_HYGIENE AND LAW_
One of the fundamental principles of society is that each individual
must, in his methods of living, conduct himself with a due regard for
the rights, comfort, and health of others in the same society. A single
man or a single family living alone on a desert island requires no
restrictions of conduct, since there are no fellow-beings on whom his
violations of good conduct might react. The inhabitants of small
villages with small families on large lots are but little concerned with
laws governing social intercourse, since, at best, the amount of that
intercourse is inconsiderable. But, as population becomes greater, as
congestion increases, and as civilization and its requirements develop,
the need for law governing the interrelations of individuals becomes
imperative. Such laws deal with the moral life under many phases, and
the courts exist for the enforcement of such laws as the people
themselves, through their legislatures, demand for their own
self-protection.
One of the primitive laws found necessary, even among uncivilized
people, is that against theft, and, whether committed in the barbarous
tribes of Africa or on the frontier plains of the West, the act is
recognized as being contrary to the greatest good of the community, and,
if detected, is severely punished. As civilization advances, the code
of laws found necessary becomes more and more complex, and, although
use has made obedience to such laws almost second nature, it is hardly
possible to-day to escape the immediate restraint of such laws for more
than a moment at a time throughout any period of twenty-four hours.
_Principle of laws of hygiene._
It is particularly the laws which pertain to health and hygiene which we
shall consider in this chapter. The principle on which laws relating to
hygiene are passed is that while nominally a person is always free to do
with his own whatever he may choose, yet as a member of a community he
must choose to do only that which shall not injure or affect the health
or comfort of his neighbors. This principle was not at first invoked to
prevent violations of laws of health, but rather to prevent the
inconvenience which might come to a neighbor or to the public at large
by some unreasonable though apparently legitimate use of individual
property. As an example we may mention the law of New York State
requiring each owner of property in the country to cut grass, weeds, and
brush along the highway twice each year. Although this interferes with
the right of the owner to have the land which belongs to him left as he
chooses, it is legal because of the greater convenience and comfort it
contributes to the larger number of persons traveling along the highway.
The state does not assume the right to interfere with the acts of
individuals so long as such acts affect only their own individual
well-being, but when those actions affect others, then the police power
of the state may be invoked. It is on this principle that the law
prohibits suicide, assuming that no man can live or die without
affecting the interests of other people. This is plainly so in the case
of the head of a family or in the case of a man upon whom others are
dependent and whose death removes their support and causes those
supported to become dependent upon the state or county. This principle
has been extended so as to include the cases where a method of living, a
lack of care, or even a mere appearance in public may adversely affect
the health of others in the same community. If, for example, a member of
a family has diphtheria or smallpox, and such a child is isolated so
that no danger of the spread of the disease exists, the state would not,
in general, insist upon the use of any preventive or curative
inoculation; but if a child with incipient diphtheria or whooping cough
goes to school where other children may be infected and the disease
spread, the state, acting through its Board of Education, would have a
perfect right to send the child home and prevent its enjoying school
privileges until recovery from the disease.
It is on this principle that the state says that no child in New York
State may attend school unless vaccinated, the law reading, "No child,
not vaccinated, shall be admitted into any of the public schools of the
state, and the trustees of the schools shall cause this provision of law
to be enforced." This law has been questioned and brought before the
Supreme Court for review, and it was held by the judges that the
protection to the community implied is of sufficient importance to
justify its enactment.
For like reason, other restrictions governing the control of contagious
diseases is a function of the police power of the state in which the
rights of the individual must yield to the greater good of the
community. The writer remembers a particularly malignant case of
smallpox where the efforts of the local Board of Health had been
concentrated on the enforcement of quarantine, and where by the aid of
policemen, day and night, it was hoped that the disease was being
confined in the one house; yet, after the death of the patient, and when
apparently efforts for protection might be relaxed, a wake was held in
the house, in the very room of the patient, which might have resulted in
the spread of the disease through the entire town. Regulations,
therefore, covering the conduct of funerals and of burials should be
agreed to, since they are intended to prevent the spread of disease.
_Self-interest the real basis of law._
Many practices which are required by law in cities where the population
is crowded are not required or are not enforced in country districts,
since there the failure to carry out protective measures reacts only on
those immediately concerned. Disinfection of rooms in which contagious
diseases have occurred is one such provision. It rarely happens that a
health officer of a country community concerns himself with seeing that
a case of scarlet fever, for example, is prevented from spreading by a
thorough disinfection of the rooms. That seems to be left to the good
sense of the individual. It is hardly conceivable that a mother with
three or four children (when one child has been sick with a contagious
disease) will neglect ordinary and reasonable precautions to prevent the
spread of that disease to the rest of the family.
It is inconceivable, when the small amount of trouble and expense is
considered, that the parents of a family, after a case of diphtheria,
will neglect to fumigate and disinfect the clothing and bedding which
may be thus infected, particularly if such clothing or bedding is to be
used by other members of the family; and yet instances are recorded
where a child has died of scarlet fever and a year later another child,
perhaps wearing some of the clothes of the previous victim, has been
seized with the disease and has followed its brother or sister to the
grave. Cases of tuberculosis have been known to follow each other almost
year after year, as one member of a family after another occupied a room
where the infection persisted, either in the carpet or furniture, which
was never properly disinfected. Such cases must be left to the good
sense, intelligence, and understanding of the persons concerned. The
police power can never in this age take the place of an enlightened
sense in the community, nor are laws, as a matter of fact, of any use
except as they are sustained and enforced by public sentiment.
QUALITY OF WATER
There is another way in which the police power of the state exercises
control over rural communities, and that is in the matter of food which
the country generally supplies to the city. Perhaps the pollution of
water, which is, after all, one kind of food, is as important as any
matter covered by health laws.
In most cities to-day the pollution of streams is prohibited on two
grounds, first, that the streams are public property, even though for a
part of their course they may be owned individually. The sum of the
parts making up the whole stream involves so many individuals as to
imply public ownership, and inasmuch as one individual is limited in
his uses of the stream by the principle already referred to, he cannot,
even on his own land, do what he pleases with a stream or with its
waters. When streams are navigable, according to the law of this
country, no private ownership can exist, for the waters are controlled
and owned by the federal government. This latter body, in general, does
not undertake to control the quality of such waters, but there are many
laws covering the quantity of water in such streams, limiting the
amounts that can be withdrawn, restricting the filling up or silting of
such streams, and qualifying the bridging or damming of such waterways.
In small streams, such as are generally found in rural communities, the
vital principle of ownership is always limited by the requirement that
no owner shall so interfere with the normal quantity or quality of water
in the stream as to prevent their full enjoyment by the next man
downstream whose rights are equal with his own. This means, in the
matter of quantity, that while one individual may water stock in a
stream or may pump water from a stream for household use, he may not
withdraw from the stream the entire volume to use for irrigation, nor
may he, as a riparian owner, sell the water to some city near by which
might take out all the water of the stream.
The quality of a stream, likewise, may only to a certain extent be
interfered with. If a stream flows through a meadow, cows pastured in
the meadow have a natural right to wade in the brook, and if, in so
doing, a certain amount of pollution is added to the waters of the
brook, no one downstream can justly complain.
If, however, a sewer is carried from barns or houses into a brook which
is later used for drinking purposes, the quality of the water is
affected, and such a discharge is so revolting to the senses that
complaint to the courts would result in an order to find some other
method of disposing of such wastes.
In New York State, the legislature has delegated to the Department of
Health certain rights in the matter of the protection from pollution of
the waters of the state, particularly when those waters are used for
drinking purposes. Upon application from the water company, this
department, having carefully inspected the watershed, will prepare a
complete and elaborate series of rules, giving in detail just what an
individual may or may not do on the watershed, and, when enacted, these
rules have all the force of law. They are, however, like all laws,
subject to the constitutional limitations, and particularly to the
clause of the constitution which provides that "no state shall make or
enforce any law which shall deprive any person of property without due
process of law." This means that if any law prevents an individual
enjoying reasonable use of his own property, or if the deprivation of
such use is for the special benefit of some special community or
company, then that special body must be prepared to make compensation
for that deprivation, although if it were for the general good of the
community of which the individual was a member, no compensation might be
required.
REGULATIONS GOVERNING FOODS
Laws covering the sale of adulterated foods are of two kinds, namely,
those enacted by the national government at Washington, and those
enacted by the local authorities, either state or municipal. The laws
enacted by the national government, which are comprehended in the
recently enacted National Pure Food Law, deal particularly with the
adulteration and misbranding, not only of foods, but of all sorts of
medicines and liquor. Their effect, however, is limited entirely to such
articles as make up interstate commerce. If an article is made and sold
within the boundaries of any single state, it is not subject to the
national law, nor could this national law be applied to the production
or sale of any article from a farm unless that article was well enough
known to be generally distributed. For example, maple sirup, widely
advertised and generally sold, would be subject to the provisions of the
national law. Butter and cheese, sold locally, would not be subject to
such a law. It is evident, therefore, that this law does not usually
apply to farm products, unless, as in the case of some sausages, for
example, a widely advertised campaign has been instituted to promote
their sale.
There are, however, in the different states, laws which do apply locally
and which prohibit adulteration of all sorts. In New York State, for
example, the law says that no person shall, within the state,
manufacture, produce, compound, brew, distill, have, sell, or offer for
sale any adulterated food or product, and the law further specifies that
an article shall be deemed to be adulterated:--
"1. If any substance or substances has or have been mixed with
it so as to reduce or lower or injuriously affect its quality
or strength.
"2. If any inferior or cheaper substance or substances have
been substituted wholly or in part for the article.
"3. If any valuable constituent of the article has been wholly
or in part abstracted.
"4. If it be an imitation or be sold under the name of another
article.
"5. If it consists wholly or in part of diseased or decomposed
or putrid or rotten animal or vegetable substance, whether
manufactured or not, or in the case of milk, if it is the
produce of a diseased animal.
"6. If it be colored, or coated, or polished, or powdered,
whereby damage is concealed, or it is made to appear better
than it really is, or of greater value.
"7. If it contain any added poisonous ingredient, or any
ingredient which may render such article injurious to the
health of the person consuming it. Provided that an article of
food which does not contain any ingredient injurious to health
shall not be deemed to have been adulterated, in the case of
mixtures or compounds which may be now, or from time to time
hereafter, known as articles of food under their own
distinctive names, or which shall be labeled so as to plainly
indicate that they are mixtures, combinations, compounds, or
blends, and not included in definition fourth of this section.
"8. If it contains methyl or wood alcohol or any of its forms,
or any methylated preparation made from it."
These provisions, just mentioned, are provisions of the New York State
Health Law, and violations are in defiance of that law, the penalties
for which are specifically stated to be $100 for every such violation.
There is also in New York a police code that prohibits adulteration of
food, and in this code the adulteration of maple sirup or fruit juices
or spoiled articles of food of all sorts, of milk from which part of the
cream has been removed, and the sale of any article which is printed or
labeled in such a way as to misrepresent the article, is called a
misdemeanor, the penalty for which is left to the discretion of the
judge and which would, under ordinary conditions, be a fine of several
hundred dollars or imprisonment in a county jail for a term of months,
or both.
_Basis of pure food laws._
Adulteration of food may be considered from two points of view, the
hygienic and the economic, and, while the laws are generally intended to
preserve the public from impure food on account of the economic loss
involved thereby, the hygienic aspect is really the more important.
Adulterations which are plainly injurious to health are very few in
number, and it is rather desirable that the economic phase should be the
one to command attention of legislators, since, when that objection to
adulteration has been so voiced as to result in laws prohibiting
adulteration, the health of the public will be promoted by the
elimination of objectionable foodstuffs. The long-continued discussion
over the use of benzoate of soda in foods is an example of this twofold
aspect; some, arguing against its use, protested that when long
continued, it had a decidedly injurious effect upon the health of those
eating or drinking it; others objected to the chemical, but contended
that its use enabled spoiled fruits, like tomatoes, to be substituted
for fresh fruits, and the price of the latter obtained where the value
of the former only was given. No one seriously thinks that butter with a
small amount of butter color added could have any injurious effect upon
the human system, yet it is, in the eyes of the law, an adulteration
because its appearance indicates a quality of the butter which it does
not naturally possess.
PROTECTION OF MILK
The one article of food produced on the farm about which the greatest
amount of agitation has been centered has been the adulteration of milk,
as well as the question of the production of milk under unclean
conditions. The responsibility for pure milk rests on the Department of
Agriculture of the State, on the Department of Health of the State, on
the Department of Health of the city where the milk is sold, and on the
Board of Health in the village or town where the milk is produced. In a
way, these four departments divide the responsibility for the milk, and,
as in all cases of divided responsibility, the very fact of the number
subtracts from their efficiency. The local Board of Health of the
village or town where milk is produced is not usually interested or
concerned particularly in the question of its quality.
If a case of contagious disease in any farmhouse occurs, the local
health officer should see that a proper quarantine is established and
that the individuals in such a house are instructed in the danger of
contamination and in the necessity of avoiding infection in the dairy.
It is, however, the Board of Health in the city where the milk is
consumed who have a particular responsibility. Such a board has no
jurisdiction or authority over matters outside of their city, so that
their executive cannot go out into the country, into the district of
another health board, and order improvements made in the methods of
production. All that a city board can do is to enact and publish
restrictions under which milk must be sold in that city.
This is the method pursued in the city of New York, where tons of milk
are consumed every day and where manifestly the jurisdiction of the city
officials cannot extend over the thousands of farms located in the five
states from which the milk supply is drawn. In New York City the local
sanitary code provides that no milk shall be received, held, kept,
offered for sale, or delivered in the city of New York without a permit
from the Board of Health, and the Board makes this permit depend upon
the sanitary conditions existing at the dairy or farm where the milk is
produced or handled. In order to find out whether the conditions at the
dairies and farms throughout these five states are in a sanitary
condition, the city has a force of twenty-five inspectors who are
continually engaged in traveling among the farms and in reporting on
their condition. If a farm is found where the cows are diseased, or if
the buildings in which the cows are stabled or in which the milk is
cooled and strained are not clean or are lacking in proper ventilation
or otherwise unhygienic, or if the water-supply is bad, the farmer is
notified that conditions are such that the city of New York will refuse
to receive his milk. He is not forced to clean up, and no orders are
given him, but the attitude of the city authorities is made plain, and
then it is left to him to decide whether it may not be wise for him to
accept the suggestions made by the inspectors. Dr. Darlington, late
Health Commissioner of the city of New York, reported in 1907, after two
years of inspection, that out of 35,000 dairies inspected, only 47 were
shut out on account of unclean conditions, although many more were
warned with the result that remedial measures were at once taken. The
same sort of procedure may be adopted by any city, and is, in fact,
practiced by a number.
Another method of securing a better grade of milk which results in
forcing farmers to clean up the barn and barnyard, at the same time
allowing the local official to remain within the strict letter of the
law, which gives him no direct authority over conditions on farms
outside a city, is to limit the number of bacteria found in samples of
milk supplied by the dealer. A common rule is that no milk shall be
distributed which contains more than 50,000 bacteria per c.c., and when
milk contains a number in excess of this, the milkman is warned, and if,
at the next sampling, the number is still higher, the milkman is
notified that his milk will no longer be received. Experience has shown
that a reasonable regard for cleanliness in the stable and dairy room,
with a prompt cooling of the milk, will limit the bacterial growth to
this standard, and the requirement, meaning, as it does, only a decent
regard for such cleanliness as a self-respecting dairyman would
recognize as essential, works no hardship on any one. New York City
prints its dairy rules on linen and has them tacked up in every cow barn
concerned in the city milk supply, and while they have merely the force
of suggestions only, practically they have the force of law in that a
disobedience to these rules is likely to involve the refusal of the milk
from that particular dairy.
LAWS GOVERNING QUARANTINE
It is much to be regretted that, in these days of scientific knowledge,
when the exact and fundamental causes and processes of diseases are so
clearly known to medical men and when laws based on this knowledge have
been enacted for the purpose of reducing mortality and preventing the
spread of disease, ignorant individuals should allow their prejudices to
stand in the way of compliance with the spirit of these laws.
In New York State, Section 24 of the Public Health Law requires the
local Board of Health to isolate all persons and things infected with or
exposed to infectious diseases. They are required to prohibit and
prevent all intercourse and communication with or use of infected
premises, places, and things, and to require and, if necessary, to
provide the means for the thorough purification and cleansing of the
same before general intercourse with the same or use thereof shall be
allowed. The Penal Code of the state further provides that a person who,
having been lawfully ordered by a health officer to be detained in
quarantine and not having been discharged, willfully violates any
quarantine law or regulation is guilty of a misdemeanor, punishable by
fine or imprisonment or both. In spite of this prohibition, it is very
rare to find that a person in a quarantined house feels any personal
obligation. He stays in or out, if obliged to by a policeman, or, if the
sentiment among the neighbors is aroused in favor of quarantine, he
waits until dark enough to escape observation.
In New York, two years ago, a case of diphtheria broke out in the family
of a Christian Scientist. The health officer visited the house, offered
to use antitoxin, which was refused, and instructed quarantine. The
mother and one daughter died, and the healer was imprisoned for entering
the house in defiance of the quarantine law. This case illustrates how
the moral obligation may be distinctly repudiated because of religious
prejudice. But even religious belief must be subservient to the laws
governing the community in which a man chooses to live, and, so long as
the residence continues, the laws governing quarantine, as all other
laws, must be obeyed. In this case another count against parents may be
found. Section 288 of the Penal Code provides "that a person who
willfully omits without lawful excuse to perform a duty by law imposed
upon him to furnish food, clothing, shelter, or medical attendance to a
minor is guilty of a misdemeanor." It would seem, therefore, that the
law is provided by which fanaticism may be overruled in the interests of
the health of children, although it must be said that this phase of the
law is generally disregarded. Again, in spite of the ample proof to the
contrary, there are to be found persons who refuse to be vaccinated even
in the midst of a smallpox epidemic. A law in New York State provides
that no unvaccinated child shall attend public schools, the law being
mandatory upon the school trustees. If this law were faithfully carried
out, smallpox would entirely disappear from the state within a few
years.
Other instances might be cited to show how the force of the law is
invoked to minimize the effects of unhealthy living and to prevent that
perfect individual liberty which a few irresponsible persons would
assume to themselves. But it will always remain for the good sense of
the individuals to direct their actions in such a way as to inflict no
evil on the community. Unfortunately, laws are generally the result of
some calamity. A law prohibiting child labor is passed only after the
evil effects of such labor have been demonstrated by sad experience.
Laws forbidding the sale of diseased meat or of spoiled fruit are passed
only after repeated cases of illness have demonstrated the need of such
laws. Laws involving quarantine are the result of epidemics which have
showed plainly, at the cost of valuable lives, perhaps, the need of such
quarantine.
It is the aim of hygiene, whether rural or urban, to raise the
standards of living to such a degree that not only will any violation of
health laws seem unreasonable and obnoxious, but also every instinct, of
the individual will, even without specific laws, direct him so to live
that no hygienic offense will be directed towards those with whom he
comes in contact. Only in this way will the present violations of the
requirements of hygienic living be avoided, and the normal man be
enabled to live as he should in absolute harmony with his environment.
INDEX
Accuracy of death-rate records, 6.
Adenoids, 288.
Advantages, of gravity water-supply, 168, 169;
of hydraulic rams, 172;
of pond or lake water over brook water, 128.
Age and sex in disease, 299.
Aim of hygiene, 424.
Air, for breathing, 68;
for consumptives, 341; in soils, 39.
Air-lifts for pumping, 107, 183.
Air-space in cellar walls, 53.
Alcohol as a stimulant, 275.
Allegheny Valley and cancer, 34.
Amount of food required, 269.
Analysis of proposed water-supply, 143.
Animal heat in barn, 88;
pollution of water, 136.
Animals, fit for butchering, 306;
in the study of disease, 250.
"Anopheles" mosquito, 380.
Antiseptics, 316; in milk, 235.
Antitoxin, 306; and disease, 396;
for diphtheria, 403;
for hydrophobia, 408;
for tetanus, 408;
for typhoid fever, 363.
Apparatus for driving wells, 119.
Appendicitis, 33.
Appetite for food, 266.
Application of sewage to land, 218.
Area for subsurface sewage disposal, 223.
Artificial sewage beds, 219.
Asphalt for cellar walls, 53.
Auto-intoxication, 312.
Automatic sewage syphon, 225.
Babylon, L. I., water-supply, 187.
Bacillus of typhoid fever, 351.
Back of cellar walls, 56.
Bacteria, and parasites, 302;
and sewage purification, 213; in milk, 235.
Bacterial agencies, 304.
Bad air and its effects, 69.
Balanced rations, 263.
Barn ventilation, 88.
Barnyard drainage, 141.
Bathing for hygienic purposes, 285.
Beneficent bacteria, 304.
Billings's suggestion for ventilation, 80.
Billings's ventilation by stoves, 83.
Blankets, 281.
Blood resistance and disease, 297.
Bob-veal, 252.
Boiler for hot water, 198.
Boiling water for disinfection, 329.
Boston, Mass., water used in, 93.
Box radiators at window, 80.
Bright's disease in the country, 20.
Brooks as water-supply, 124.
Brush dam, 163.
Bubonic plague, 393.
Bucket water wheel, 175.
Cancer and soils, 33;
in Europe, 34.
Carbohydrates and digestion, 261.
Carbolic acid as disinfectant, 322.
Carbon dioxid in the air, 75.
Causes of typhoid fever, 350.
Cell disintegration, 297.
Cellar, floors, 59;
in limestone rock, 47;
ventilation, 60;
walls of dry masonry, 55.
Cellars and their drainage, 28.
Cement joints for well walls, 115.
Cesspools and wells, 116.
Changes in air breathed, 75.
Chemical poisons, 311.
Chicken pox, 375;
preliminary symptoms of, 367.
Children, as affecting the death rate, 8;
in Otsego and Putnam counties, 9.
Children's diseases, 364.
Chloride of lime, 325.
City milk, 247.
Cleanliness of stables, 63.
Clean milk, 242, 421.
Clean stables and their effects, 237.
Clothing, 280.
Coal-tar disinfectants, 323.
Coffee and tea, 272.
Cold baths, 286.
Composition, of air, 75;
of soils, 32.
Computations for rain-water storage, 101.
Concrete, core for dam, 159; dam, 160;
for spring-chamber, 158;
in cellar floor, 60;
in stables, 64;
method of mixing, 66.
Construction, of air-tight barns, 89;
of dug wells, 113;
of houses, 49;
of septic tanks, 230.
Consumption and bad ventilation, 74.
Contagion in children's diseases, 386.
Contagious diseases, 305.
Cooking and digestion, 268.
Cooling of milk, 242, 247.
Corn and pellagra, 391.
Corrosive sublimate, 324.
Cost, of driven wells, 121;
of flush tank, 207;
of fuel for pumping, 178;
of operating gas engines, 178;
of plumbing, 200; of ventilation, 87;
of water pipe, 168.
Cows and ventilation, 71.
Cow stables, ventilation of, 62.
Creamery and typhoid fever epidemic, 147.
Creosols, 323.
Crib dam, 163.
"Culex" mosquito, 380.
Curb for well, 141.
Cure of hookworm disease, 390.
Cut-off wall for dam, 160, 161.
Damp cellars, 27.
Damp courses in house walls, 56.
Dampness, and disease, 26;
of cellar walls, 52.
Damp soils, 27; and their effects, 40.
Dams for reservoirs, 158.
Danger, from drainage of barns and barnyards, 137;
from leachings from privies and cesspools, 138.
Dangers, of polluted air, 73;
of polluted water, 144.
Death-rate, from typhoid fever, 11;
from typhoid fever in New York State, 15;
of babies in Rochester, 237;
records, accuracy of, 6.
Death-rates, at various ages, 10;
in general, 2;
in New York State, 4;
in rural communities, 8;
in various countries, 3;
of children, 9;
outside of New York City, 7.
Deaths from measles and scarlet fever, 365.
Decomposition in sewage, 209.
Deep well pump, 106.
Deep wells, 115.
Deficiency of water from well supply, 104.
Definition of sewage, 208.
Deodorizers, 317.
Detection of animal pollution, 137.
Diagnosis of diphtheria, 404.
Digestion and its requirements, 261.
Digestive processes, 259.
Dimensions of hydraulic rams, 173.
Diphtheria, 401;
and milk, 239;
antitoxin, 310, 402;
in the country, 19.
Direct causes of disease, 302.
Dirt and disease, 296.
Dirt dam, 159.
Disadvantages, of hydraulic rams, 171;
of windmills, 169.
Disease, the causes of, 295.
Diseases caused by milk, 238.
Disinfecting, agents, 315;
a room, directions for, 319;
gases, 318.
Disinfection, 314;
by heat, 327;
for chicken pox, 376;
for consumption, 337;
for measles, 373;
for scarlet fever, 371;
for whooping cough, 375.
Disposal of sewage and water-supply, 141.
Distilled water, 131.
Dogs and hydrophobia, 406.
"Don't Spit" axioms, 334.
Drafts from windows prevented, 79.
Drainage, 41;
around the house, 44, 50.
Drain, for house on side hill, 42;
from house plumbing, 200.
Drains leading to dug well, 104.
Driven well, in dug well, 105;
machinery, 119.
Driven wells, 118.
Drugs and their immoderate use, 275.
Dry heat for disinfection, 328.
Dry masonry for cellar walls, 55.
Dug wells, 112.
Dust and its dangers, 301.
Earache, 288.
Effect of bad ventilation, 73;
of hard water on health, 133;
of vegetable pollution of water, 135.
Elimination, of dangers of surface pollution, 140;
of mosquitoes, 381.
Enameled iron for plumbing fixtures, 196.
Epidemic diseases, 305.
Epidemics of typhoid fever, 354.
Eruption of measles, 372.
Eucalyptus trees and malaria, 378.
Evaporation from reservoirs, 103.
Exercise, after meals, 271;
of the body, 278.
Expectorations in cases of consumption, 334.
Exposure, and pneumonia, 346; of a house, 29.
External causes of disease, 312.
Eyes and their troubles, 290.
Factory life and disease, 301.
Fall River, Mass., water used in, 93.
Faucets for plumbing, 195.
Field-stone dam, 160.
Filter beds for sewage in winter, 221.
Filtration of sewage, 219.
Finishing concrete surfaces, 67.
Fire protection and water-supply, 98.
Fire streams and water flow, 97.
Fish as destroyers of mosquitoes, 381.
Fixtures for plumbing, 191.
Fleas and the bubonic plague, 393.
Fletcher, and chewing, 259;
and his two meals, 269.
Flies and typhoid fever, 359.
Floods and stone dams, 161.
Floor of cellars, 59.
Flow of underground water, 111, 143.
Flush tank for water-closet, 206.
Food, for consumptives, 340;
for various body needs, 258.
Food adulteration laws, 416.
Foods and beverages, 257.
"Foos" gas engine, 178.
Formaldehyde, 321.
Forms for concrete cellar walls, 65.
Foul-air outlet for ventilation, 81.
Foundation for dam, 160.
Freezing in plumbing, 190.
Fresh-air inlet for ventilation, 77.
Friction with fire streams, 98.
Fried foods, 269.
Fuel for pumping, 178.
Galvanized iron water tanks, 185.
Garbage for filling low ground, 37.
Gas engines for pumping, 177.
Gastric juice, 260.
Gate house for reservoirs, 165.
Goiter and soils, 33.
Goulds Manufacturing Co. pumps, 181.
Grade, for house drains, 45;
for cellar drains, 51;
of subsurface tile, 222.
Ground water, 43.
Growth of mosquitoes, 384.
Habit and food, 267.
Hand basin in bath-room, 199.
Hands to be washed frequently, 287.
Hand valves for sewage tanks 227.
Hard water, 133.
Health departments, 416.
Heat, and plumbing, 190;
as a disinfectant, 327.
Heating and ventilation, 87.
Heredity and health, 298.
Homer, N. Y., water-supply, 105.
Hookworm disease, 302, 388.
Hot-air engines for pumping, 175.
Hot-water boiler, 198.
Hot-water circulation, 194.
House drainage, 200.
House drains, 44.
Hydraulic rams, 171.
Hydrophobia, 407.
Hygiene, and its laws, 410;
and its true purpose, 23.
Ice and typhoid fever, 353.
Ideality of life, 22.
Immunity--natural and artificial, 310.
Importance of bacteria, 305.
Impurity of surface water-supply, 140.
Indians and ventilation, 74.
Indirect causes of death, 312.
Infection in pneumonia, 348.
Influenza in the country, 19.
Inlet for fresh air, 78, 81.
Inspection of dairies, 421.
Installation of plumbing, 189.
Intermittent application of sewage on land, 213.
Iron pipe for conveying water, 167.
Irrigation and sickness, 36.
Irritation of cell tissue, 297.
Ithaca typhoid epidemic, 354.
Joints in soil-pipe, 203;
in tile pipe, 167.
Kerosene and mosquitoes, 383.
Kewanee Water Supply Co. tanks, 187.
King of ventilation, 86.
King's experiments on ventilation, 70.
Kitchen sinks, 196.
Kitchen stove and hot water, 195.
Koch and consumption, 333.
Land treatment of sewage, 216
Laundry tubs, 196.
Law and hygiene, 410.
Laws against impure food, 416.
Lesions of tuberculosis, 252.
Level for house drain, 200.
Light, as a disinfectant, 330;
in cow stables, 62.
Lime for disinfecting, 324.
Liquid disinfectant, 321.
Location, of a house, 29;
of a house on a side hill, 32;
of privies and cesspools, 31;
of windmill, 171.
Long Island wells, 112.
Loss of head by friction, 129.
Lowell typhoid epidemic, 355.
Lungs, air required by the, 68;
developed by exercise, 279.
Made ground and health, 37.
Malaria, 302, 377;
caused by soil formation, 33;
from cellars, 39.
Malarial attacks, 385.
Manure from cow stables, 244.
Maximum rate of water consumption, 95.
Measles, and its virulence, 371;
preliminary symptoms, 367.
Meat and its dangers, 249.
Mercury as a disinfectant, 324.
Metchnikoff's theory of auto-intoxication, 233.
Methods of collection of water, 153;
of securing fall for hydraulic rams, 175.
Milk, and its adulteration, 419;
and its care, 233;
and typhoid fever, 358;
of lime, 325;
supply of Rochester, N. Y., 237.
Milk-pail for clean milk, 245.
Mineral matter in water, 132.
Minimum rainfalls, 100.
Mixing concrete, 66.
Moisture and its dangers, 39.
Montclair typhoid epidemic, 359.
Mosquitoes, and malaria, 380;
and yellow fever, 387.
Mount Savage typhoid epidemic, 357.
Mouth breathing, 287.
Muslin cloth to prevent drafts, 81.
Narrow-topped milk-pail, 245.
Natural immunity, 310.
Need for rural hygiene, 21.
Newton, Mass., water used in, 92.
New York State, death-rates in, 6.
Night air and malaria, 26.
Objectionable construction work at a spring reservoir, 154.
Objections to brooks as source of water-supply, 125.
Occupation and disease, 301.
Old age mortality in the country, 20.
Openings for ventilation, size of, 85.
Organic matter, in soil, 38;
in the air, 76.
Outfall for cellar drain, 52.
Outlet, for drains, 47;
for foul air, 81.
Ownership in streams, 415.
Oxygen in the air, 75.
Oysters and typhoid fever, 361.
Pancreatic juice and digestion, 261.
Parasites as causes of disease, 302.
Pasteurization for typhoid fever, 352.
Patented disinfectants, 317.
Patent medicines, 276.
Peeling, in measles, 373;
in scarlet fever, 369.
Pellagra, 391.
Pipe lines, 165.
Plank dam, 159.
Pleasure in eating, 270.
Plumbing, 189;
and heating, 190;
and water consumption, 93.
Pneumonia, 333;
germ, 344;
in the country, 20.
Pollution, of streams, 211;
of water, 414;
of water by animal matter, 136;
of wells, 142.
Ponds or lakes as water-supply, 127.
Position of fresh-air inlet, 81.
Precautions on part of consumptive, 337.
Preparation of rabies antitoxin, 309.
Pressure for water-supplies, 128.
Pressure tanks, 186.
Prevention of pneumonia, 346.
Principle of hygienic law, 411.
Privy, construction of, 61.
Process of bacterial attack, 307.
Production of diphtheria antitoxin, 403.
Protection, against mosquitoes, 385;
against smallpox, 398.
Proteids in food, 260.
Ptomaines, 250.
Pump for deep well, 106.
Pumping water, 168.
Purity of water-supply, 131.
Quantity of water in stables, 94;
of water per person, 92;
of water used, 90.
Quarantine, regulations, 422;
for scarlet fever, 369.
Quinine and malaria, 378, 386.
Rabies, 406; antitoxin, 309.
Radiators by windows, 79.
Rain-water, storage, 101;
supply, 99.
Rates of water consumption, 95.
Rations for daily use, 263.
Register in the ceiling, 85.
Remedies, for consumption, 340;
for pneumonia, 347.
Reservoir, for brook supply, 126;
on a brook, 102.
Resistance, of body to disease, 297, 308;
to tuberculosis, 335.
Rest for consumptives, 340.
Results of measles and scarlet fever, 366.
Rochester and the milk supply, 237.
Rock formations and hygiene, 35.
Roof of spring-chamber, 157.
Rubber boots, 283.
Running trap for main drain, 201.
Rusting of driven-well casing, 119.
Saliva from mouth, 260.
Sand filter beds for sewage, 219.
Scarlet fever, and milk, 240;
preliminary symptoms of, 367;
quarantine, 369.
Scarlatina, 369.
School vaccination, 412.
Scurvy and fresh vegetables, 266.
Sedimentation of sewage, 227.
Septic tanks, 229.
Sewage disposal, 208.
Sewage-sick land, 214.
Sewage treatment on land, 213.
Sewer pipe in wells, 105.
Sewers and sickness, 36.
Sex and age in disease, 299.
Shallow wells, 113.
Sinks, for kitchen, 196;
and their discharges, 214.
Size, of openings for fresh air, 85;
of pipe for conveying water, 166;
of spring reservoir, 156;
of waste weir, 163.
Slaughter-houses, 255.
Sleep, 292.
Smallpox, 396;
and chicken pox, 399;
instead of chicken pox, 376.
Smoking and its effects, 275.
Soap, as an antiseptic, 326;
its relation to hard and soft water, 134.
Soil, air and its exclusion, 49;
for disinfection, 331.
Soil-pipe in house, 201.
Somerville typhoid epidemic, 359.
Sources of water-supply, 108.
Space between houses, 30.
Spring-chamber, 157.
Spring, extensions, 123;
reservoirs, 155.
Springs, 121;
and their formation, 109.
Squirrels, and the bubonic plague, 395;
in the attic, 30.
Stables, and dirty milk, 237;
and water consumption, 94;
for clean milk, 242;
space required per cow, 63;
ventilation, 86.
Stamford typhoid epidemic, 359.
Steam, for disinfection, 329; pumps, 179.
"Stegomyia mosquito," 386.
Sterilization of milk, 234.
Stone dam, 159.
Storage, on a brook, 102;
reservoirs, 127;
tank for rain-water, 101.
Stoves used in ventilation, 82.
Strainer for milk-pail, 246.
Stream, pollution, 210;
supplies, 158.
Subsurface, irrigation field, 224;
sewage disposal, 223.
Sulfur as a disinfectant, 318.
Sunlight as a disinfectant, 331.
Supply tank for domestic plumbing, 192.
Surface use of land for sewage treatment, 216.
Swamps and malaria, 381.
Symptoms of diphtheria, 401,404;
of smallpox, 399;
of yellow fever, 387.
Syphons, for automatic discharge, 225;
for septic tanks, 229.
Systems of house drainage, 45.
Tanks, for sedimentation, 228;
for water storage, 183.
Tannin in tea, 274.
Tapeworm, 303.
Tar, for cellar walls, 53;
paper for water-proofing, 54.
Tea as a drink, 273.
Teeth and their care, 291.
Tetanus, 408.
Thymol for hookworm disease, 390.
Tile pipe line, 166.
Tobacco and its effects, 275.
Topography and hygiene, 34.
Toxic action, 308.
Transmission of typhoid fever by polluted water, 145.
Traps for plumbing, 204.
Trap-vents, 203.
Treatment, of hydrophobia, 408;
of sewage on land, 213;
of smallpox, 400;
of typhoid fever, 361.
Trees and the hygienic home, 30.
Trichinosis, 253, 303.
Tuberculosis, 332;
and milk, 240;
death-rates, 18;
in the country, 19;
in the United States, 18.
Tuberculous meats, 251.
Typhoid bacillus, 351.
Typhoid fever, 308, 349;
and milk, 238;
epidemic at Butler, Pa., 146;
epidemic at Caterham, England, 145;
epidemic at Kerhonkson, N. Y., 150;
epidemics, 354;
in ice, 353;
in New York State, 13;
in small cities, 14;
in Spanish-American War, 360;
rates in the country, 12.
Unadilla Valley and cancer, 34.
Uncinariasis, 389.
Underdrains for sewage disposal, 231.
Underground waters, 109.
Underwear, 281.
United States Department of Agriculture and diseased meat, 251.
University of Pennsylvania radiators, 79.
Use of cement in well walls, 115.
Vaccination, 397.
Variation in maximum rates of water use, 96.
Vegetable, beds and sewage, 218;
pollution of water, 135.
Ventilation, 68;
experiments on hens, 71;
by stoves, 82;
of bedrooms, 283;
of cellars, 60;
of stables, 86;
through walls, 72.
Vents for traps at fixtures, 203.
Vitality of the typhoid germ, 352.
Volume, of sewage, 209;
of space in cow stables, 63.
Vomiting in whooping cough, 374.
Walls for spring reservoirs, 155, 156.
Wash-basin in bath-room, 199.
Washing, milk-pails, 246;
soda for disinfection, 329.
Wash-tubs, 197.
Waste weirs, 163.
Water, in the soil, 38;
needed for house, 90;
transmission of typhoid fever, 354;
used per head, 92;
with meals, 272.
Water-closets, 205.
Water-proofing of cellar walls, 58.
Water-supply and intelligence, 91.
Water tanks, 183.
Water-tight masonry for wells, 142.
Weather and pneumonia, 345.
Wells, and cesspools, 31;
and typhoid fever, 357;
on Long Island, 112.
Well supplies, 104.
Whooping cough, 373.
Will power and sleep, 293.
Windmills, 169, 170.
Windmill with pressure tanks, 188.
Window openings for ventilation, 78.
Winter care for sewage beds, 221.
Wooden tank for water, 193.
Work of a farmer's day, 21.
Worthington pump, 182.
Yellow fever, 386.
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