenching. Water put in
bottles and left in a refrigerator until properly chilled is the best
way of preparing a summer beverage. When any beverage is sufficiently
cold to cause a pain in the head or throat when drinking it the result
may be harmful. Cold water poured on the wrist or head has a cooling
effect and tends to reduce the ice water habit.
If one could afford it, it would be well to drink nothing but mineral
water in the summer. Not only does it assure purity, but the gas is an
aid to digestion and serves to render the water more palatable. This
results in more of it being drunk than if it were flat water, and it is
desirable to drink as much water as possible in hot weather. By mineral
water I mean carbonated bottled waters intended for table use. Care
should be taken that the water is only lightly impregnated with salt.
It is much safer to drink a well-known water. The water may not be
bottled at the spring or it may be bottled under unsanitary conditions.
In many cases mineral water is not all that it should be in cleanliness.
Unless one is sure of the purity of a bottled water good hydrant water
supplied through the city pipes is safer.
In traveling, however, and at summer resorts it would be well to drink
nothing but mineral water of a well-known brand. Only by doing this and
by being certain that the bottle has not been refilled can one be safe.
The supplied on trains and in resorts frequently is not as pure as that
supplied in large cities.
On the whole, however, mineral water has no particular advantage over
ordinary water except that the well-known brands are sure to be pure,
and the carbonization makes it more tasty and so increases the amount
consumed. It is much safer and more healthful to drink a well-known
mineral water than the so-called soft drinks, many of which are unclean
and harmful.
DISEASES OF WOMEN