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Harris. + </title> + <style type="text/css"> +/*<![CDATA[ XML blockout */ +<!-- + p { margin-top: .75em; text-align: justify; + text-indent: 1.25em; margin-bottom: .75em; } + + .noindent {text-indent: 0em;} + + h1 {text-align: center; clear: both; } + h2 {text-align: center; margin-top: 3em; margin-bottom: 1em; clear: both; } + h3 {text-align: center; clear: both; } + h4 {text-align: center; clear: both; } + h5 {text-align: center; clear: both; } + + table {margin-left: auto; margin-right: auto;} + +div.trans-note {border-style: solid; border-width: 1px; + background-color: #DEE; color: #000; + margin: 3em 15%; padding: 1em;} + +/* LISTS */ + ul { position: relative; width: 90%; margin-left: 2%; + list-style-type: none; font-size: 95%;} + + li { margin-top: 0.25em; line-height: 1.2em; } + + .ix { margin-left: 2%; list-style-type: none; font-size: 95%;} + + body{margin-left: 10%; margin-right: 10%; } + + .pagenum { position: absolute; left: 2%; font-size: 65%; + text-indent: 0em; text-align: right; } /* page numbers */ + + .blockquot{margin-left: 10%; margin-right: 12%;font-size: 90%; } + + .bbox {border: solid 2px; font-size: 80%; padding: .5em; width: 50%; + margin: auto; background: #eeeeee; } + + .totoc {position: absolute; right: 2%; font-size: 75%; text-align: right;} + + .center {text-align: center;} + + .smcap {font-variant: small-caps;} + + .caption {font-weight: bold; font-size: 85%;} + +/* FOOTNOTES */ + .footnotes {border: dashed 1px; margin-top:1em; clear: both;} + .footnotes h3 { margin-top: 0.5em;} + .footnote {margin-left: 10%; margin-right: 10%; font-size: 0.9em;} + .footnote .label {position: absolute; right: 82%; text-align: right;} + .fnanchor {font-size: .8em; text-decoration: none;} + + // --> + /* XML end ]]>*/ + </style> + </head> +<body> + + +<pre> + +The Project Gutenberg EBook of Health on the Farm, by H. F. Harris + +This eBook is for the use of anyone anywhere at no cost and with +almost no restrictions whatsoever. You may copy it, give it away or +re-use it under the terms of the Project Gutenberg License included +with this eBook or online at www.gutenberg.org + + +Title: Health on the Farm + A Manual of Rural Sanitation and Hygiene + +Author: H. F. Harris + +Release Date: September 28, 2008 [EBook #26718] + +Language: English + +Character set encoding: ISO-8859-1 + +*** START OF THIS PROJECT GUTENBERG EBOOK HEALTH ON THE FARM *** + + + + +Produced by Tom Roch, Marcia Brooks and the Online +Distributed Proofreading Team at http://www.pgdp.net (This +file was produced from images produced by Core Historical +Literature in Agriculture (CHLA), Cornell University) + + + + + + +</pre> + + +<div class="trans-note"><center>Transcriber's Notes:</center> +<p>Inconsistencies with regards to hyphenated words have been left as in +the original. Inconsistencies in spelling and other unexpected spelling +have been retained as in the original book.</p></div> + + + +<h3>THE YOUNG FARMER'S PRACTICAL LIBRARY</h3> + +<h4>EDITED BY ERNEST INGERSOLL</h4> +<br /> +<h1>HEALTH ON THE FARM</h1> + +<h3>BY</h3> +<h2>H. F. HARRIS</h2> + + +<div class="bbox"> +<h3>The Young Farmer's Practical<br /> +Library</h3> + +<center>EDITED BY ERNEST INGERSOLL</center> + +<center>Cloth 16mo Illustrated 75 cents <i>net</i> each.</center> + +<p class="noindent"><b>From Kitchen to Garret.</b> By <span class="smcap">Virginia +Terhune Van de Water</span>.</p> + +<p class="noindent"><b>Neighborhood Entertainments.</b> By <span class="smcap">Renée +B. Stern</span>, of the Congressional Library.</p> + +<p class="noindent"><b>Home Water-works.</b> By <span class="smcap">Carleton J. +Lynde</span>, Professor of Physics in Macdonald +College, Quebec.</p> + +<p class="noindent"><b>Animal Competitors.</b> By <span class="smcap">Ernest Ingersoll</span>.</p> + +<p class="noindent"><b>Health on the Farm.</b> By <span class="smcap">Dr. H. F. +Harris</span>, Secretary, Georgia State Board +of Health.</p> + +<p class="noindent"><b>Co-operation Among Farmers.</b> By <span class="smcap">John +Lee Coulter</span>.</p> + +<p class="noindent"><b>Roads, Paths and Bridges.</b> By <span class="smcap">L. W. +Page</span>, Chief of the Office of Public +Roads, U. S. Department of Agriculture.</p> + +<p class="noindent"><b>Farm Management.</b> By <span class="smcap">C. W. Pugsley</span>, +Professor of Agronomy and Farm Management +in the University of Nebraska.</p> + +<p class="noindent"><b>Electricity on the Farm.</b> By <span class="smcap">Frederick +M. Conlee</span>.</p> + +<p class="noindent"><b>The Farm Mechanic.</b> By <span class="smcap">L. W. Chase</span>, +Professor of Farm Mechanics in the +University of Nebraska.</p> + +<p class="noindent"><b>The Satisfactions of Country Life.</b> By +<span class="smcap">Dr. James W. Robertson</span>, Principal of +Macdonald College, Quebec.</p> +</div> +<br /><br /> + + +<h1>HEALTH ON THE FARM</h1> + +<h3>A MANUAL OF RURAL SANITATION<br /> AND HYGIENE</h3> + + +<h4> +BY<br /> +H. F. HARRIS</h4> +<h5><span class="smcap">SECRETARY OF THE GEORGIA STATE BOARD OF HEALTH</span></h5> +<br /> +<center> +<b>New York</b><br /> +STURGIS & WALTON COMPANY<br /> +1911<br /> +<i>All rights reserved</i><br /> +</center> + + +<h5> +Copyright 1911<br /> +By STURGIS & WALTON COMPANY<br /> +<br /> +Set up and electrotyped. Published July, 1911<br /> +</h5> + + + +<h2><a name="INTRODUCTION" id="INTRODUCTION"></a>INTRODUCTION</h2> + +<h3>BY THE GENERAL EDITOR</h3> + + +<p>This is the day of the small book. There is +much to be done. Time is short. Information +is earnestly desired, but it is wanted in compact +form, confined directly to the subject in view, +authenticated by real knowledge, and, withal, +gracefully delivered. It is to fulfill these conditions +that the present series has been projected—to +lend real assistance to those who are +looking about for new tools and fresh ideas.</p> + +<p>It is addressed especially to the man and +woman at a distance from the libraries, exhibitions, +and daily notes of progress, which are +the main advantage, to a studious mind, of living +in or near a large city. The editor has had +in view, especially, the farmer and villager +who is striving to make the life of himself and +his family broader and brighter, as well as to +increase his bank account; and it is therefore +in the humane, rather than in a commercial direction, +that the Library has been planned.</p> + +<p>The average American little needs advice on +the conduct of his farm or business; or, if he +thinks he does, a large supply of such help in +farming and trading as books and periodicals +can give, is available to him. But many a man +who is well to do and knows how to continue +to make money, is ignorant how to spend it in +a way to bring to himself, and confer upon his +wife and children, those conveniences, comforts +and niceties which alone make money worth +acquiring and life worth living. He hardly +realizes that they are within his reach.</p> + +<p>For suggestion and guidance in this direction +there is a real call, to which this series is an +answer. It proposes to tell its readers how +they can make work easier, health more secure, +and the home more enjoyable and tenacious +of the whole family. No evil in American rural +life is so great as the tendency of the young +people to leave the farm and the village. The +only way to overcome this evil is to make rural +life less hard and sordid; more comfortable and +attractive. It is to the solving of that problem +that these books are addressed. Their central +idea is to show how country life may be made +richer in interest, broader in its activities and +its outlook, and sweeter to the taste.</p> + +<p>To this end men and women who have given +each a lifetime of study and thought to his or +her specialty, will contribute to the Library, +and it is safe to promise that each volume will +join with its eminently practical information a +still more valuable stimulation of thought.</p> + +<p style="text-align: right;"><span class="smcap">Ernest Ingersoll.</span></p> + + +<p><span class='pagenum'><a name="Page_1" id="Page_1">[Pg 1]</a></span></p> +<a name="toc" id="toc"></a> +<h2>TABLE OF CONTENTS</h2> + +<div class='center'> +<table border="0" cellpadding="4" cellspacing="0" summary="Table of Contents"> +<tr><td align='left'><small>CHAPTER</small></td><td></td><td align='right'><small>PAGE</small></td></tr> +<tr><td align='left'></td><td align='left'><a href="#INTRODUCTION"><b>INTRODUCTION</b></a></td></tr> +<tr><td align='left'>I</td><td align='left'><a href="#CHAPTER_I"><b>Importance of Our Subject</b></a></td><td align='right'><a href="#Page_3">3</a></td></tr> +<tr><td align='left'>II</td><td align='left'><a href="#CHAPTER_II"><b>Care of the Person</b></a></td><td align='right'><a href="#Page_12">12</a></td></tr> +<tr><td align='left'> III</td><td align='left'><a href="#CHAPTER_III"><b>Sanitation In and About the House</b></a></td><td align='right'><a href="#Page_35">35</a></td></tr> +<tr><td align='left'>IV</td><td align='left'><a href="#CHAPTER_IV"><b>Hygiene of Infancy and Childhood</b></a></td><td align='right'><a href="#Page_63">63</a></td></tr> +<tr><td align='left'>V</td><td align='left'><a href="#CHAPTER_V"><b>Proper Eating—The Secret of Good Health</b></a></td><td align='right'><a href="#Page_92">92</a></td></tr> +<tr><td align='left'>VI</td><td align='left'><a href="#CHAPTER_VI"><b>Bread and Its Relations</b></a></td><td align='right'><a href="#Page_104">104</a></td></tr> +<tr><td align='left'> VII</td><td align='left'><a href="#CHAPTER_VII"><b>Meats, Sugars and Milk</b></a></td><td align='right'><a href="#Page_117">117</a></td></tr> +<tr><td align='left'>VIII</td><td align='left'><a href="#CHAPTER_VIII"><b>Food-Value of Vegetables</b></a></td><td align='right'><a href="#Page_130">130</a></td></tr> +<tr><td align='left'>IX</td><td align='left'><a href="#CHAPTER_IX"><b>Danger in Fruits and Pickles</b></a></td><td align='right'><a href="#Page_144">144</a></td></tr> +<tr><td align='left'>X</td><td align='left'><a href="#CHAPTER_X"><b>Drinks—Proper and Harmful</b></a></td><td align='right'><a href="#Page_148">148</a></td></tr> +<tr><td align='left'>XI</td><td align='left'><a href="#CHAPTER_XI"><b>Importance of Good Cooking</b></a></td><td align='right'><a href="#Page_164">164</a></td></tr> +<tr><td align='left'> XII</td><td align='left'><a href="#CHAPTER_XII"><b>Seven Avoidable Diseases</b></a></td><td align='right'><a href="#Page_171">171</a></td></tr> +<tr><td align='left'>XIII</td><td align='left'><a href="#CHAPTER_XIII"><b>Hygiene of the Sick Room</b></a></td><td align='right'><a href="#Page_217">217</a></td></tr> +<tr><td align='left'> XIV</td><td align='left'><a href="#CHAPTER_XIV"><b>Emergencies and Accidents</b></a></td><td align='right'><a href="#Page_223">223</a></td></tr> +<tr><td align='left'>XV</td><td align='left'><a href="#CHAPTER_XV"><b>What to do When Poisoned</b></a></td><td align='right'><a href="#Page_251">251</a></td></tr> +<tr><td align='left'></td><td align='left'><a href="#APPENDIX"><b>Appendix</b></a></td><td align='right'><a href="#Page_273">273</a></td></tr> +<tr><td align='left'></td><td align='left'><a href="#INDEX"><b>Index</b></a></td></tr> +</table></div> +<br /><br /> + + +<p><span class='pagenum'><a name="Page_2" id="Page_2"></a></span></p> +<p><span class='pagenum'><a name="Page_3" id="Page_3">[Pg 3]</a></span></p> +<h1>HEALTH ON THE FARM</h1> + + + +<h2><a name="CHAPTER_I" id="CHAPTER_I"></a>CHAPTER I</h2> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>IMPORTANCE OF OUR SUBJECT</h3> + + +<p>Notwithstanding the extraordinary advances +in a material way that have been accomplished +in this country within the last few decades, it +is a significant and most alarming fact that +progress in hygienic matters has lagged far +behind. Why this is, it would be very difficult +to say,—for the reason that the causes are perhaps +many. Chief among these, probably, is +the fact that our progress along industrial lines +has occupied the entire time of the majority +of our best intellects, and it is also in no small +degree the consequence of a fatalism that regards +disease as a direct visitation of providence +and therefore a thing which man may not +avoid. Another cause in some instances is the<span class='pagenum'><a name="Page_4" id="Page_4">[Pg 4]</a></span> +pride of our people in their homes and respective +localities, which causes them to repel with +indignation the suggestion that any special +measures are necessary in order to conserve the +public health where they reside. Ignorant as +the average man is of the causes that produce +sickness and the means by which this result is +accomplished, he is naturally not in a position +to form a correct judgment concerning such +matters, and as a consequence, sees no reasons +for taking the precautions that are necessary in +order to ward off disease. This ignorance, it +must be confessed with sorrow, is in a measure +the fault of the medical profession, which has +not in the vast majority of instances lived up +to its ideals in this connection. Petty and unworthy +rivalry has played an extremely important +part in this failure of medical men to do +their duty in this particular—none of the physicians +of a community being, as a rule, willing +that others should instruct the public, however +vital this might be for the general good. As a +consequence, that class of vultures known as +medical quacks has furnished to the laity by +far the greater proportion of their instruction<span class='pagenum'><a name="Page_5" id="Page_5">[Pg 5]</a></span> +on hygienic subjects, with the result that the +average man has a greater misconception and +less real knowledge of such matters than of anything +else in which he is vitally interested.</p> + +<p>Another, and very curious explanation for +our general disregard of the laws of health is +that our strong belief in ourselves impels us +to think that however much others may suffer +from things generally regarded as unhygienic, +we, ourselves, will be immune. This belief is +fostered by the fact that in early life there often +seems no end to our capacity to endure, and we +find ourselves constantly defying without apparent +harm, what we are told by others is +directly contrary to all rules of proper living. +But it is unfortunately true also that the reserve +force and great power of resistance that enables +us to do these things begins to wane towards +the end of the third decade of life, and we, therefore, +find ourselves sooner or later breaking +down after we have become thoroughly convinced +that we were made of iron, and that +while other people might not be able to do as +we were, it could not possibly result in evil in +our own cases.<span class='pagenum'><a name="Page_6" id="Page_6">[Pg 6]</a></span></p> + +<p>What a pity it is that the young will not learn +from the experience of those who have gone +before them! Could they only do so, how much +suffering and woe could be avoided in this +world. Unfortunately, however, there are few +men so constituted that they are willing to be +guided by the experience of those who have preceded +them, and there is but a faint possibility, +therefore, that any good can be accomplished +by warning the coming generation of the +troubles in store for them should they not heed +the advice of those who have suffered before +them. Notwithstanding this, the writer feels +that these words of warning should be spoken +to the young, since they, alas, are the only ones +to be benefited by such advice.</p> + +<p><i>As you value your happiness materially, and +as you desire a healthy old age and a long life, +inform yourselves as to the few simple laws that +govern human existence, and attempt so far as +lies in your power to follow them. If you do +not do this, disaster will follow as surely as the +night follows the day.</i></p> + +<p><i>Apathy of the Public as to Hygiene.</i>—As a +partial consequence, probably, of all the reasons<span class='pagenum'><a name="Page_7" id="Page_7">[Pg 7]</a></span> +mentioned, along with others, there exists in +the popular mind a curious apathy concerning +hygienic matters—an apathy so great that it is +scarcely possible to get the average man to +discuss, much less to put in practice the all-important +laws that govern health. As a result of +the work of the various State boards of health +and of the Public Health and Marine Hospital +Service, this condition of affairs happily shows +some signs of abatement, and we certainly have +reasons to believe that the future promises +great things along these lines. No sign of this +change is more significant than the awakening +of the press of the country to the vast importance +of instructing the public in health matters, +and their changed attitude toward the charlatans +and quacks who live by promising the impossible. +Largely subsidized by the infamous +vendors of patent medicine, our newspapers +and magazines still lend their columns to these +human vampires who prey pre-eminently on +the ignorance and credulity of the hopelessly-diseased +poor; but within recent years some +of our foremost journals show signs of an +awakening of conscience, and a very few have<span class='pagenum'><a name="Page_8" id="Page_8">[Pg 8]</a></span> +even gone so far as to exclude advertisements +of this character altogether.</p> + +<p>It has been said, certainly with more or less +truth, that we are creatures of our surroundings, +but whether we accept this in its broadest +sense or not, there can be no question that our +well being is most intimately connected with +those things with which we come into every day +contact. <i>Nothing is more important for us to +recognize than that our diseases are contracted +from neighboring subjects just in proportion +as we are closely associated with them.</i> From +our fellowmen we contract, as everyone knows, +a large number of diseases, either by direct contact +or by means of the air that surrounds us. +From the earth we get hook-worms and other +animal parasites, either by coming directly in +contact with it or through eating uncooked +fruits and vegetables. From water we get +typhoid fever, dysentery, cholera, and many +other parasitic diseases. From our food we +likewise contract dangerous maladies such as +tapeworms from uncooked meats and fish and +the deadly trichina from raw hog meat. With +decomposed breads we take the poisons that<span class='pagenum'><a name="Page_9" id="Page_9">[Pg 9]</a></span> +produce pellagra, kak-ke, ergotism and acrodinia. +From uncooked fruits and vegetables we +get dysentery, typhoid fever, cholera, and parasitic +diseases. Spoiled beans give us the deadly +lathyrismus. From decomposed meat and fish +we get ptomaine poisoning. Mosquitoes convey +to us malaria, yellow fever and a parasite +known as the filaria. The dreaded sleeping-sickness +of Africa comes through the bites of a +small fly; the bedbug is believed to be the +means of conveying a frightful disease known +as kala-azar, and the house-fly often brings to +us the germs that produce typhoid fever, dysentery, +and probably other diseases as well.</p> + +<p>The bubonic plague, which is one of the most +frightful diseases known, is conveyed to man +by the rat and mouse.<a name="FNanchor_1_1" id="FNanchor_1_1"></a><a href="#Footnote_1_1" class="fnanchor">[1]</a> Hydrophobia is usually +contracted from the bite of the dog, and it is +a well-known fact that this animal often harbors +a minute tapeworm, a single egg of which, +when swallowed by the human being, is often +followed by death. Both dogs and cats probably<span class='pagenum'><a name="Page_10" id="Page_10">[Pg 10]</a></span> +convey diphtheria, and both unquestionably +often have within their intestinal tracts +tapeworms that occasionally infect children. +With the exception of the rare disease known +as glanders, the horse is not believed to be directly +responsible for any of the maladies from +which the human being suffers, but it is well +established that fully 95 per cent. of house-flies +hatch in the manure of these animals, and +they, therefore, become indirectly responsible +for some of the most serious diseases affecting +the human being. It is thus seen that almost +every object with which man comes in intimate +contact is capable of conveying to him the +poison of one or more diseases. If it were possible +for us to separate ourselves completely +from everything with which we are ordinarily +associated there can be no question that the +span of human life would be greatly increased, +and that death from bacterial and parasitic diseases +generally would no longer occur. All this +is said not with the object of startling the +reader, but to warn him of the dangers that surround +him on every hand, and to urge a recognition +of that which can so materially prolong his<span class='pagenum'><a name="Page_11" id="Page_11">[Pg 11]</a></span> +life. Fortunately these sources of infection +may be almost entirely done away with by a few +simple rules of life, and the health and longevity +of mankind must necessarily be directly proportionate +to the care with which we observe +them.</p> + +<p>It is now in order to discuss in detail the +subject of personal hygiene.</p> + + +<div class="footnotes"><h3>FOOTNOTE:</h3> + +<div class="footnote"><p><a name="Footnote_1_1" id="Footnote_1_1"></a><a href="#FNanchor_1_1"><span class="label">[1]</span></a> See the volume in this Library, <i>Animal Competitors</i>, by +<span class="smcap">Ernest Ingersoll</span>, for the agency of rats and mice in the +introduction and dissemination of plague and other diseases; +and the means of destroying these pests of the farm.</p></div> +</div> + + + +<h2><a name="CHAPTER_II" id="CHAPTER_II"></a>CHAPTER II</h2> +<p><span class='pagenum'><a name="Page_12" id="Page_12">[Pg 12]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>CARE OF THE PERSON</h3> + + +<p>It is happily the case that in America the importance +of personal cleanliness is more +thoroughly understood, and is more generally +practiced than any of the other important +hygienic procedures. While it is true that there +are many—particularly those of foreign extraction, +and who live for the most part in the +larger cities—to whom an occasional bath appeals +only as a painful necessity, a very large +percentage of those born in this country bathe +regularly. It should be thoroughly understood +that a daily bath is essential, not only from the +standpoint of cleanliness, but from the fact that +this practice is in the highest degree conducive +to health. It should never be forgotten that by +cleanliness infectious materials are removed +from the surface of the body, and at the same +time the skin is put into a condition to eliminate +from the system those waste products<span class='pagenum'><a name="Page_13" id="Page_13">[Pg 13]</a></span> +which it is its special function to remove. The +close relationship of the proper activity of the +skin to health is perhaps not generally sufficiently +appreciated—for it is true that the body +cannot remain normal when the secretory power +of its glands is impaired, and that even death +quickly follows when they cease to functionate +altogether.</p> + +<p><i>Advice as to Bathing.</i>—Much difference of +opinion exists as to the proper temperature of +the water for bathing, some holding that it +should be quite cold, while others are equally +positive that it should be warm. Unfortunately +it is impossible to give fixed rules concerning +this somewhat important matter, for there is +every reason to believe that it should be determined +in each individual case according to +circumstances, and that, therefore, both may be +right. Some persons unquestionably do better +with one, and some with the other. It has been +established clearly that the cold bath is highly +stimulating, and where not too prolonged, and +when followed by vigorous rubbing, is undoubtedly +healthful for a large number of people. +The cold bath is often used by physicians<span class='pagenum'><a name="Page_14" id="Page_14">[Pg 14]</a></span> +in the treatment of diseases of low vitality. +Many persons however, are unpleasantly affected +by bathing in water of a temperature +much below that of the body; particularly is +this true of women, and the like may be said of +thin and nervous persons of the other sex. It +is claimed by the advocates of the cold bath +that those who practice this procedure daily +are practically immune from colds, but this, +certainly, is not always true; on the contrary +the writer has seen instances where the cold +bath has unquestionably led to chronic nasal +catarrh, with increased tendency to inflammatory +conditions of the air passages. It is also +the case that baths of this description tend in +some persons to prevent a normal accumulation +of fat beneath the skin, and keep individuals +of this kind unnaturally lean.</p> + +<p>The warm bath is perhaps, on the whole, +more popular than the cold, since it is preferred +usually by children and women, and is practiced +by a considerable proportion of adult males. +It is unquestionably somewhat enervating, and +at best fails entirely to give the agreeable +stimulation experienced by those who take a<span class='pagenum'><a name="Page_15" id="Page_15">[Pg 15]</a></span> +cold plunge. It is, however, to be preferred in +those instances where cold water produces disagreeable +effects, and if the bath be not too +long continued it is followed by no ill results. +Persons who become lean under cold baths not +uncommonly take on flesh when they begin to +use warm ones. It is unquestionably true that +the latter is to be preferred in hot climates.</p> + +<p>The sea bath is invigorating not only from +the water being cool, but as a consequence of the +pleasurable excitement with which it is attended. +Its greatest disadvantage lies in the +fact that there is a tendency to overdo it, many +persons remaining in the water for hours. Ten +or fifteen minutes is as long as the average +person should indulge in sea-bathing, and it is +a question if even those who are young and +vigorous should remain in the water longer than +half an hour.</p> + +<p>Bathing of any kind should be indulged in +before meals, the best time being before breakfast +in the morning.</p> + +<p><i>Care of the Teeth.</i>—Nothing in connection +with the subject of personal hygiene is of more +importance than keeping the teeth properly<span class='pagenum'><a name="Page_16" id="Page_16">[Pg 16]</a></span> +cleansed. The fact is not generally appreciated +that sound teeth stand in a most intimate +relationship with good health, and that disastrous +consequences are sure to follow sooner or +later where these most important structures +are neglected.</p> + +<p>While it is true that in a person of vigorous +health one or two decayed teeth do not, as a +rule, occasion obvious trouble at once, ill effects +are sure sooner or later to be felt. For +one thing, a person without good teeth cannot +chew his food well. Those who begin by neglecting +what at first are slight defects in the +teeth seem to acquire in the course of time a +sort of habit of doing this, and ultimately disregard +and fail to have corrected the more serious +diseases of the dental structures. Nothing +is more common than for the practicing physician +to find patients with one or more teeth +partially gone, or, even worse, with only the +exposed roots remaining.</p> + +<p>Where cavities exist, food is constantly forced +into them, and undergoing decomposition, the +breath of their owner becomes foul, and portions +of decayed food mixed with multitudes of<span class='pagenum'><a name="Page_17" id="Page_17">[Pg 17]</a></span> +bacteria are constantly swallowed; sooner or +later there inevitably follows under such +circumstances catarrhal conditions of the +stomach, which reaches a point in some individuals +where the health is seriously threatened. +Not only do bad teeth produce trouble in the +way just mentioned, but there is every reason +to believe that germs that produce disease—particularly +those that cause consumption—not +uncommonly find their way to the interior of +the body through the resulting cavities.</p> + +<p>It is the duty of everyone to properly cleanse +the teeth at least once daily—to do so after each +meal would be even still better. This should +be done with a moderately soft brush, with +which it is unnecessary to use tooth-powders or +lotions—though many prefer to do so. Where +something of the kind is desired, ordinary lime-water +is perhaps as satisfactory as anything +else; peroxide of hydrogen, diluted eight or ten +times with water, to which a pinch or two of +ordinary cooking soda has been added, undoubtedly +aids the cleansing process, and has +the advantage that it leaves a pleasant after-taste +in the mouth. In brushing the teeth care<span class='pagenum'><a name="Page_18" id="Page_18">[Pg 18]</a></span> +should be taken that every part of the tooth receives +attention, it being not sufficient, as is so +often done, merely to brush the front. It +should be the practice of everyone to have the +teeth looked over at least once a year by a good +dentist, as even where cleansing is diligently +performed decay frequently sets in on their +inner sides.</p> + +<p>The utmost care should be taken of the permanent +teeth especially, and as long as it is +possible to prevent it no one should be allowed +to pull them. There can be no doubt that life is +shortened by the early loss of the permanent +teeth in most, if not in all, cases—not to count +loss in health and happiness that follows their +absence.</p> + +<p><i>Clothing,—Material and Color.</i>—Clothing +will be considered in this article only as regards +its function of properly protecting the body, +which it does by preventing the escape of heat, +thus keeping the body warm, or, under other +circumstances, by keeping out excessive heat or +cold.</p> + +<p>Materials of which clothing is made differ +very greatly in their ability to accomplish the<span class='pagenum'><a name="Page_19" id="Page_19">[Pg 19]</a></span> +object just mentioned, some being comparatively +poor conductors of heat and hence fulfill +the desired function admirably, while others, +for opposite reasons, are of comparatively little +value for this purpose. In general it may be +said that structures of animal origin, such as +wool and silk, are much poorer heat conductors +than those obtained from the vegetable world, +and as a consequence the former are justly held +in much higher esteem as material for clothing +than the latter. It should not be forgotten, +however, that the protective value of a fabric +also depends upon the manner in which it is +woven, since those that are loosely constructed +are much warmer, other things being equal, than +those that are put together more closely; this +depends upon the fact that in the former there +are innumerable small cavities between the +fibers in which air is contained, and as this substance +is a very poor conductor of heat, it follows +that a garment made loosely and containing +many such chambers is warmer than where +the number is less. It may well be the case +that a fabric constructed of a material which +is a poor conductor of heat and closely woven<span class='pagenum'><a name="Page_20" id="Page_20">[Pg 20]</a></span> +may be actually cooler than another composed +of a substance which is a much better conductor +of heat but of a loose texture.</p> + +<p>The efficiency of different materials of which +clothing is made also depends upon their +capacity to absorb water. This may be done +in two ways: the water may simply collect between +the fibers, in which case it may be in a +large measure removed by wringing, or it may +be actually absorbed into the substance composing +the fabric, and, as a consequence, the latter, +even though containing much moisture, do +not appear damp. Fabrics made from vegetable +materials, as cotton or linen, have little +power of actually absorbing water, and hence +they become wet on the slightest addition of +moisture, while on the other hand those of +animal origin have the capacity of absorbing +water, and appear dry even after the addition +of this substance in considerable amounts. A +person, therefore, dressed in cotton fabrics will +find after active perspiration has begun that +his clothing quickly becomes moist, while if he +have on woolen garments this will not occur. +It is particularly noteworthy that water is<span class='pagenum'><a name="Page_21" id="Page_21">[Pg 21]</a></span> +gradually removed by evaporation from animal +fabrics, which causes a general cooling without +producing a chill; it is therefore readily understood +that woolen clothing is much to be preferred +where active exercise is being taken.</p> + +<p>Color is also of some importance in determining +the value of a fabric for protecting the +body from the sun's heat. Within recent times +we have learned a great deal respecting the +wonderful penetrating power of the invisible +light rays, and we have every reason to believe +that these modify to a very considerable degree +every process going on within the body. The +violet and ultra-violet rays are those that unquestionably +exert most influence, and it has +been suggested that they may be broken up and +rendered innocuous by covering the body with +materials having a reddish-yellow color. It is +not necessary to put these materials on the outside +where they would be conspicuous, but they +may be used as lining for hats and clothing; and +there are good reasons to believe that if their +use were generally adopted suffering and actual +loss of life from overheating would be greatly +reduced, particularly in warm countries.<span class='pagenum'><a name="Page_22" id="Page_22">[Pg 22]</a></span></p> + +<p><i>Work and Rest.</i>—Very slowly the people of +our country are beginning to realize that it is +quite as necessary to rest as to work, though +unfortunately in some quarters a strenuous life +is urged as being only secondary in importance +to possessing a big family; that there is an +intimate association between the two there can +be no doubt, since the latter beyond peradventure +would entail the former. It has ever been +the habit and misfortune of sages now and then +to desert the field of their own peculiar activities +and to make incursions into unknown regions—generally +giving advice with a dogmatism +and finality proportionate to their ignorance +of the subject under discussion.</p> + +<p>As a matter of fact the average American +works entirely too much, and while he sometimes +accumulates an immense fortune with astounding +rapidity, to his sorrow he often learns +later that he has likewise acquired a damaged +heart, premature thickening of his blood-vessels +or nervous dyspepsia with all of its attendant +evils. Descended as we are in a large measure +from the most vigorous and adventurous Europeans +of the last few centuries, and coming into<span class='pagenum'><a name="Page_23" id="Page_23">[Pg 23]</a></span> +possession of a new world where everything +was to be done, this tendency to overwork is +most natural,—and for this reason is all the +more to be combated. That we have been able +so successfully to carry the burden for several +generations is indeed remarkable, but there are +not wanting numerous indications that the +strain is beginning to tell. If we do not call a +halt, and devote more time to rest and agreeable +pastimes, disastrous consequences are sure +to follow, and we will become in the course of +time a race of neurasthenics and degenerates. +Attention should likewise be directed to the fact +that men do not develop to the highest point +of mentality who devote their entire time to +work, as leisure is absolutely essential for +thought and the development of all that is best +in man.</p> + +<p>Let us then cast aside the shallow and ignorant +preachments of those who do not understand +the subject, and devote a reasonable time +to the reading of good books, to thought, to +the cultivation of the arts and sciences, and to +pleasurable pastimes. In these particulars we +are far behind Europe, and we shall never take<span class='pagenum'><a name="Page_24" id="Page_24">[Pg 24]</a></span> +our place as an intellectual people until we +radically change our method of life. A nation +must dream before becoming great. Let it not +be understood from the foregoing that the +writer would in the slightest degree minimize +the necessity for a reasonable amount of work, +for he thoroughly appreciates that without labor +neither the individual nor the nation itself +could remain sound—it is only urged that excessive +work is quite as much to be feared as +none at all.</p> + +<p><i>Health and Labor.</i>—As to the number of +hours that should be devoted to labor no rule +can be laid down. It all depends on the age, +physical and mental vigor of the individual, and +likewise, to a considerable degree, on the character +of the work. Occupations requiring intense +mental or physical strain can only be kept +up for short periods of continuous application, +while, on the other hand, quite naturally, those +of a less strenuous nature would permit longer +hours. The young man, in pride of perfect +bodily and mental vigor, too often assumes, because +he has been able in the past to do pretty +much anything that pleased him without ill-effect,<span class='pagenum'><a name="Page_25" id="Page_25">[Pg 25]</a></span> +that he can continue to do the same through +life. No greater mistake could be made.</p> + +<p>Anything that has a tendency to undermine +the health, repeated sufficiently often, will ultimately +cause a complete breakdown. How often +do we see the strength and beauty of early manhood +blighted and turned to premature old age +and death as a consequence of disregarding the +warnings that have just been given! How frequently +do we observe young men rejoicing in +the emancipation from home and school and +spurred on by the fatal delusion that while +others might suffer they will not, becoming in +the end the victim of that arch enemy of early +manhood, consumption! Every practicing +doctor has seen this, not once, but hundreds of +times, and in the vast majority of instances +he can say with truth that the frightful result +is a consequence of overwork—too often associated +with nocturnal dissipation. The man +who works during the day, and devotes his +nights to alcohol and gay company when he +should be sleeping, will assuredly, sooner or +later—and usually sooner—suffer the inevitable +consequences.<span class='pagenum'><a name="Page_26" id="Page_26">[Pg 26]</a></span></p> + +<p>To those who live sedentary lives, active out-door +exercise is very essential, but inasmuch as +this little volume is being written for those who +live a saner and more healthful existence, it is +not deemed necessary to discuss here this phase +of the subject.</p> + +<p><i>Value of Sleep.</i>—Closely connected with the +subject just discussed is sleep. Here also we +have no rules, or laws, from which we can clearly +determine the amount required in individual +cases. Overwise philosophers have asserted +that seven hours for a man, eight hours for a +woman, and nine hours for a fool, was the allotted +time for sleep. As a matter of fact, the +necessity for repose varies greatly in different +individuals, some of them requiring less while +others demand more. It is a safe rule to follow +that every man should sleep as long as he +naturally desires, for nature is a much better +mentor than any man could be—however +learned. The majority of men require at least +eight hours of sleep for the day and night, and +this should be secured if possible at such a time +as will permit it to be undisturbed; hence it is +that man usually prefers to sleep at night, and,<span class='pagenum'><a name="Page_27" id="Page_27">[Pg 27]</a></span> +all things considered, it is probably the time +best suited for his repose. We read many +marvelous stories of certain great men who required +little or no sleep. Within recent years +the press has frequently contained articles recounting +the extraordinary fact that a certain +prominent inventor of this country lived daily +on a mere spoonful or so of food, and only slept +a few hours now and then when there was nothing +else particularly to do. Such stories should +be accepted only on absolute proof, as, irrespective +of their utter improbability, one may observe +that they are generally insisted upon in +and out of season with a pertinacity that +would indicate that they were conceived and +are scattered abroad with the sole idea of impressing +the general public with what a marvelous +and unusual person the individual in question +is. There can be no reasonable doubt that +they are merely evidences of childish vanity +and puerile mendacity, and are only referred to +here for the reason that young persons, ignorant +of the laws of health, might attempt to +emulate them, with results that could be but disastrous. +<i>Nothing so preserves youth, health,</i><span class='pagenum'><a name="Page_28" id="Page_28">[Pg 28]</a></span> +<i>and good looks as a sufficient amount of sleep, +and it is pre-eminently the secret of long life.</i></p> + +<p>Reference will be made in the chapter on the +<a href="#CHAPTER_IV">Hygiene of Infancy</a> to the necessity of children +sleeping as much as is possible. It will do no +harm to say again here that nothing is so essential +for the proper development of the body +as sleep, <i>and that it is absolutely a crime to +awaken a child except under circumstances of +absolute necessity</i>.</p> + +<p><i>Precautions in Respect to Eating.</i>—A sufficient +amount of sleep, and a proper quantity +of digestible and nutritious food, thoroughly +cooked and carefully masticated, are the things +which above all others are most important for +the maintenance of health. In the chapter on +Foods, the nutritive values and digestibility of +the various articles eaten by man will be discussed +with sufficient thoroughness to instruct +the reader as to a wholesome dietary; it is, +therefore, not necessary here to go into the matter +fully, but the subject is so important that a +few general remarks will not be out of place.</p> + +<p>Eating should never, so far as is possible, be +hurried. Nothing is more important for the<span class='pagenum'><a name="Page_29" id="Page_29">[Pg 29]</a></span> +proper digestion of food than its thorough +mastication, and this can only be accomplished +when sufficient time is allowed for eating. It is +not necessary that this be done to the extreme +advocated by some, but it is certainly of the +highest importance that the food be so +thoroughly chewed that it is reduced to fine +particles, and that it should be so soaked in +saliva that it may be swallowed without the aid +of liquids of any kind.</p> + +<p>It is also desirable that food should not be +taken while the individual is tired, so that it is a +good plan where this condition exists for one +to lie down for a short time before eating.</p> + +<p>Regularity in eating is likewise of importance, +it being best to take the meals at stated periods; +the consumption of food at irregular hours often +leads to indigestion and is a practice which +should not be indulged in.</p> + +<p>It is highly desirable to have food served +under agreeable circumstances, digestion being +accomplished in a much more satisfactory manner +if pleasant conversation be indulged in during +the meal, and if the food be of an appetizing +character. Nothing is of more importance<span class='pagenum'><a name="Page_30" id="Page_30">[Pg 30]</a></span> +in connection with this subject than to have the +food properly prepared. Not only is thorough +cooking important from the standpoint of making +foods digestible, but as is shown in another +part of this volume, grave and sometimes fatal +diseases are contracted by a neglect of this important +procedure.</p> + +<p>Fruits, contrary to what is generally thought, +contain but little nourishment, and severely tax +the digestive powers of those who have a tendency +to dyspepsia. When eaten at all, they +should be perfectly ripe and fresh, and should +always be taken after meals rather than before.</p> + +<p><i>Drinks,—Coffee, Tea, Milk, etc.</i>—Much misconception +exists, among people generally, and +even among the medical profession, concerning +the proper amount of water that should be +drunk. While this substance is unquestionably +the most wholesome of all drinks, there exists +no necessity for taking it in great quantities +at times when the system does not call for it. +It would perhaps be a good rule for all to form +the habit of drinking little while eating, the +reason for which will be explained hereafter.</p> + +<p>Coffee is exceedingly popular both on account<span class='pagenum'><a name="Page_31" id="Page_31">[Pg 31]</a></span> +of its delicious odor and taste when properly +made, and for the reason that it is highly stimulating. +While it is borne by young and vigorous +persons of either sex with apparent impunity, +there frequently comes a time in life +when it can no longer be drunk without ill +effects. As a general rule, dyspeptics do not +bear it well.</p> + +<p>Tea, if properly prepared, is a most palatable +beverage, and one that is generally better borne +than coffee. It is more wholesome when taken +without lemon juice, and like coffee it is less +disposed to produce trouble if largely diluted +with milk, or if taken without cream or sugar.</p> + +<p>Cocoa and chocolate are often used as substitutes +for tea or coffee, and where they agree +with the individual are perhaps as wholesome +as either. Both, however, contain considerable +quantities of fat, and as they are frequently +prepared with cream, or very rich milk, they +are not as a rule well borne.</p> + +<p>While milk might be considered as being almost +as much a food as a drink still the fact +that it is fluid, and that it contains a very large +percentage of water, causes it to be regarded<span class='pagenum'><a name="Page_32" id="Page_32">[Pg 32]</a></span> +as a beverage. When taken slowly—and this +precaution is particularly necessary where it is +fresh and sweet—milk is a drink that should +be regarded as being on a par with water. It +contains no injurious substances, but sour milk +should, as a rule, be avoided by dyspeptics.</p> + +<p>The cardinal principle in taking beverages of +any kind at mealtime is that they should be +drunk alone after the food has been swallowed, +as when they are taken with the purpose of +softening the latter, mastication is seriously interfered +with and the proper soaking of the +food in the saliva prevented.</p> + +<p><i>Alcoholic Beverages.</i>—Alcoholic drinks are +so fully discussed in a latter part of this book +that here it may merely be stated that they cannot +be regarded as having food-value to any +degree, and so far as the matter is at present +understood, appear to be entirely superfluous, +and even positively injurious. If taken at all, +they should be consumed in extreme moderation, +after meals rather than before. The +young especially should be particularly warned +against the use of all beverages of this class.</p> + +<p><i>A Word on “Soft Drinks.”</i>—Mention should<span class='pagenum'><a name="Page_33" id="Page_33">[Pg 33]</a></span> +also be made of those drinks commonly sold at +soda-fountains. The vast majority of them +may be taken occasionally without any appreciable +ill effects, but the habitual use of beverages +containing considerable quantities of syrup +is not entirely wholesome. Particularly is this +true where the drink contains stimulating +drugs, such as do some of those most advertised. +Some of them are, if no worse, the equivalent of +a strong cup of coffee, and should, therefore, no +more be taken every hour or two during the day +than a cup of the substance just mentioned. If +their use is persisted in, it is sure to be followed +by indigestion, and in many instances nervous +disorders of even a serious character. The +reader should also be warned against the use of +drinks containing medicine for the relief of pain—particularly +those that are advertised as remedies +for headache. Practically without exception, +all such drinks contain coal-tar preparations +that greatly depress the heart, and have in +a number of instances been followed by death. +Drugs of this character should be taken with +the utmost circumspection, and only on the prescription +of a competent physician.<span class='pagenum'><a name="Page_34" id="Page_34">[Pg 34]</a></span></p> + +<p><i>Tobacco.</i>—Tobacco, of all nerve sedatives, is +the most universally used. In moderation it +could not be said that it is followed by any apparent +ill effects in the majority of people, but +if used in excess oftentimes sets up serious disturbances. +It is peculiarly injurious to boys, +and should never be indulged in until manhood +is reached. Some persons seem to possess a +natural immunity to the ill effects of nicotine, +and appear to be able throughout their lives to +chew or smoke tobacco in any amount without +harmful results; such instances are, however, +rare—its excessive use being usually followed +by symptoms that may be of a serious nature. +Of the two methods of use perhaps smoking is +less open to objection, though it is unquestionably +true that chewing is not so apt to cause disturbances +of the heart. Smoking affects the +stomach, but not to the extent that chewing +does.</p> + + + + +<h2><a name="CHAPTER_III" id="CHAPTER_III"></a>CHAPTER III</h2> +<p><span class='pagenum'><a name="Page_35" id="Page_35">[Pg 35]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>SANITATION IN AND ABOUT THE HOUSE</h3> + + +<p>The bearing of intelligently located houses +of proper construction on health is not so generally +understood, even by physicians, as the +facts warrant, and, of course, is even less well +recognized by the non-medical public. It is +true that some attention has been given to the +matter of <i>location</i>, but even in this connection +there prevails a woful ignorance among all +classes as to just how the diseases are transmitted +that are most influenced in this way. As +a result of recent advances in medicine it has +been clearly shown that at least some of the +diseases that are most influenced by locality +may be easily avoided, and as a consequence we +find that the views of the modern sanitarians +have necessarily undergone a certain amount +of change in this direction. On the other hand +recognition of the necessity of hygienic <i>construction</i><span class='pagenum'><a name="Page_36" id="Page_36">[Pg 36]</a></span> +has not been sufficiently accentuated,—since +it is possible by proper attention +to the details of building to do away entirely +with at least two of the diseases that have heretofore +been the principal drawbacks to life in +all tropical and sub-tropical countries. Much +importance likewise attaches to houses being +thoroughly ventilated, and to their being sufficiently +roomy to properly accommodate their +inmates. The following table shows the striking +relationship that mortality bears to over-crowding:—</p> + + +<h4><span class="smcap">Relation of Death-rate to Density of Population.</span></h4> + +<div class='center'> +<table border="0" cellpadding="4" cellspacing="0" +summary="Relation of Death-rate to Density of Population" width="50%"> +<tr><td>City.</td><td>Mean number of inhabitants to each house.</td><td>Average death-rate per 1,000 inhabitants.</td></tr> +<tr><td align='left'>London</td><td>8</td><td>24</td></tr> +<tr><td align='left'>Berlin</td><td>32</td><td>25</td></tr> +<tr><td align='left'>Paris</td><td>35</td><td>28</td></tr> +<tr><td align='left'>St. Petersburg</td><td>52</td><td>41</td></tr> +<tr><td align='left'>Vienna</td><td>55</td><td>47</td></tr> +</table></div> + +<p>Many other statistics could be quoted, but all +follow the general trend of those just given.</p> + +<p><i>Choice of Site.</i>—In our rural districts the inhabitants +have a wide latitude in the matter of +the selection of the location for their houses,<span class='pagenum'><a name="Page_37" id="Page_37">[Pg 37]</a></span> +and it is usually the case that our people are +sufficiently intelligent to make the best use of +their opportunities in this direction. It may, +however, be mentioned that it is generally considered +that building-sites in the neighborhood +of cemeteries are not favorable locations, nor +should houses be erected in the vicinity of a +manufacturing plant that gives off injurious +gases, or obnoxious materials of other kinds. +Inasmuch as we now know that malaria is transmitted +by a certain mosquito, and that by properly +screening the house their attacks may be +avoided, the necessity no longer exists for +avoiding the vicinity of lakes and rivers as +building-sites; such localities being as a rule +pleasant and often picturesque, they would +naturally under ordinary circumstances be selected, +and there now remains no reason why +this may not be done,—provided that the house +is so constructed that mosquitoes can be effectually +prevented from gaining entrance.</p> + +<p>Of much importance is the selection of a +locality where good and pure water can be +easily procured, as otherwise disastrous consequences +are sure to follow.<span class='pagenum'><a name="Page_38" id="Page_38">[Pg 38]</a></span></p> + +<p>The soil should be of a light and porous character, +easily permeable by water, and free from +the decomposing remains of excretions of man +or animals. There is much reason for the belief +also that the level of the ground-water +plays a somewhat important part in the salubrity +of any given locality, and it is generally +considered that this should be at least ten feet +below the surface. It is generally thought, +and probably with truth, that those sites are +most healthful which have their location on a +basis of granite, or other rock-foundation; in +such localities there is usually a considerable +slope of the general surface of the ground, with +the result that water rapidly runs off after +rains, and consequently stagnant pools, which +might serve as a breeding place for mosquitoes +and bacteria, do not form. Soils through which +water easily permeates are likewise, as a rule, +healthy, though this depends in a measure upon +whether or not they contain a very considerable +proportion of vegetable matter. Clay foundations +are healthful where there is a considerable +slope to the surface of the ground, but +where this does not exist the soil is damp, owing<span class='pagenum'><a name="Page_39" id="Page_39">[Pg 39]</a></span> +to its impermeability, and often has stagnant +pools upon its surface. Marls and alluvial +soils are not regarded as being wholesome, but +it is not unlikely that their bad reputation is +largely due to the fact that they generally exist +in the neighborhood of rivers and other considerable +bodies of water where mosquitoes are +numerous. There are no reasons going to +show that cultivated lands are unhealthy—even +where they receive yearly abundant additions +of manure. Where it is necessary to +build in damp localities the site should be thoroughly +drained, and the space upon which the +house is constructed should be carefully covered +with some impermeable cement.</p> + +<p><i>Building Materials.</i>—Of all building materials, +the one most commonly employed in +America is wood. This arises from the fact +that in the past we have had unlimited quantities +of timber from which lumber could be +procured at a price so reasonable that no other +material could ordinarily be considered. That +the wooden house has some advantages cannot +be denied; its walls rapidly cool following the +torrid days that so commonly occur during the<span class='pagenum'><a name="Page_40" id="Page_40">[Pg 40]</a></span> +summer in almost all portions of the United +States, and it is usually well ventilated as a result +of the numerous fissures naturally existing +in its structure.</p> + +<p>Next to wood, bricks are most commonly used +for building purposes, and have many advantages, +among which are their handsome effect, +their stability, and their being poor conductors +of heat; the last mentioned is of considerable +importance, since it keeps both heat and frost +from rapidly permeating the interior, and as a +consequence houses constructed of this material +are cooler in summer and warmer in winter.</p> + +<p>Other materials occasionally used are concrete, +granite, marble, and sandstone, any of +which, on account of their durable character +and the beauty that they lend to structures +made from them, may be selected for building +purposes, but inasmuch as they are rarely used +in rural districts, a detailed consideration of +their peculiar advantages for building purposes +is not deemed here necessary.</p> + +<p>The internal wall-coating of houses deserves +more consideration than is commonly accorded +it, since the dyes used for coloring wall-paper<span class='pagenum'><a name="Page_41" id="Page_41">[Pg 41]</a></span> +and curtains in some instances contain noxious +materials. Chief among those that are dangerous +are the bright green pigments which +commonly contain arsenic as their principal +constituent; where these or other poisonous +substances are employed in interior decorations +the air, wherever the room is kept closed, may +become more or less impregnated with poisonous +gases, and serious consequences to the inmates +may ensue.</p> + +<p><i>Screening Indispensable to Health.</i>—Nothing +is more important in connection with house +construction than having every opening thoroughly +screened. We have learned that both +malaria and yellow fever are transmitted always +by certain kinds of mosquitoes, and it +therefore, becomes a matter of the greatest importance +to effectually prevent the entrance of +these insects. It cannot be too strongly insisted +upon that we absolutely know that the +statement just made is correct, and that avoiding +the diseases referred to becomes as a consequence +entirely a matter of preventing the +entrance of mosquitoes into houses.<span class='pagenum'><a name="Page_42" id="Page_42">[Pg 42]</a></span></p> + +<div class='center'> +<table border="0" cellpadding="4" cellspacing="0" summary="Mosquito" width="90%"> +<tr> +<td><img src="images/i0049-1.png" width="250" height="376" alt="Malarial Mosquito" title="Malarial Mosquito" /></td> +<td><img src="images/i0049-2.png" width="250" height="374" alt="Common Mosquito" title="Common Mosquito" /></td> +</tr> +<tr><td><span class="caption">Fig. 1.<br />ANOPHELES.<br />(Malarial Mosquito.)</span></td> +<td><span class="caption">Fig. 2.<br />CULEX.<br />(Common Mosquito.)</span></td></tr> +</table></div> + +<p>The <i>Anopheles</i> mosquito, which is the one +that transmits malaria, often exists in localities +where the more common varieties do not occur, +and on account of the habits of this insect +their presence is liable to be overlooked. They +seldom attempt to bite during the day, and it +is only rarely the case that they try to do so at +night in a well lighted room;—particularly +where movement of any kind is going on. During +the day this mosquito remains perfectly +quiet in the dark corners of the house, and is +very fond of resting on cobwebs, presenting, +when doing so, an appearance strikingly similar +to that of fragments of leaves, soot or of +other natural objects that are frequently found<span class='pagenum'><a name="Page_43" id="Page_43">[Pg 43]</a></span> +suspended on such structures. On account of +these peculiarities and for the further reason +that the insect bites mainly just following daybreak, +when the victim is profoundly unconscious +in sleep, its presence often remains undetected, +and as a consequence we occasionally +hear from those who do not take the trouble to +inform themselves that malaria exists in this or +that locality where mosquitoes do not occur.</p> + +<p>The yellow-fever mosquito bites for the most +part during the day, but will do so at any time +when there is light. In districts where this +disease occurs it is quite as important to prevent +its entrance as that of the malarial mosquito. +Not only does screening prevent malaria +and yellow fever, but it keeps out flies and +other insects that unquestionably bring with +them the germs of other diseases.</p> + +<p>There now remains no doubt that several +affections, notably typhoid fever and dysentery, +are frequently communicated by means of the +common house-fly, which spends its time alternately +on the fecal material around privies or +in other filth, and in our kitchens and dining-rooms; +it is one of the most astounding evidences<span class='pagenum'><a name="Page_44" id="Page_44">[Pg 44]</a></span> +of the power of habit, in the face of common +sense and ordinary decency, that we have +not long ago taken active steps to rid ourselves +of its disgusting presence. Fortunately in +screens we have a perfect barrier to the entrance +of flies, and no house can be considered +complete without being thoroughly equipped +with these all-necessary appliances.</p> + +<p>It is scarcely possible to overestimate the +economy that results from the use of screens; +among the various means employed for conserving +the public health they take first rank, +and undoubtedly insure those who live in houses +to which they have been added an immunity +against the costly effects of disease that could +scarcely be computed. A house would be more +habitable without chairs, beds, or tables than +screens, since in the absence of the former we +may be healthy, though somewhat uncomfortable, +but without the latter serious disorders are +pretty certain, sooner or later, to make their appearance.</p> + +<p>It is of considerable importance to use a +screen the mesh of which is sufficiently fine. +Where mosquitoes exist, the screen should be of<span class='pagenum'><a name="Page_45" id="Page_45">[Pg 45]</a></span> +such fineness that at least sixteen, or better +eighteen meshes be in each inch of the gauze. +Where it is absolutely certain that mosquitoes +are not to be feared, the spaces may be somewhat +larger—but always of such size as will +prevent the entrance of the smallest fly.</p> + +<p><i>Air-space Required.</i>—It is of much importance +from a hygienic standpoint that the rooms +of dwellings should be sufficiently large. The +height should never be less than eight feet, and +the living-room should be made as large as circumstances +will permit. Bed-chambers should +contain at least 1,000 cubic feet of air space for +each adult, with somewhat less for children, +though it should never be forgotten that the +more the better; this means that each person +should have the equivalent of a room which is at +least 10 x 12 x 9 feet.</p> + +<p><i>Heating.</i>—Americans are extravagant in the +matter of heating to a degree that astonishes the +average foreigner, and it is by no means sure +that we do not go to unhygienic extremes in this +direction. It is not, perhaps, true that the excessive +heat itself could be considered as especially +hurtful, but it is too often the case that<span class='pagenum'><a name="Page_46" id="Page_46">[Pg 46]</a></span> +the conditions required to secure the degree of +heat preferred by us are incompatible with +proper ventilation, and hence are to be condemned. +It is generally considered that the +temperature of living-rooms should be somewhere +about 70°F.; for many persons this is +lower than would be entirely comfortable, and +as a consequence our houses in the winter are +frequently kept nearer 80°F. than the figure +just given. The reader should be urged to see +to it that, at whatever temperature his habitation +is kept, a sufficient amount of ventilation be +secured.</p> + +<p>There are many different methods of heating, +the most satisfactory of which are by means of +hot water or steam; a modified form of the latter +is the so-called vapor method, which in recent +years has proven extremely satisfactory. +Hot air, supplied by a furnace is also extensively +used, and for the reason that by this +method fresh air from the outside is constantly +brought into the house, it is theoretically to be +commended; practically, however, a considerable +difficulty is experienced in securing an +equable distribution of this heat throughout the<span class='pagenum'><a name="Page_47" id="Page_47">[Pg 47]</a></span> +various parts of the house, and as a consequence +it has not achieved the popularity that +it would otherwise have done.</p> + +<p>Inasmuch as the installation of plants for +heating by the methods just referred to entails +quite an expense, and for the further reason +that they require coal for satisfactory operating, +they have not been employed in the rural +districts of America to any considerable extent. +The farmer, for the most part, depends on the +old open fireplace where wood is plentiful and +the weather does not become excessively cold, +while in those portions of the country where +the temperatures in winter go very low, the +stove is generally employed. Of the two +methods, the former is much the more hygienic +where it can be used successfully, but over a +greater portion of the United States this cannot +be done owing to the cold winter climate.</p> + +<p>The principal objection to the stove lies in +the fact that the heat that comes from it is +very dry, and that where its walls have to be +heated excessively, unpleasant odors are apt +to be generated; the former is usually and ought +always to be obviated by keeping upon the stove<span class='pagenum'><a name="Page_48" id="Page_48">[Pg 48]</a></span> +a vessel of water, the vapors from which +moisten the atmosphere, and the latter by having +the stove of such size that it will not require +excessive heating in order to warm the room in +which it is placed. Wherever possible the open +fireplace is to be preferred to the stove for the +reason that it very thoroughly ventilates the +room.</p> + +<p><i>Ventilation.</i>—In order that the health of the +inmates may be conserved proper ventilation of +all habitations is essential. However cold the +weather may be, an abundance of fresh air +should be allowed to enter all parts of the house. +In the average wooden dwelling there are so +many cracks that good ventilation is generally +secured without opening doors or windows, but +where the construction does not permit this, +openings for the entrance of air should be left +in the most convenient and suitable places. +Windows may be slightly raised and draughts +prevented by proper screening, or what is even +better, rooms should be so constructed that they +have openings at the top and at the bottom to +allow free ventilation. Openings towards the +upper portion of rooms are especially important<span class='pagenum'><a name="Page_49" id="Page_49">[Pg 49]</a></span> +in hot weather, as the warm air rises to the +ceiling and escapes only very slowly where such +exits do not exist. Lowering windows from the +top aids materially in allowing the hot air to +escape, but this is not altogether so satisfactory +as having openings higher up on the walls, or +in the ceiling.</p> + +<p><i>Disposal of Sewage.</i>—No problem that confronts +the dweller in the rural district is of +greater importance than the proper disposal of +sewage. It is unfortunately impossible in +most instances for the farmer to have in his +house a system of water-works, and, therefore, +all dish-waters and slops are thrown into the +yard, and a privy is used instead of a modern +water-closet. Where the lay of the land is such +that water readily runs off, or the soil is of a +character that permits rapid absorption, throwing +slops on the ground around the house may +not constitute a danger to the inmates, but nothing +is more certain than that the old fashioned +privy is a dire menace to the health of all those +in its vicinity.</p> + +<p>Not only are infectious materials brought +into houses by flies, from fecal matter and other<span class='pagenum'><a name="Page_50" id="Page_50">[Pg 50]</a></span> +excretions, but they are carried away by the +rains and sometimes contaminate sources of +water-supply. It is furthermore extremely +probable that bacteria in particles of dust from +dried fecal material may be carried by the winds +from privies into wells and houses, and as a consequence +diseases may be spread; of perhaps +still more importance—and certainly of far +greater moment all over the southern portions +of the country—is the fact that hook-worm disease +and other infections caused by animal parasites +are transmitted from man to man as the +result of our adherence to the old fashioned +privy.</p> + +<p>As will be explained in the chapter devoted +to the common communicable diseases, the eggs +of the hook-worm pass from the intestine along +with the feces of those who are victims of this +parasite and reaching the ground, hatch out in +the course of a few days minute hook-worm embryos, +which crawl away and permeate the soil +in the vicinity; later collecting in little pools that +form after rains, or in dew-drops during the +night, they attach themselves to the skin of barefooted +children who come in contact with such<span class='pagenum'><a name="Page_51" id="Page_51">[Pg 51]</a></span> +collections of water, and boring into the body +ultimately, through a circuitous route, reach the +intestines. Here they undergo further development, +and in a short time become mature hook-worms, +which in their turn lay eggs, and the +life cycle begins over again. It is thus seen that +a child having hook-worm disease becomes a +menace, on account of the privy, to its brothers +and sisters, and of course quite commonly receives +back into its own body, worms that had +previously escaped as eggs.</p> + +<p>In the same way eggs of the two common tapeworms +pass out with the feces, and the offal +containing them being eaten by hogs in the one +case, or being scattered in the vicinity and taken +in with grass by cows in the other, have their +shells dissolved off as soon as they reach the +stomachs of these animals, and there are liberated +small embryos that bore through the walls +of the stomach and later find their way into the +muscular tissues of these beasts, and there lie +dormant until eaten by man with imperfectly +cooked meat; after being swallowed, the embryo +parasite passes to the intestine and soon becomes +a fully developed tapeworm.<span class='pagenum'><a name="Page_52" id="Page_52">[Pg 52]</a></span></p> + +<p>Particular reference at this point should be +directed to the evil effects, which are even still +greater than those that come from the privy, +of permitting children and hired helpers to scatter +their feces indiscriminately in corners of the +yard, the apple-orchard, or in the horse-lot; +under such circumstances, where hook-worm +disease is once introduced, the soil in the course +of a short time becomes thoroughly permeated +with the embryos of this worm, and, as a consequence, +all of the children who play in the infected +area barefooted, as is customary in the +country, are sooner or later infected with these +parasites. It is thus seen that soil-pollution +from fecal material is a most dangerous thing, +and, particularly in the southern portion of the +United States, deserves the most earnest consideration +of everyone. We should see to it that +our children only evacuate their bowels in +properly constructed closets; and it is the duty +of the head of every family to provide such a +place for the accommodation of those who are +dependent on him.</p> + +<p><i>Proper Construction of Out-door Privies.</i>—The +most practical and generally satisfactory<span class='pagenum'><a name="Page_53" id="Page_53">[Pg 53]</a></span> +device heretofore invented for the disposal of +the sewage of communities unprovided with +water-works is what is known as the Rochdale, +or dry-closet, system. By this system a privy, +at a distance from the dwelling, is constructed +in the ordinary manner, with the exception that +instead of being open at the back it is tightly +closed. In the space beneath the seat receptacles +are placed for receiving the urine and feces. +These may consist of pails of wood or better +of galvanized iron; or a single box occupying the +whole space. If wooden receptacles are used, +they should be thoroughly coated on the inside +with tar, to prevent both leakage and the soaking +of the liquids into the wood. One such +structure, which the writer knows has been +wholly satisfactory has a brick foundation with +walls two feet high around the front and sides, +within which rests a shallow tarred box. It ensures +perfect cleanliness.</p> + +<p>In any case this space under the seat is +tightly closed, being guarded by doors that open +outward, through which the pails or box may be +introduced and removed for emptying.</p> + +<p>Each privy contains a box in which is placed<span class='pagenum'><a name="Page_54" id="Page_54">[Pg 54]</a></span> +either wood ashes or dry powdered earth, with +a small shovel by which a sufficient quantity of +the dust to cover the deposit is thrown into the +pail after each evacuation. It is remarkable +how completely this shovelful of earth or ashes +destroys all disagreeable smell. The privy +should be provided with at least two opposite +windows, both of which should be thoroughly +screened. The entrance should have a door that +is closed with a spring, so that it cannot be +carelessly or accidentally left open when vacant. +At intervals the pails containing the +feces are removed, and the contents are carried +to a distance and buried.</p> + +<p>Another plan that is quite satisfactory where +iron pails are used, is to place a quantity of +water in the vessels for receiving the feces, and +then to pour in a small quantity of kerosene; +the latter substance forms a layer over the water +that keeps out flies, and does away largely with +the disagreeable odors that are likely to emanate.</p> + +<p>If any contagious disease exists among those +who use such a closet, the fecal material should +be carefully sterilized before being removed, as<span class='pagenum'><a name="Page_55" id="Page_55">[Pg 55]</a></span> +by means of corrosive sublimate, carbolic acid, +chlorinated lime, or any one of the many commercial +disinfectants containing crysylic acid, +all of which may be obtained at any drug store. +If carbolic acid or other liquid antiseptics be +used the amount by volume should be equal to +about five per cent. of the material to be treated; +the proportion of corrosive sublimate should +be at least 1 to 1,000 where this disinfectant +is used. Along with whatever antiseptic is +chosen, water should be added in sufficient quantity +to permit the whole to be rendered semi-fluid, +and the mixture should then be thoroughly +stirred, and the chemical left to act for some +hours before emptying the receptacle. By far +the most satisfactory method of sterilizing infected +material, however, is by boiling, since +disease-germs are killed by such a temperature +in a few moments. Where iron receptacles are +used, therefore, the simplest method is to set +them upon an open fire in the yard for a little +while.</p> + +<p>A privy constructed after the manner just described +possesses some advantages even over +the regulation water-closets that are used in<span class='pagenum'><a name="Page_56" id="Page_56">[Pg 56]</a></span> +cities, since they are cheaper in original cost, +require less repairs, and are uninjured by a +freezing temperature. The amount of care required +to keep them in proper condition is not +excessive, and they are so infinitely superior +from a hygienic standpoint to the old-time privy +that no sort of comparison is possible.</p> + +<p>It should always be remembered that the +principal advantages of this closet are that +where it is used we are able to collect all of +the evacuations, which may then be properly +deodorized with soil or ashes, and that it may +then be finally disposed of in such a way that +it cannot be reached by hogs or other animals; +of very great importance also is the screening +of the closet, since only in this way is it possible +to prevent flies from gaining entrance to +the fecal material in the receiving pails.</p> + +<p><i>Water supply.</i><a name="FNanchor_2_2" id="FNanchor_2_2"></a><a href="#Footnote_2_2" class="fnanchor">[2]</a>—In the location of houses +and schools an eye should always be had to<span class='pagenum'><a name="Page_57" id="Page_57">[Pg 57]</a></span> +selecting a site where it is possible to obtain +good, pure water. To those fortunate dwellers +in the mountainous regions of our country this +is usually a matter of little difficulty, since it +is always possible to find a location in the +neighborhood of which the purest spring water +may be obtained. In less favored regions the +well becomes the main reliance, while cisterns +are used in some portions of our country, in +which water is collected during the rainy +seasons of the year. Of the two, the former is +undoubtedly to be preferred, provided a pump +be used instead of the old fashioned bucket. +The writer is strongly of the opinion that a very +large proportion of the contamination to which +sources of water-supply are subject comes from +the bucket being drunk from or handled by persons +with contagious diseases, or from germs<span class='pagenum'><a name="Page_58" id="Page_58">[Pg 58]</a></span> +being blown into the well with dust, or carried +in by means of insects and small animals. It +is inconceivable that any appreciable amount of +contamination from the surface can reach the +underground streams that supply wells in localities +that are thinly populated, though it is +unquestionably true that a well might be infected +as a result of the entrance of surface-water +where its top is not properly protected. +On the other hand we have in an open well or +cistern every facility afforded for the entrance +of bacteria.</p> + +<p>It is unquestionably of the utmost importance +that wells be carefully covered over, and every +precaution should be taken to prevent surface-water +leaking into them around their edges. +In order to comply with these conditions a +pump is essential, since it is the only means by +which water can be brought to the surface without +exposing the contents of the well to contamination. +It is likewise of the first importance +to have the walls of the well curbed to a sufficient +depth to prevent the possibility of seepage +from the surface. It is, of course, also +quite necessary that the well be of sufficient<span class='pagenum'><a name="Page_59" id="Page_59">[Pg 59]</a></span> +depth—the lower we go the more likely are we +to secure a perfectly pure water. In regions +where the water rises to within eight or ten +feet, or less, of the surface, the possibility of +the well being contaminated during the rainy +season by seepage is considerably increased, +and the waters of such wells should be used +only after analyses have shown that they are +pure; where this cannot be done, the water +should be boiled before being drunk. Of +course, the possibilities of contamination are +greatly increased if the locality be thickly inhabited.</p> + +<p>As has been before remarked, cisterns are +more liable to contamination from the air than +are wells, chiefly owing to the fact that they are +supplied by water that is conducted into them +by gutters from the tops of houses. There is +no question that during the dry seasons dust +containing many kinds of bacteria is deposited +all over the tops of houses and remains there +until washed away by the rains. While it is +true that the sunlight quickly kills most germs +that produce disease a certain number of them +would inevitably escape, and having gained entrance<span class='pagenum'><a name="Page_60" id="Page_60">[Pg 60]</a></span> +to a cistern, would be likely to multiply +and later cause trouble. It is thus seen that +however pure the rain-water may originally +have been—and it is among the purest of all +waters—it is likely to become contaminated in +the process of collection, and may ultimately in +this way become the source of disease. Where +any doubt exists as to the purity of such water +it should be boiled before use.</p> + +<p>Surface-streams also occasionally supply +drinking-water in rural districts, and while the +use of such waters may not always be attended +by danger, their contamination by disease-producing +germs is much more to be feared than +when they are derived from wells or springs; +where streams arise from and keep their course +through uninhabited districts the probabilities +are strong that their waters are pure and fit +for use, but where they run through cultivated +fields, and particularly where they pass in the +neighborhood of houses, their waters should +never be looked upon as being drinkable,—except +after being boiled or properly filtered. Inasmuch +as adequate filtration is exceedingly +difficult to carry out, and requires a somewhat<span class='pagenum'><a name="Page_61" id="Page_61">[Pg 61]</a></span> +extensive and costly plant, this is, as a rule, not +feasible for the dweller in country districts, and +boiling, therefore, remains the only satisfactory +method of rendering the water fit for use where +doubt exists as to its purity.</p> + +<p><i>Location of Pens and Stables for Animals.</i>—Animals +should always be housed at some little +distance from the dwelling. While it is +true that man does not often contract directly +diseases from hogs, sheep, horses and cattle, +there are some maladies of a most serious character +that come to us in this way, and we +should, therefore, always guard against their +occurrence by removing ourselves as far as is +possible from sources of possible infection. +The matter also has an æsthetic side, as odors +of a disagreeable character may prove very +annoying where animals are kept too close to +the house. It is likewise of importance that +stables should be, if possible, on lower ground +than the dwelling, since during rains materials +from their dung may be washed around and +under the house, and may possibly gain access +to the well.</p> + +<p>Every care should be taken to keep hog-pens<span class='pagenum'><a name="Page_62" id="Page_62">[Pg 62]</a></span> +and stables clean, since otherwise very foul +smells are engendered that oftentimes find their +way to neighboring houses. There is also a +suspicion that some of the germs that produce +disease find the conditions suitable for their +stables and pig-sties.</p> + +<p>In this connection it might be well to warn +those unacquainted with the subject against the +<i>all too common practice</i> of close association +with dogs, since it is well established that in +addition to hydrophobia they may transmit, +while apparently in perfect health, maladies of +a deadly character to the human being. It cannot +be too often emphasized that the less intimate +our association with the lower animals is, +the greater the likelihood of our escaping many +serious diseases.</p> + + +<div class="footnotes"><h3>FOOTNOTE:</h3> + +<div class="footnote"><p><a name="Footnote_2_2" id="Footnote_2_2"></a><a href="#FNanchor_2_2"><span class="label">[2]</span></a> This subject is fully treated in another volume of this +Library, entitled <i>Home Water-works</i>, written by <span class="smcap">Prof. Carleton +J. Lynde</span>. It shows where water should be sought, and +how it may be supplied under perfectly safe conditions to +the household, with descriptions of machinery, estimates of +expense, etc. This thoroughly practical book meets a widely +recognized need for information, and is written by a specialist. +Thousands of men living in rural parts of the United States +and Canada, out of reach of a public water-system, have +equipped their homes with water-supply conveniences equal +to any found in the cities. Thousands more who could well +afford to do so and who could do so advantageously, have not +done so for various reasons—because the idea has not occurred +to them, or because they did not know how to go about it, or +because they mistakenly thought the expense too great. To +all such this book should prove of the greatest practical help.</p></div> +</div> + + + +<h2><a name="CHAPTER_IV" id="CHAPTER_IV"></a>CHAPTER IV</h2> +<p><span class='pagenum'><a name="Page_63" id="Page_63">[Pg 63]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>HYGIENE OF INFANCY AND CHILDHOOD</h3> + + +<p>No characteristic of the Caucasian mind is +more marked, and none more universally affects +his actions than a constant, gnawing suspicion +that the things going on around him are not being +done in the proper way, and consequently an +irrepressible desire to experiment, and if possible, +to change everything. Such a spirit is +unquestionably the basis of what we call progress, +and, in so far as it conduces to the health +and happiness of mankind, is entitled to our +most hearty commendation. On the other +hand, it cannot be denied that too often we endeavor +to bring about changes with but an imperfect +understanding of the basic principles +at issue, and naturally, under such circumstances, +our efforts are crowned with anything +but success. In other words, an enlightened investigation +of the whys and wherefores of any<span class='pagenum'><a name="Page_64" id="Page_64">[Pg 64]</a></span> +existing state of affairs may and often does, +lead to improvement, while, on the other hand, +ignorant meddling is likely to be followed by +disastrous consequences.</p> + +<p>Nowhere do we see the bad results of false +conceptions more marked than in our treatment +of infants and children.</p> + +<div class="blockquot"><p>Particularly do young infants suffer in this way, +as they are pounced upon as soon as they enter the +world by every old “granny” and negro “mammy” +in the neighborhood, and plied with abominable concoctions +that would be productive of homicide if we +were to attempt forcibly to administer them to grown +men, and whose only effect on the defenseless little +sufferer is to cause colic and indigestion. Many times +has the writer seen a wee, tiny little mortal, who was +too young and weak to even protest, bundled up with +a mountain of flannels in the hottest weather of +July and August. True to the superstition that the +warmer we kept an infant the better, too frequently +we see them confined to hot stuffy rooms when they +should be out in the sunshine, or under the trees. +Instead of being allowed to gain health and strength +in the forests, which are the schoolhouses of nature, +the miserable little wretch is later sent to a public +school as soon as he or she can be trusted to go +alone on the streets, and the tiny victim too frequently +contracts diphtheria, scarlet fever, whooping-cough, +measles, or some other disease as a reward of +<span class='pagenum'><a name="Page_65" id="Page_65">[Pg 65]</a></span>merit. Truly we see to it that the helpless innocents +early realize the truth of the melancholy and hopeless +biblical lament that “man's days here are few +and full of trouble.”</p></div> + +<p>We should rear our children with as little interference +as possible, allowing them the utmost +freedom compatible with their safety, and +permitting them to do those things that nature +and instinct demand. Above all let them sleep +as much and as long as they will, insist that +they live in the open air, and encourage them +in every possible way to perfect their physical +education by those active amusements that they +instinctively prefer. After they have established +a sound and rugged constitution ample +time will be left for them to develop mentally.</p> + +<p><i>Feeding of Nursing Infants.</i>—The most important +thing in connection with the feeding of +infants is to always remember that nature has +provided in their mother's milk, when sufficiently +abundant and normal in quality, everything +in the way of food and drink that they +require. During the three days that usually +intervene between birth and the coming of the +milk in the mother's breast, infants may be<span class='pagenum'><a name="Page_66" id="Page_66">[Pg 66]</a></span> +given from time to time small quantities of +pure water, but under no circumstances should +anything else be allowed. During this period +the child may be put to the breast four or five +times in the twenty-four hours, for, while it +gets but little in the way of nourishment, there +is even at this time a watery fluid secreted in +the breast that goes far towards supplying +everything that the infant needs for the time +being.</p> + +<p>A child should never nurse longer than +twenty minutes at one time. It is likewise of +importance that the time of nursing be strictly +regulated.</p> + +<p>Particularly during the first year it is of the +utmost importance to watch with an intelligent +eye the growth and development of the child. +Where the milk agrees with it it has a good +color and gains regularly in weight; it cries +but little, and is good natured, and thoroughly +contented. Should it, on the other hand, lose +weight, appear fretful and listless, and sleep +badly, there is something wrong, and the mother +should at once have her milk examined by a +competent physician.<span class='pagenum'><a name="Page_67" id="Page_67">[Pg 67]</a></span></p> + +<p>In case the mother does not give sufficient +nourishment there is no objection to partially +feeding the infant on modified cow's milk—the +method of the preparation of which will be considered +later on.</p> + +<p>Where colic occurs it generally means that +the infant is getting a diet too rich in albuminous +foods, which should be corrected by advising +the mother to take an abundance of out-door +exercise, and to avoid all causes of worry +so far as is possible.</p> + +<p>Vomiting freely is a very common occurrence +in small children, and is usually the result +of too much food being taken at a time. It +also occurs, particularly some time after feeding, +as a result of indigestion, which is frequently +the consequence of the milk being too +rich in fats. Wherever an infant shows signs +of trouble it is well to advise the mother to use +a diet less rich in meats, and to caution her +against over-eating.</p> + +<p>Children should be weaned at the end of their +first year. This had best be brought about +gradually, by, in the beginning, feeding the +child once daily, and then gradually increasing<span class='pagenum'><a name="Page_68" id="Page_68">[Pg 68]</a></span> +the frequency, at the same time proportionately +leaving off the nursing. Where children are +not thriving, it is often a good practice to wean +earlier, in which case modified cow's milk, taken +from a bottle, must be substituted.</p> + +<p><i>Artificial Feeding.</i>—While it is true that +children often thrive for a time on the various +baby-foods with which the market is so abundantly +supplied, it is, nevertheless, the case +that where fed in this way they are very apt to +develop rickets or scurvy, and not uncommonly +show evidences of bad nutrition in loss of +weight and strength, becoming peevish and +fretful, and sleeping badly.</p> + +<p>Much better than any of the artificial foods +is properly modified cow's milk, which, with +care, may be prepared in such a manner as +to take the place of mother's milk in the vast +majority of instances. In order, however, that +this be successfully carried out, much care and +attention is necessary.</p> + +<div class="blockquot"><p>At this point it is well to stress the fact that the +mother's milk differs from that of the cow in some +quite important particulars, and it is only by intelligently<span class='pagenum'><a name="Page_69" id="Page_69">[Pg 69]</a></span> +taking these differences into consideration +that it is possible for us to prepare an artificial food +that will be satisfactory. Principal among these differences +are that cow's milk contains three times as +much albuminous material as that of the human being, +and that it is less rich by about half in milk-sugar; +furthermore, the former is acid in reaction, +while the latter is neutral, or faintly alkaline. It +will be seen, then, that in order to prepare a modified +cow's milk that will approximate that of the human +being it is necessary to dilute it with water sufficiently +to cause the albumin to approach in proportion +that of mother's milk, and at the same time +some alkali must be added to neutralize the excessive +acidity. Modified milk prepared, however, from the +whole cow's milk, would contain much less fat than +is desirable, so that we must use in making it the +upper third of the whole milk after it has been allowed +to remain undisturbed for a number of hours; +in other words, in making modified cow's milk we +use a large proportion of the cream, with a less +amount of the other constituents.</p> + +<p>The following table for calculating the proper proportion +of milk to be used at the various periods of +the infant's life may be recommended, as it gives +quite as satisfactory results as those that are more +elaborate; it also gives the frequency of feeding and +the proper amounts that should be used. The table +was devised by Dr. C. E. Boynton, of Atlanta, +Georgia.</p></div> +<p><span class='pagenum'><a name="Page_70" id="Page_70">[Pg 70]</a></span></p> + +<div class='center'> +<table border="0" cellpadding="4" cellspacing="0" summary="The proper proportion of milk" width="75%"> +<tr> +<td></td> +<td align='center'>Fat percentage<br />desired.</td> +<td align='center'>Quantity<br />ounces at<br />feeding.</td> +<td align='center'>No. of<br />feedings in<br />24 hours.</td> +<td align='center'>Intervals<br />by day.</td> +</tr> +<tr> +<td align='left'>Premature</td><td>1.00</td><td>¼ - ¾</td><td>12 - 18</td><td>1 - 1½</td><td>hrs.</td> +</tr> +<tr> +<td align='left'>1 - 4 day</td><td>1.00</td><td>1 - 1½</td><td>6 - 10</td><td>2 - 4</td><td>"</td> +</tr> +<tr> +<td align='left'>5 - 7 "</td><td>1.50</td><td>1 - 2</td><td>10</td><td>2</td><td>"</td> +</tr> +<tr> +<td align='left'>2 - week</td><td>2.00</td><td>2 - 2½</td><td>10</td><td>2</td><td>"</td> +</tr> +<tr> +<td align='left'>3 - "</td><td>2.50</td><td>2 - 2½</td><td>10</td><td>2</td><td>"</td> +</tr> +<tr> +<td align='left'>4 - 8 "</td><td>3.00</td><td>2½ - 4</td><td>9</td><td>2½</td><td>"</td> +</tr> +<tr> +<td align='left'>2 - month</td><td>3.00</td><td>3 - 5</td><td>8</td><td>2½</td><td>"</td> +</tr> +<tr> +<td align='left'>4 - "</td><td>3.50</td><td>3 - 5½</td><td>7</td><td>3</td><td>"</td> +</tr> +<tr> +<td align='left'>5 - "</td><td>3.50</td><td>4 - 6</td><td>7</td><td>3</td><td>"</td> +</tr> +<tr> +<td align='left'>6 - 10 month</td><td>4.00</td><td>5 - 8</td><td>6</td><td>3</td><td>"</td> +</tr> +<tr> +<td align='left'>11 - month</td><td>4.00</td><td>6 - 9</td><td>5</td><td>4</td><td>"</td> +</tr> +<tr> +<td align='left'>12 - "</td><td>4.00</td><td>7 - 9</td><td>5</td><td>4</td><td>"</td> +</tr> +<tr> +<td align='left'>13 - "</td><td>4.00</td><td>7 - 10</td><td>5</td><td>4</td><td>"</td> +</tr> +</table></div> + +<div class="blockquot"><p>In making calculations from this table it is assumed +that the milk from the upper third of the +bottle, after it has been allowed to sit for at least +four hours, contains 10% of fat, and this is therefore +called 10% milk. The calculation is made as +follows:—10% milk is to the fat percentage desired, +as the amount which we wish to make up is to X. +For example, if we wish to prepare twenty ounces +of milk for an infant two months old, we will note +by referring to the table that 3% is the amount of +fat that is desirable for a milk for a child of this +age, and the formula will be constructed as follows:—</p> + +<center><pre> +10:3::20:X. X = 60/10. X = 6. +</pre></center> + +<p>Six ounces is then the amount of 10% milk that +must be used for making twenty ounces of modified +<span class='pagenum'><a name="Page_71" id="Page_71">[Pg 71]</a></span>milk,—this being mixed with one ounce of lime-water +and thirteen ounces of boiled water. It should never +be forgotten that while milk modified by the foregoing +formula is suitable for most children, it is by +no means always satisfactory, and we may, therefore, +be compelled to do a considerable amount of experimenting +in some cases before arriving at the correct +formula.</p> + +<p>Suppose the infant is twelve months old, we would +get according to the rules just stated the following +equation:—</p> + +<center><pre> +10:4::20:X. X = 80/10. X = 8. +</pre></center> + +<p>Eight ounces would then be the amount of milk +required for preparing twenty ounces of modified +milk for an infant of this age.</p> + +<p>In preparing modified milk according to the formulas +just given, it must be remembered that in all +instances only that portion is to be used which collects +in the upper third of a bottle of milk that has +been allowed to sit undisturbed in a refrigerator for +at least four hours. The lime-water is for the purpose +of correcting the acidity of the milk.</p> + +<p>It is of much importance to select the milk from +a healthy cow in all instances where it is to be fed +to infants, and where possible, it should be examined +by a competent laboratory man in order to determine +if it answers the proper requirements. The writer +has often seen milk from apparently healthy cows, +which seemed in every way good, that showed on +microscopic examination pus cells and a harmful +germ (streptococcus).</p> + +<p><span class='pagenum'><a name="Page_72" id="Page_72">[Pg 72]</a></span>It is not desirable to have a milk for this purpose +that is too rich in fats, and for this reason a +cow of the ordinary mixed breed is more satisfactory +than the blooded Jerseys or Alderneys.</p> + +<p>Not only is it essential to get the proper kind of +milk, but the utmost care is necessary in handling +it. It should, of course, be as free as possible from +every source of contamination, and should be strained +thoroughly as soon as milked. It should then be bottled, +and chilled at once by being placed in cold +water, and after being properly sealed, should be +placed in a refrigerator at a temperature of about +50°F., where it should remain undisturbed for four +hours before the top portion is skimmed off for making +the modified milk.</p> + +<p>After the modified milk has been prepared it +should be returned to the refrigerator, where it +should be kept until required for feeding. It is best +not to use milk that has been in the refrigerator +longer than twenty-four hours, or at most forty-eight +hours, and then only if kept at a proper temperature. +The modified milk should be poured directly from +the receptacle in which it is kept into the feeding-bottle, +and the latter should then be placed in warm +water until its content is milk-warm, at which time +it is ready to be given to the child.</p></div> + +<p>It is highly necessary in feeding infants by +the bottle to remember that cleanliness in +everything connected with the process only<span class='pagenum'><a name="Page_73" id="Page_73">[Pg 73]</a></span> +makes success possible, and in no particular +does this apply with greater force than in connection +with the proper care of the bottle and +nipple. In every case immediately after use +they should both be put in water, which should +then be brought to a boiling temperature, and +both should then be kept in a saturated solution +of boric acid. The nipple, after being +placed on the bottle, should not come in contact +with anything but the infant's mouth. Bottles +that have no neck are much to be preferred to +others, as they can be readily cleansed. There +is on the market at the present time a bottle +called the “Hygeia,” which possesses the necessary +qualifications in a perfectly satisfactory +way.</p> + +<p>When children who have nursed at the +mother's breast reach the age of weaning it is +of importance to remember that they cannot +eat without digestive disturbances the modified +cow's milk of a strength that would otherwise +correspond to their age; they should invariably +under such circumstances begin with a milk +prepared by the formula used for a child +several months younger, after which the proportion<span class='pagenum'><a name="Page_74" id="Page_74">[Pg 74]</a></span> +of milk may be gradually increased +until it is used in a pure state.</p> + +<p>During very warm weather it is well to reduce +the amount of fat by using the whole milk +instead of the top portions, as heretofore described. +The same precaution should be followed +where children have acute diseases, and +the total quantity taken should be less than +under ordinary circumstances. Where infants +have acute indigestion, accompanied by vomiting +and diarrhœa, all milk should be for the +time withheld,—boiled water being substituted; +some hours later barley water may be given, +but no milk for at least twenty-four hours. +Where children have loss of appetite, it is well +to give less cream, and the intervals between +food should be increased.</p> + +<p><i>Sterilized (Pasteurized) Milk.</i>—During epidemics +of dysentery, diarrhœa, typhoid fever, +scarlet fever, and diphtheria, as well as in those +instances where it is suspected that the cow is +not healthy, or where the milk has to be kept +for considerable periods of time, it is well to +sterilize it by heating. The most effective +method of accomplishing this is by boiling the<span class='pagenum'><a name="Page_75" id="Page_75">[Pg 75]</a></span> +milk for an hour or so, but inasmuch as it is believed +to be then not quite so wholesome as +when less heat is employed, a process known as +<i>pasteurization</i> is frequently used; this consists +in heating the milk for thirty minutes to from +155° to 160°F.,—such temperatures killing all +of the ordinary germs, but not altering the milk +so completely as when it is boiled.</p> + +<p><i>Peptonized Milk.</i>—It now and then happens +that children fail to thrive where all of the precautions +heretofore referred to have been +strictly adhered to, and under such circumstances +good results are frequently secured by +subjecting the milk to a process known as <i>peptonization</i>. +This consists in the addition of a +digestive ferment, obtained from the pancreas +of lower animals, together with ordinary cooking-soda. +In carrying out the process the milk, +whether whole or modified, is placed in a clean +bottle, and the peptonizing powder added after +having been rubbed up with a teaspoonful of +milk. The container is then placed in a pitcher +of water at a temperature of 110°F., which is +about as warm as the hand can bear comfortably, +and is here left for from ten to twenty<span class='pagenum'><a name="Page_76" id="Page_76">[Pg 76]</a></span> +minutes if only partial peptonization is desired, +or for a couple of hours should it be +wished to complete the process. The peptonized +milk may be prepared at each feeding, or +the whole amount for the day may be made at +one time in the morning; in the latter case, +where it is desired to have the milk only partially +peptonized, the ferment should be destroyed +by boiling after it has been allowed +to act for from ten to twenty minutes.</p> + +<p><i>Feeding after the First Year.</i>—As the infant +is weaned other food should be gradually +added; this should still consist largely of milk, +to which some time later may be added gruels +prepared from well-cooked oats or barley, beef-juice, +or the white of an egg slightly cooked. +The various broths may also be allowed. +Children relish very much all fruit-juices, and +they may be given in moderation without harm, +and even with benefit in many cases. As the +child grows older, the various cereals should +form a greater and greater proportion of its +diet, but due care should be exercised in always +seeing to it that they are thoroughly cooked;<span class='pagenum'><a name="Page_77" id="Page_77">[Pg 77]</a></span> +in order to be digestible for children such substances +should be cooked at least three or four +hours before eaten.</p> + +<p><i>General Hygiene of Infant Life.</i>—In order +for children to be healthy, the greatest regularity +is necessary in their habits. They +should arise at a certain hour in the morning +and go to bed at a fixed time at night. Their +clothing should be loose, and not too tight fitting, +and should at all times correspond to the +state of the weather. Nothing is more common, +and nothing produces irritability, loss of +sleep, and even serious general disturbances +in infants, more frequently than too much clothing. +It is generally customary to use from the +time of birth and during the period of infancy +a flannel band around the child's abdomen. +Just how this acts is not clear, but there seems +good reason for the belief that in some unexplained +way the practice has the effect of +warding off intestinal disturbances, and is, +therefore, to be recommended.</p> + +<p>Napkins should be changed when soiled, and +then should be immediately placed in water,<span class='pagenum'><a name="Page_78" id="Page_78">[Pg 78]</a></span> +in which they should remain until washed out; +under no circumstances should they be left lying +around the nursery.</p> + +<p>When the weather permits, the child should +be kept as much out-of-doors as is possible. +For the first few days of the infant's life, particularly +if the weather be cool, it should, of +course, be kept indoors, but even then free access +of air should be allowed. There is no objection +whatever to the infant sleeping out-of-doors—in +fact, where this is feasible, it generally +shows improvement as soon as the practice +is commenced. When out-of-doors, it is of +course necessary to see that the sun does not +shine directly into the infant's face, and wetting +should, of course, be avoided; also the hood +of the carriage should be arranged to prevent +strong winds from blowing on the child.</p> + +<p>The nursery should be well aired, a window +being left up at night except during severe +weather.</p> + +<p><i>Sleep.</i>—Nothing is more important for the +proper development of a child than for it to +have an abundance of sleep. During the first +few months of its life it sleeps practically all of<span class='pagenum'><a name="Page_79" id="Page_79">[Pg 79]</a></span> +the time—the period becoming gradually lessened +as it grows older. Infants should be suffered +to sleep just as much as is possible, it +being not only unjustifiable but absolutely +criminal to interfere with them in this particular +in the slightest degree. Not only is it +necessary that infants have all the sleep that +they desire, but it is true throughout childhood, +a fact to which many foolish parents +seem utterly oblivious. How often do we see +a child scarcely more than an infant aroused +in the morning and sent off to school, and how +frequently do we hear misguided parents boast +of their inflexible rules in enforcing such evil +practices. Truly man comes hard by the +knowledge that nature is much wiser than he, +and the vast majority never learn the fact at +all.</p> + +<p>As soon as the child is able to crawl, it should +be placed on a clean quilt or blanket on the +floor, and allowed to move about to its heart's +content. When it is able to walk, allow it to +run about and play to its full capacity—as in +such exercises consists the great school of its +physical being, the school upon which will depend<span class='pagenum'><a name="Page_80" id="Page_80">[Pg 80]</a></span> +its strength and health in after life. Allow +the child to keep up his play as long as he +has any inclination to do so, and never be so +foolish as to confine him in the house when he +wishes to be out under the blue heavens, for +here only will it be possible for him or her to +develop into a real man or woman. Allow this +to go on until the child of its own accord comes +and asks to be taught other things, for not +until then is its outside education nearing completion, +and not until then is it possible for him +to take interest in and learn things connected +with books. No boy should ever be sent to +school before he is twelve or fourteen years of +age; girls, on account of their maturing earlier, +may begin a couple of years sooner.</p> + +<p>The whole science and art of properly raising +children consists in feeding them good +clean food in proper amounts, in never allowing +them to be awakened, and in permitting +them to play in the open air to their hearts' content.</p> + +<p><i>Teething.</i>—Teething is a subject which has +at all times interested both doctor and layman,<span class='pagenum'><a name="Page_81" id="Page_81">[Pg 81]</a></span> +and in its supposed relation to all kinds of +disorders of infancy has undoubtedly exercised +an influence over the popular imagination out +of all proportion to its real importance. Too +often it has happened that this perfectly +normal, and usually by no means serious, process, +has been held responsible for grave diseases +in children—diseases which in reality +were the consequence of neglect and mismanagement +in the far more serious matters of food, +sleep, out-of-door exercises, and general hygiene. +It cannot, however, be denied—particularly +in respect to nervous children—that +teething appears occasionally to induce unpleasant +disturbances, such as fretfulness, broken +sleep, digestive disorders, and occasionally +fever; as a rule such symptoms persist only for +a few days, if the infant be properly looked +after. The treatment should consist in lancing +the gums should they become much swollen, +and the withholding of the usual amount of +food, particularly where intestinal disturbances +occur. The ages at which the teeth usually +come are as follows:<span class='pagenum'><a name="Page_82" id="Page_82">[Pg 82]</a></span></p> + +<div class='center'> +<table border="0" cellpadding="4" cellspacing="0" summary="The ages at which the teeth usually come" width="60%"> +<tr><td align='left'>2</td><td align='left'>Middle Lower Teeth</td><td align='right'>5 to  9 months.</td></tr> +<tr><td align='left'>4</td><td align='left'>Upper Front Teeth</td><td align='right'>8 to 12 months.</td></tr> +<tr><td align='left'></td><td align='left'>Remaining Lower Front Teeth</td><td align='right'>12 to 18 months.</td></tr> +<tr><td align='left'>4</td><td align='left'>Front Jaw Teeth</td><td align='right'>12 to 18 months.</td></tr> +<tr><td align='left'></td><td align='left'>Stomach Teeth (Canine)</td><td align='right'>18 to 24 months.</td></tr> +<tr><td align='left'></td><td align='left'>Eye Teeth (Canine)</td><td align='right'>18 to 24 months.</td></tr> +<tr><td align='left'>4</td><td align='left'>Back Jaw Teeth</td><td align='right'>24 to 30 months.</td></tr> +</table></div> + + +<p><i>Bowel Diseases.</i>—Digestive disturbances, +accompanied by diarrhœa, are the bane of infancy, +and are responsible for a very large +part of the frightful mortality among babies. +The subject, therefore, is one of tremendous importance, +but is so complicated that the limits +of this little volume will only permit its being +touched upon.</p> + +<p>As already mentioned, indigestion accompanied +by looseness of the bowels may be and +often is the result of milk being used from diseased +cows, or it may be the consequence of such +carelessness in handling it that disease-producing +bacteria are later allowed to contaminate +it. It should also never be forgotten that where +children are eating artificially prepared food +improper mixing of the different components +may result in serious disturbances, and we +should, therefore, exercise the utmost care always<span class='pagenum'><a name="Page_83" id="Page_83">[Pg 83]</a></span> +in seeing to it that the food is prepared +strictly according to the table which has already +been given—not forgetting that in a certain +number of instances we can go by no rule, +and will have to experiment until we ascertain +the proper proportion of the ingredients.</p> + +<p>After a diarrhœa begins we should at once +reduce the quantity of fat in the milk that is +being given to the infant, and if the trouble be +at all severe it is best to take it off of all food +for twenty-four hours, and substitute boiled +water or barley-water. As soon as the trouble +is checked we may then begin to feed cautiously +with largely diluted milk, and, gradually increasing +its strength, in the course of a few +days return to the food that was being given +before the disturbance occurred. A dose of +calomel or castor oil in the beginning of diarrhœal +troubles often has a very salutary effect; +the parent should not hesitate to administer +this if a doctor is not at hand.</p> + +<p>In warm climates during the time of teething +children very commonly develop chronic diarrhœal +conditions which often end fatally; +wherever possible the parent should under such<span class='pagenum'><a name="Page_84" id="Page_84">[Pg 84]</a></span> +circumstances at once remove the little sufferer +to a colder climate where recovery is generally +rapid and complete. Even the most careful +nursing under the most competent physician is +often fruitless in combating disorders of this +character as long as the infant remains in a +warm climate.</p> + +<p><i>Colic.</i>—Colic is always due to indigestion, +and is the result of the food undergoing fermentative +changes, with the production of +gases. This goes on even under normal conditions +to a certain extent, but when it is excessive +the intestines become greatly distended, +and pain of a severe or even agonizing character +is produced.</p> + +<p>In the treatment of this condition warm applications +should be made to the abdomen, and +as quickly as possible an enema (injection), +consisting of a few ounces of warm solution +of salt water should be given; the salt should +be in the proportion of a level teaspoonful to +the quart of water. Parents will find the little +ear syringe, which may be purchased at any +drug store, a most satisfactory instrument for +giving enemas to infants, as they do not hold<span class='pagenum'><a name="Page_85" id="Page_85">[Pg 85]</a></span> +too much, and being soft, are incapable of tearing +the delicate tissues of the child. It is of +the utmost importance to remember that the +salt solution should be tepid, yet not sufficiently +hot to scald the infant. As the water when +given in this way is expelled very quickly the +enemas may be repeated any number of times +desired.</p> + +<p>Where these measures fail, a physician should +be sent for at once, but in the meantime if +it be evident that the infant is suffering very +much, a small dose of paregoric may be given; +it should not however be forgotten that opiates +are exceedingly hurtful to nervous children, and +that soothing syrups and other mixtures containing +drugs of this class should be avoided.</p> + +<p><i>Constipation.</i>—Constipation among very +young children generally passes off as the food +becomes richer, but should it occur at a later +time, the trouble may be more difficult +to remedy. Of first importance is having the +bowels of the infant move at a certain time each +day, which may be quickly accomplished in +many little children by placing them upon a +small chamber daily at a given hour; usually the<span class='pagenum'><a name="Page_86" id="Page_86">[Pg 86]</a></span> +baby very quickly learns what this procedure +means, and in this way a regular habit is established +which is of the utmost value to the +child throughout its infancy, and every effort, +therefore, should be made to bring it about as +quickly as possible.</p> + +<p>The addition of malted milk or Mellin's Food +may also have the effect of diminishing constipation;—the +result being brought about by the +maltose contained in these preparations. The +same thing may be accomplished by substituting +for a part of the milk sugar in the baby's +food a similar quantity of maltose. Milk of +magnesia may be used in preparing the baby's +food in the place of lime-water, with the result +oftentimes of relieving a tendency to constipation.</p> + +<p><i>Croup.</i>—By croup is meant a spasmodic condition +which usually affects children at night, +and is in no way to be confounded with that +really dangerous disease, membranous croup, +or diphtheria, to which so many children fall +victims.</p> + +<p>Spasmodic croup is a condition which has as +its basis digestive disturbances, and is almost<span class='pagenum'><a name="Page_87" id="Page_87">[Pg 87]</a></span> +always relieved as soon as the stomach is +emptied. Vomiting may be brought about by +making the child swallow a small quantity of +mustard stirred up in water, or by the use of +ipecac. Such severe and extremely unpleasant +remedies are rarely necessary, however, since +the disease may be in almost all instances at +once relieved by placing around the victim's +throat a cloth wrung out of cold water, which +may itself be covered by a dry bandage to prevent +the bed from getting wet. Children will +usually go to sleep in a few minutes after the +cold cloth is applied, and suffer no ill consequences +as a result of its remaining around +their throats throughout the night. Where the +croup is very severe the little sufferer's feet +may be placed in hot water, in addition to the +cold cloth around the neck—the combination +practically always resulting in the rapid relief +of the unpleasant symptoms.</p> + +<p>Great care should be exercised in the diet of +children who are subject to croup, as by intelligent +supervision the tendency to this very annoying +trouble may be in a short time entirely +overcome.<span class='pagenum'><a name="Page_88" id="Page_88">[Pg 88]</a></span></p> + +<p><i>Nervousness.</i>—Children of neurotic parents, +particularly where they are reared in cities, are +exceedingly prone to nervousness in one form +or another. The condition is undoubtedly often +due to heredity, but may be induced in otherwise +healthy children by unhygienic surroundings +and improper food. Infants exhibiting +symptoms that indicate trouble of this kind +should not be played with, and every care +should be exercised to so direct their lives that +the trouble may be gradually overcome. In all +cases where nervousness persists an intelligent +physician should be consulted.</p> + +<p><i>Vaccination.</i>—The only safe method that we +possess of preventing small-pox is by means of +vaccination. Its great value has been so +thoroughly tested that the writer does not deem +it necessary to go into a discussion as to its +merits. A child should be vaccinated in at +least three places during its early infancy,—there +being no danger in doing the operation +immediately after birth. Persons ignorant of +aseptic surgery should not do this operation, +but should always call in the services of some +person prepared to do the work in a cleanly<span class='pagenum'><a name="Page_89" id="Page_89">[Pg 89]</a></span> +manner. Either the leg or the arm may be +selected; and children should be revaccinated +whenever small-pox breaks out in the community.</p> + +<p><i>Kissing Babies to be Avoided.</i>—Kissing infants +in the mouth is a very bad practice, as in +this way disease may be quite innocently conveyed +to them. The public should be taught to +understand that it is not infrequently the case +that bacteria may be present in the mouths of +individuals who are quite immune to their ill +effects, and who are, therefore, perfectly well, +but who may, by conveying them to others, particularly +children, induce in them serious disease. +When caressed in this way at all children +should be kissed upon their necks or feet, and +never in their mouths or on their hands.</p> + +<p><i>Juvenile Contagious Diseases.</i>—Children are +peculiarly prone to a class of highly contagious +diseases, the exact nature of which is not +yet understood, and we possess therefore little +knowledge as to the proper means of preventing +their spread. Practically all that is known +about them is that they are conveyed by contact, +or even by the air, particularly where a<span class='pagenum'><a name="Page_90" id="Page_90">[Pg 90]</a></span> +child suffering from one of them is placed in a +confined place with another who is susceptible; +these diseases likewise may be carried by means +of clothing and other articles that have been +in close contact with a child suffering with any +of them. The lesson of importance to be +learned, therefore, is that if we wish our children +to escape maladies of this class we should +not permit their indiscriminate association with +others. As these diseases cease to be a serious +menace after children have passed through +their earlier years it does not at a later time +matter so much as to whether they are exposed +to them or not. As a general thing children +develop these affections in from ten to fifteen +days after having been exposed, though one of +the most severe of them, scarlet fever, may +make its appearance as early as twenty-four +hours after it is contracted. These diseases +are usually ushered in by a severe headache, +pains in the head, back, and limbs, high fever, +and oftentimes a chill. As soon as a child develops +such symptoms the advice of a competent +medical man should be at once sought, and<span class='pagenum'><a name="Page_91" id="Page_91">[Pg 91]</a></span> +the little sufferer should be at once completely +isolated.</p> + +<p>In concluding, the writer would particularly +exhort parents to obey to the letter the instructions +of their physicians, and never under +any circumstances to dose their helpless off-spring +with patent or proprietary medicines, +which contain no man knows what, and which +unquestionably are often highly injurious, especially +to children.</p> + + + + +<h2><a name="CHAPTER_V" id="CHAPTER_V"></a>CHAPTER V</h2> +<p><span class='pagenum'><a name="Page_92" id="Page_92">[Pg 92]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>PROPER EATING—THE SECRET OF<br /> +GOOD HEALTH</h3> + + +<p>Very slowly the world is awakening to the +fact that no agencies play such an important +part in the preservation of health as the consumption +of reasonable quantities of well-cooked +and properly selected food, and the habitual +taking of wholesome drinks. On all +sides the observant medical man sees constant +and reckless disregard of the simplest and +most fundamental laws governing this subject. +Nothing is more common than to hear of men in +the prime of life being seized with what is +called a “nervous breakdown,”—which generally +means a digestive breakdown—to be followed +by an era of misery for the unfortunate +subject and his scarcely happier family. Nervous +and irritable, the slightest inconveniences +are magnified into terrible calamities, he constantly +fears death, and his sleepless nights become<span class='pagenum'><a name="Page_93" id="Page_93">[Pg 93]</a></span> +a saturnalia of gloomy thoughts and abject +fears.</p> + +<p>Of course, not everyone guilty of dietetic sins +goes through such sad experiences, for the +naturally strong frequently escape the consequences +of their rashness, particularly where +they live in the rural districts and take plenty +of out-door exercise. Let not such, however, +flatter themselves that their disregard of hygienic +laws will go unpunished. After indiscretions +in eating they will all, at one time or +another, have acute indigestion with diarrhœa; +and how often does the previously well and +hearty man after indiscretion in eating wake +up with a dull headache, furred tongue, foul +breath, and a general feeling of sluggishness +and mental depression?</p> + +<p>Is it his liver? Our unscientific medical ancestors—at +a loss to account for the state of +affairs in any other way—answered in the affirmative, +and, believing it was produced by a +collection of bile in the liver, called the condition +“biliousness.” How absurd modern science +has shown this assumption to be! We +now know that the liver is rarely diseased, and<span class='pagenum'><a name="Page_94" id="Page_94">[Pg 94]</a></span> +that it furnishes its secretion, called bile, for +the purpose of aiding digestion rather than +hindering it, and that this substance is rarely, if +ever, produced in excess. It is undigested, +putrefying food in the intestinal tract that produces +the trouble. Under such circumstances +one usually takes a dose of calomel, which, being +perhaps the most satisfactory and perfect purgative +that we possess, relieves the condition +promptly by getting rid of the offending material; +but the drug does not act on the liver.</p> + +<p>Unfortunately ill results of quite a different +and a much more serious character often follow +in the wake of dietetic errors; in those who +have a tendency to consumption, particularly +where they overwork, this dread disease frequently +makes its appearance as a consequence +of bad eating and drinking. Many, if not all, +of the degenerative diseases that appear in the +latter half of life are produced in this way, and +nothing is more certain than that the peace, happiness +and longevity of mankind could be incalculably +increased by the simple observance of +what is known concerning proper eating and +drinking.<span class='pagenum'><a name="Page_95" id="Page_95">[Pg 95]</a></span></p> + +<p>We will now consider the very important subject +of the quantity and character of foods +which should be taken in health, with suggestions +as to those most suitable for dyspeptics.</p> + +<p><i>Over-eating too Prevalent.</i>—The majority of +us take much more food than is necessary, with +the result that we suffer from indigestion.</p> + +<p>When we consume more than a reasonable +amount of food habitually serious digestive disturbances +are sure to result,—to be often followed +at a later time by tuberculosis, morbid +alterations in the blood-vessels, Bright's disease, +and other serious maladies of a chronic +nature. Professor Chittenden, who is America's +greatest physiological chemist, has demonstrated +that in all probability previous workers +along these lines have been excessive in their +estimates as to the amount of food required. +He showed that a man could live for a period of +nine months on a daily ration which contained +about one-third of the usual amount of proteids +generally thought to be necessary, and at the +same time the fats and carbohydrates were reduced +to such a degree that the total number of +heat units, or calories, liberated from the food<span class='pagenum'><a name="Page_96" id="Page_96">[Pg 96]</a></span> +scarcely exceeded in number one-half of the +standard requirements. He also experimented +on thirteen volunteers from the hospital corps +of the United States Army, to whom he daily +fed rations of only 2,000 calories, and, notwithstanding +that they engaged in physical work, all +were found to be in better condition at the end +of six months than they were at the beginning.</p> + +<p>These results strongly point to the conclusion +that previous estimates as to the quantity of +food required are erroneous, and that man can +not only live, but may continue in strength and +health on much smaller amounts. It is highly +probable that this discrepancy may be accounted +for, at least to a considerable extent, +by the assumption that much of the food ordinarily +taken is rejected by the system, and +passes out as waste, while, when small quantities +are eaten, it is for the most part absorbed.</p> + +<p><i>Mastication.</i>—Thorough chewing of the food +is absolutely essential for proper digestion. +While it is true that this, like all other good +things in life, may be, and often is, carried to an +unnecessary extreme, it is certainly true that we +would be infinitely better off if we were to go to<span class='pagenum'><a name="Page_97" id="Page_97">[Pg 97]</a></span> +the extent in this direction of so called “Fletcherism” +rather than perform this most important +function in an indifferent manner.</p> + +<p>This rule applies with especial force to food +of a starchy nature,—bread, potatoes, oatmeal, +rice, etc. In order to digest food of this character +it must be very thoroughly cooked and +when finally placed upon the table it should be +of such consistence that it requires chewing +before it can be swallowed. Not only is this +necessary from the standpoint of breaking up +the larger particles into smaller ones, thus permitting +the food to pass freely through the +stomach and intestine, but it is of the greatest +importance for it to be thoroughly soaked with +the saliva during the process. It is thus of no +advantage for starches to be served in a finely +divided form—in fact it is directly the contrary, +since under such circumstances it is almost +always the case that such foods are swallowed +without having been insalivated.</p> + +<p>What has been said concerning the mastication +of starches applies with almost equal +force to other foods. Without exception their +digestibility is much increased by thorough<span class='pagenum'><a name="Page_98" id="Page_98">[Pg 98]</a></span> +chewing. As the result of recent experiments +carried out by means of the X-ray, it has been +shown that particles of food of any considerable +size will not pass from the stomach into the +intestine; as often as an object of this kind attempts +to force its way from the former into +the latter the opening between the two closes, +and as a consequence the food is retained in +the stomach longer than it is in health—resulting +in the course of time in catarrhal conditions +of the organ just named, and an unnatural +relaxation of its muscular walls. +Under such circumstances the patient quickly +develops symptoms of indigestion, and if his +habits be not corrected the trouble gradually +grows worse until the sufferer becomes a +chronic dyspeptic.</p> + +<p><i>Classes of Nutritive Substances.</i>—All substances +that are of any appreciable value in +nutrition may be divided into those that are +nitrogenous in character (albumins, legumins), +the carbohydrates (starches and sugars) and +compound ethers (fats). Of all these the +nitrogenous foods are the most important, +since they contain the material from which the<span class='pagenum'><a name="Page_99" id="Page_99">[Pg 99]</a></span> +great bulk of the body is largely composed, +and at the same time there is every evidence +that in case of need they may be broken up +into chemical substances that may take the +place of any of the other kinds of foods; upon +nitrogenous food, then, a man may live alone, +while this cannot be done on other articles of +diet. The fats, starches and sugars are very +closely related to each other, and it is generally +believed that they subserve much the +same end in the economy; by undergoing chemical +change they furnish energy (heat and muscular +force) and are undoubtedly largely responsible +for the formation of the fats of the +body. While there is some evidence that under +certain conditions alcohol may be a food, its +value is certainly very small, and it is not +of sufficient importance to be considered in +this connection. The ideal diet then for a +healthy man is a proper proportion of nitrogenous +(albuminous) food, along with a reasonable +portion of fats, starches and sugars. +Professors Voight and Atwater have calculated +the following table, which fairly represents +the amount of proteids, fats and carbohydrates<span class='pagenum'><a name="Page_100" id="Page_100">[Pg 100]</a></span> +that should compose the rations for +twenty-four hours for the ordinary adult male.</p> + +<h4>ADULT MALE OF AVERAGE WEIGHT.</h4> + +<div class='center'> +<table border="0" cellpadding="4" cellspacing="0" summary="Adult Male of Average Weight"> +<tr><td align='center'></td><td align='center'>At Rest.</td><td align='center'>Moderate Labor.</td><td align='center'>Severe Labor.</td></tr> +<tr><td align='left'>Proteids</td><td align='center'>110 grammes</td><td align='center'>118 grammes</td><td align='center'>145 grammes.</td></tr> +<tr><td align='left'>Fats</td><td align='center'>50 " </td><td align='center'>50 " </td><td align='center'>100 " </td></tr> +<tr><td align='left'>Carbohydrates</td><td align='center'>450 " </td><td align='center'>500 " </td><td align='center'>500 " </td></tr> +</table></div> + + +<p>The tables that follow, which were arranged +by Hutchinson, give a very good idea of the +generally accepted views as to the relative +quantities of the different foods that are +thought necessary for the average adult engaged +in ordinary muscular work:—</p> + +<div class='center'> +<table border="0" cellpadding="2" cellspacing="4" summary="Relative quantities" width="70%"> +<tr><td align='center'>Food Materials.</td><td align='center'>Amount.</td><td align='center'>Albumins.</td><td align='center'>Fats.</td><td align='center'>Starches.</td><td align='center'>Fuel<br />Value.</td></tr> +<tr> + <td align='center' style='padding-top: 2em;'>1.</td> + <td align='right' style='padding-top: 2em;'>Ozs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Calories.</td> +</tr> +<tr> + <td align='left'>Beef, round st'k</td> + <td align='right'>13</td> + <td align='right'>0.14</td> + <td align='right'>0.12</td> + <td align='right'>....</td> + <td align='right'>695</td> +</tr> +<tr> + <td align='left'>Butter</td> + <td align='right'>3</td> + <td align='right'>....</td> + <td align='right'>0.16</td> + <td align='right'>....</td> + <td align='right'>680</td> +</tr> +<tr> + <td align='left'>Potatoes</td> + <td align='right'>6</td> + <td align='right'>0.02</td> + <td align='right'>....</td> + <td align='right'>0.15</td> + <td align='right'>320</td> +</tr> +<tr> + <td align='left'>Bread</td> + <td style="border-bottom: 1px solid black;" align='right'>22</td> + <td style="border-bottom: 1px solid black;" align='right'>0.12</td> + <td style="border-bottom: 1px solid black;" align='right'>0.02</td> + <td style="border-bottom: 1px solid black;" align='right'>0.75</td> + <td style="border-bottom: 1px solid black;" align='right'>1760</td> +</tr> +<tr> + <td align='center'>Totals</td> + <td align='right'>44</td> + <td align='right'>0.28</td> + <td align='right'>0.30</td> + <td align='right'>0.90</td> + <td align='right'>3455</td> +</tr> +<tr> + <td align='center' style='padding-top: 2em;'>2.</td> + <td align='right' style='padding-top: 2em;'>Ozs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Calories.</td> +</tr> +<tr> + <td align='left'>Pork, salt </td> + <td align='right'>4</td> + <td align='right'>....</td> + <td align='right'>0.21</td> + <td align='right'>....</td> + <td align='right'>880</td> +</tr> +<tr> + <td align='left'>Butter</td> + <td align='right'>2</td> + <td align='right'>....</td> + <td align='right'>0.11</td> + <td align='right'>....</td> + <td align='right'>450</td> +</tr> +<tr> + <td align='left'>Beans</td> + <td align='right'>16</td> + <td align='right'>0.23</td> + <td align='right'>0.02</td> + <td align='right'>0.59</td> + <td align='right'>1615</td> +</tr> +<tr> + <td align='left'>Bread</td> + <td style="border-bottom: 1px solid black;" align='right'>8</td> + <td style="border-bottom: 1px solid black;" align='right'>0.04</td> + <td style="border-bottom: 1px solid black;" align='right'>0.01</td> + <td style="border-bottom: 1px solid black;" align='right'>0.28</td> + <td style="border-bottom: 1px solid black;" align='right'>640</td> +</tr> +<tr> + <td align='center'>Totals</td> + <td align='right'>30</td> + <td align='right'>0.27</td> + <td align='right'>0.35</td> + <td align='right'>0.87</td> + <td align='right'>3585</td> +</tr> +<tr> + <td align='center' style='padding-top: 2em;'>3.<span class='pagenum'><a name="Page_101" id="Page_101">[Pg 101]</a></span></td> + <td align='right' style='padding-top: 2em;'>Ozs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Calories.</td> +</tr> +<tr> + <td align='left'>Beef, neck</td> + <td align='right'>10</td> + <td align='right'>0.10</td> + <td align='right'>0.09</td> + <td align='right'>....</td> + <td align='right'>550</td> +</tr> +<tr> + <td align='left'>Butter</td> + <td align='right'>1</td> + <td align='right'>....</td> + <td align='right'>0.05</td> + <td align='right'>....</td> + <td align='right'>225</td> +</tr> +<tr> + <td align='left'>Milk, one pint</td> + <td align='right'>16</td> + <td align='right'>0.04</td> + <td align='right'>0.04</td> + <td align='right'>0.05</td> + <td align='right'>325</td> +</tr> +<tr> + <td align='left'>Potatoes</td> + <td align='right'>16</td> + <td align='right'>0.02</td> + <td align='right'>....</td> + <td align='right'>0.15</td> + <td align='right'>320</td> +</tr> +<tr> + <td align='left'>Oatmeal</td> + <td align='right'>4</td> + <td align='right'>0.04</td> + <td align='right'>0.02</td> + <td align='right'>0.17</td> + <td align='right'>460</td> +</tr> +<tr> + <td align='left'>Bread</td> + <td align='right'>16</td> + <td align='right'>0.09</td> + <td align='right'>0.02</td> + <td align='right'>0.56</td> + <td align='right'>1280</td> +</tr> +<tr> + <td align='left'>Sugar</td> + <td style="border-bottom: 1px solid black;" align='right'>3</td> + <td style="border-bottom: 1px solid black;" align='right'>....</td> + <td style="border-bottom: 1px solid black;" align='right'>....</td> + <td style="border-bottom: 1px solid black;" align='right'>0.19</td> + <td style="border-bottom: 1px solid black;" align='right'>345</td> +</tr> +<tr> + <td align='center'>Totals</td> + <td align='right'>66</td> + <td align='right'>0.29</td> + <td align='right'>0.22</td> + <td align='right'>1.12</td> + <td align='right'>3505</td> +</tr> +<tr> + <td align='center' style='padding-top: 2em;'>4.</td> + <td align='right' style='padding-top: 2em;'>Ozs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Calories.</td> +</tr> +<tr> + <td align='left'>Beef, up. sh'lder</td> + <td align='right'>10</td> + <td align='right'>0.09</td> + <td align='right'>0.13</td> + <td align='right'>....</td> + <td align='right'>800</td> +</tr> +<tr> + <td align='left'>Ham</td> + <td align='right'>6</td> + <td align='right'>0.06</td> + <td align='right'>0.13</td> + <td align='right'>....</td> + <td align='right'>650</td> +</tr> +<tr> + <td align='left'>Eggs, two</td> + <td align='right'>3</td> + <td align='right'>0.03</td> + <td align='right'>0.02</td> + <td align='right'>....</td> + <td align='right'>135</td> +</tr> +<tr> + <td align='left'>Butter</td> + <td align='right'>2</td> + <td align='right'>....</td> + <td align='right'>0.11</td> + <td align='right'>....</td> + <td align='right'>450</td> +</tr> +<tr> + <td align='left'>Milk, one pint</td> + <td align='right'>16</td> + <td align='right'>0.04</td> + <td align='right'>0.04</td> + <td align='right'>0.05</td> + <td align='right'>325</td> +</tr> +<tr> + <td align='left'>Potatoes</td> + <td align='right'>12</td> + <td align='right'>0.01</td> + <td align='right'>....</td> + <td align='right'>0.11</td> + <td align='right'>240</td> +</tr> +<tr> + <td align='left'>Flour</td> + <td align='right'>9</td> + <td align='right'>0.05</td> + <td align='right'>0.01</td> + <td align='right'>0.38</td> + <td align='right'>825</td> +</tr> +<tr> + <td align='left'>Sugar</td> + <td style="border-bottom: 1px solid black;" align='right'>1</td> + <td style="border-bottom: 1px solid black;" align='right'>....</td> + <td style="border-bottom: 1px solid black;" align='right'>....</td> + <td style="border-bottom: 1px solid black;" align='right'>0.06</td> + <td style="border-bottom: 1px solid black;" align='right'>115</td> +</tr> +<tr> + <td align='center'>Totals</td> + <td align='right'>59</td> + <td align='right'>0.28</td> + <td align='right'>0.44</td> + <td align='right'>0.60</td> + <td align='right'>3540</td> +</tr> +<tr> + <td align='center' style='padding-top: 2em;'>5.</td> + <td align='right' style='padding-top: 2em;'>Ozs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Calories.</td> +</tr> +<tr> + <td align='left'>Sausage</td> + <td align='right'>4</td> + <td align='right'>0.03</td> + <td align='right'>0.11</td> + <td align='right'>....</td> + <td align='right'>510</td> +</tr> +<tr> + <td align='left'>Codfish</td> + <td align='right'>14</td> + <td align='right'>0.07</td> + <td align='right'>....</td> + <td align='right'>....</td> + <td align='right'>140</td> +</tr> +<tr> + <td align='left'>Butter</td> + <td align='right'>2</td> + <td align='right'>....</td> + <td align='right'>0.11</td> + <td align='right'>....</td> + <td align='right'>450</td> +</tr> +<tr> + <td align='left'>Milk, one pint</td> + <td align='right'>16</td> + <td align='right'>0.04</td> + <td align='right'>0.04</td> + <td align='right'>0.05</td> + <td align='right'>325</td> +</tr> +<tr> + <td align='left'>Beans</td> + <td align='right'>5</td> + <td align='right'>0.01</td> + <td align='right'>....</td> + <td align='right'>0.18</td> + <td align='right'>505</td> +</tr> +<tr> + <td align='left'>Rice</td> + <td align='right'>2</td> + <td align='right'>0.01</td> + <td align='right'>....</td> + <td align='right'>0.10</td> + <td align='right'>205</td> +</tr> +<tr> + <td align='left'>Potatoes</td> + <td align='right'>16</td> + <td align='right'>0.01</td> + <td align='right'>....</td> + <td align='right'>0.23</td> + <td align='right'>420</td> +</tr> +<tr> + <td align='left'>Bread</td> + <td align='right'>9</td> + <td align='right'>0.04</td> + <td align='right'>0.01</td> + <td align='right'>0.28</td> + <td align='right'>640</td> +</tr> +<tr> + <td align='left'>Sugar</td> + <td style="border-bottom: 1px solid black;" align='right'>3</td> + <td style="border-bottom: 1px solid black;" align='right'>....</td> + <td style="border-bottom: 1px solid black;" align='right'>....</td> + <td style="border-bottom: 1px solid black;" align='right'>0.19</td> + <td style="border-bottom: 1px solid black;" align='right'>345</td> +</tr> +<tr> + <td align='center'>Totals</td> + <td align='right'>71</td> + <td align='right'>0.27</td> + <td align='right'>0.28</td> + <td align='right'>1.03</td> + <td align='right'>3540</td> +</tr> +<tr> + <td align='center' style='padding-top: 2em;'>6.<span class='pagenum'><a name="Page_102" id="Page_102">[Pg 102]</a></span></td> + <td align='right' style='padding-top: 2em;'>Ozs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Lbs.</td> + <td align='right' style='padding-top: 2em;'>Calories.</td> +</tr> +<tr> + <td align='left'>Beef</td> + <td align='right'>8</td> + <td align='right'>0.08</td> + <td align='right'>0.10</td> + <td align='right'>....</td> + <td align='right'>560</td> +</tr> +<tr> + <td align='left'>Mackerel, salt</td><td align='right'>4</td> + <td align='right'>0.04</td> + <td align='right'>0.04</td> + <td align='right'>....</td> + <td align='right'>230</td> +</tr> +<tr> + <td align='left'>Eggs, two</td> + <td align='right'>3</td> + <td align='right'>0.03</td> + <td align='right'>0.02</td> + <td align='right'>....</td> + <td align='right'>135</td> +</tr> +<tr> + <td align='left'>Butter</td> + <td align='right'>2½</td> + <td align='right'>....</td> + <td align='right'>0.13</td> + <td align='right'>....</td> + <td align='right'>565</td> +</tr> +<tr> + <td align='left'>Cheese</td> + <td align='right'>1</td> + <td align='right'>0.02</td> + <td align='right'>0.02</td> + <td align='right'>....</td> + <td align='right'>130</td> +</tr> +<tr> + <td align='left'>Milk, one pint</td> + <td align='right'>16</td> + <td align='right'>0.04</td> + <td align='right'>0.04</td> + <td align='right'>0.05</td> + <td align='right'>325</td> +</tr> +<tr> + <td align='left'>Potatoes</td> + <td align='right'>8</td> + <td align='right'>0.01</td> + <td align='right'>....</td> + <td align='right'>0.08</td> + <td align='right'>160</td> +</tr> +<tr> + <td align='left'>Rice</td> + <td align='right'>2</td> + <td align='right'>0.01</td> + <td align='right'>....</td> + <td align='right'>0.10</td> + <td align='right'>205</td> +</tr> +<tr> + <td align='left'>Bread</td> + <td align='right'>9</td> + <td align='right'>0.05</td> + <td align='right'>0.01</td> + <td align='right'>0.32</td> + <td align='right'>720</td> +</tr> +<tr> + <td align='left'>Sugar</td> + <td style="border-bottom: 1px solid black;" align='right'>1½</td> + <td style="border-bottom: 1px solid black;" align='right'>....</td> + <td style="border-bottom: 1px solid black;" align='right'>....</td> + <td style="border-bottom: 1px solid black;" align='right'>0.09</td> + <td style="border-bottom: 1px solid black;" align='right'>175</td> +</tr> +<tr> + <td align='center'>Totals</td> + <td align='right'>55</td> + <td align='right'>0.28</td> + <td align='right'>0.36</td> + <td align='right'>0.64</td> + <td align='right'>3205</td> +</tr> +</table></div> +<br /> + +<p><i>Calories Defined.</i>—It should be explained +that the term “calorie” is one which has been +adopted as a scientific expression for the fuel-value +of substances undergoing oxidation, and +in this connection refers to the heat-producing +capacity of foods. The “calorie” is the +amount of heat required to raise the temperature +of one gramme of water 1°C. It has been +estimated that starches, sugars and albumins +liberate during combustion 4.1 calories per +gramme, while fats produce 9.3 calories. It +will be noted that in the tables just given the +total number of calories is in each instance +somewhere in the neighborhood of 3,500, which<span class='pagenum'><a name="Page_103" id="Page_103">[Pg 103]</a></span> +is considered to be about the number of heat +units required by the average man at moderate +muscular work. The weight of the average +woman being less than that of the adult male, +a reduction of about 20 per cent. from the foregoing +figures would approximate the amount of +food required by the former.</p> + + + + +<h2><a name="CHAPTER_VI" id="CHAPTER_VI"></a>CHAPTER VI</h2> +<p><span class='pagenum'><a name="Page_104" id="Page_104">[Pg 104]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>BREAD AND ITS RELATIONS</h3> + + +<p>At all times, and among all peoples, bread +has been recognized as one of the great staple +articles of diet. Although its commonly quoted +designation, “the staff of life,” would more +appropriately belong to the albumins, there can +be no question that breads of one kind or another +are among the most wholesome and necessary +of all food-substances. Not alone is this +true on account of the starch of which they are +largely composed, but they contain more or less +vegetable albumin; it is thus seen that bread +is a mixture of the two most important food-stuffs, +starch and albumin, but the quantity +of the latter is so small that an individual +would have to eat an enormous amount of the +mixture to secure enough of this ingredient +to meet the needs of the body. For practical +purposes, then, we may regard bread as being +starch.<span class='pagenum'><a name="Page_105" id="Page_105">[Pg 105]</a></span></p> + +<div class="blockquot"><p>Within recent years quacks have disseminated +very widely throughout this country the error that +foods are more digestible when raw. It was long +ago demonstrated that pure albumins, of which eggs +and milk are the nearest natural examples among +foods, are assimilated somewhat better when eaten +raw, but this applies to no other foods except sugars. +Any success that has followed the teachings just referred +to undoubtedly rests purely on the fact that +their followers are instructed to live largely on raw +eggs and milk, and as the patient usually discovers +in a short time that these two foods agree with him +while other uncooked ones do not, he naturally eats +them to the exclusion of the rest and where he takes +a sufficient quantity increases in weight and strength.</p> + +<p>The idea that starches are more digestible when +eaten raw could be easily refuted by any intelligent +farm-boy who recalls one or more sad experiences +from over-indulgence in raw sweet potatoes.</p></div> + +<p>What shall we look upon as bread? Of course +all such food-stuffs as are commonly included +within this designation are to be accepted; such +as wheat-bread, graham-bread, whole-wheat +bread, biscuits, rolls, light bread, bakers' bread, +waffles and batter-cakes, rye bread, corn bread, +preparations of corn-starch, with which we +should place those articles of diet so commonly +used in the south, usually called grits, hominy,<span class='pagenum'><a name="Page_106" id="Page_106">[Pg 106]</a></span> +egg-bread, muffins, corn-meal cakes, potatoes, +both sweet and Irish, arrowroot and the so-called +cereals or breakfast-foods, including oatmeal.</p> + +<p>Now which of these is the most wholesome? +This inquiry cannot be answered conclusively +for the reason that the digestibility of this, +as of other foods, depends largely on the individual. +For the sake of clearness the various +breads will now be considered in detail.</p> + +<p><i>Wheat-bread the Best.</i>—It may be confidently +asserted that well-cooked and perfectly +dry wheat-breads are to be regarded as being +generally the most digestible of all bread-stuffs. +This is not dependent on any inherent property +in wheaten starch as a result of which it is +acted upon more readily by the juices whose +office it is to render it fit for absorption in the +body, but is wholly due to the fact that breads +of wheat-flour may be made very dry and light.</p> + +<p>As has been already explained, it is particularly +necessary that starches should be +thoroughly soaked in saliva, and this can only +be accomplished when the bread is of such consistence +that it must be chewed for a time, and<span class='pagenum'><a name="Page_107" id="Page_107">[Pg 107]</a></span> +so dry that it will readily absorb the salivary +secretion. The writer, then, would advocate +well cooked light-bread or bakers' bread, or +toast made from either, as being the best of all +food-stuffs of this character. The crusts of +biscuit a day or so old are quite digestible, as +are also waffles, if made with little grease and +cooked thoroughly. The soft inner portion of +biscuit and that of hot rolls, as well as batter-cakes, +is decidedly unwholesome.</p> + +<p>Graham-bread should not be constantly indulged +in for the reason that it contains multitudes +of sharp particles of the husk of the grain +that cut the delicate mucous membrane of the +stomach and intestines as it passes along, and +if its use be long and continued, severe ill effects +necessarily follow.</p> + +<div class="blockquot"><p>In this connection attention should also be called +to the common error that particles of husk are of +advantage to breads of all sorts; the former consist +chemically of exactly the same thing as sand, and are +quite as indigestible, and this, in connection with +what has just been said of their action on the delicate +mucous membranes of the intestinal tract, should +be quite enough to convince anyone that they are +not only useless, but injurious. It is true that the +<span class='pagenum'><a name="Page_108" id="Page_108">[Pg 108]</a></span>irritation produced by the husk will oftentimes cause +the bowels to act, but results of the same character +may be induced by many other agencies, within +themselves less harmful.</p></div> + +<p><i>Rye-bread.</i>—There is no reason why rye-bread +should not be prepared in quite as wholesome +a way as is wheaten-bread, and this grain +should undoubtedly rank as one of the best of +the cereals. Its use, however, is so limited in +this country that it is scarcely necessary to go +into a lengthy discussion as to its merits. It +may be remarked that the ergot fungus frequently +grows on this grain, and when ground +up with it occasionally poisons the consumer +where the quantity of the substance is large +and the bread is eaten in considerable quantities. +Instances of this kind are not uncommon +among the peasantry of Europe, where a black +bread made from rye is the staple article of +diet. Of course, when making food-preparations +of rye, we should be careful to have the +flour thoroughly winnowed, and to cook the +bread until sufficiently dry to acquire a proper +consistency for chewing.</p> + +<p><i>Corn-bread and Corn Food-products.</i>—When<span class='pagenum'><a name="Page_109" id="Page_109">[Pg 109]</a></span> +made from perfectly sound grain, and if not +allowed to undergo fermentative changes afterward, +there can be no question that food-products +of corn are entirely wholesome, and, from +the standpoint of chemical composition, quite +as nourishing as similar articles of diet prepared +from other grains. It is, however, unfortunately +true that we cannot, in the majority +of instances, definitely assure ourselves that +our corn-bread is made from grain that comes +up to the above specification, nor can we be sure +that the meal is fresh, or preserved at such a +temperature as would forbid the growth of +various germs. It has long been known that +bad corn would kill horses, but notwithstanding +this, we have accepted the view that no amount +of deterioration in the grain could result harmfully +to man. That this latter assumption is incorrect +seems now in the highest degree probable.</p> + +<div class="blockquot"><p><i>Pellagra.</i>—It is known that a very curious and +fatal disease called pellagra is prevalent to a considerable +degree at the present time in the United +States, and it is not going too far to say that all of +those best capable of judging are of the opinion that +<span class='pagenum'><a name="Page_110" id="Page_110">[Pg 110]</a></span>the malady is the result of eating just such corn +as we know kills horses.</p> + +<p>It is likewise true that the nutritive power of this +grain could in no way be increased by allowing it +to decay before consumption; indeed, the contrary +must be the case, and, if it were in no manner +actually harmful, our sense of the æsthetic and of +what is proper to eat, should make us reject in this +case, as with other foods, that which is unsightly to +the eye and unpleasant to the taste. We should no +more eat bad grain than a rotten apple, or putrefying +meat. The increased prevalence of pellagra is +exciting attention all over the United States, and is +very generally assumed to be the result of lack of +care in the harvesting and preservation of our corn. +Instead of being cut before it is ripe, and shocked +in the field during the latter part of the summer, +it should be allowed to ripen on the stalk, and after +cold weather sets in gathered while dry, and preserved +in well-covered and well-ventilated barns. +Every care should be taken to keep it dry while being +shipped from one part of the country to another, +and similar precaution should be observed +with the various food-products made from it. If +kept in a cold place, meal or grits made of good +corn may be preserved in excellent condition for +eating throughout the winter; but as soon as the +warm weather begins they should be stored in the +refrigerator, and should there remain during the +summer; similar precaution should be taken with +meal or other corn-products during the hot months.</p></div> + +<p><span class='pagenum'><a name="Page_111" id="Page_111">[Pg 111]</a></span>Over a large area of the United States corn-bread +is an article of daily diet with a great +majority of the inhabitants, and its wholesomeness +as compared with other breads becomes, +therefore, an important question. Unfortunately, +corn-meal does not lend itself to the +preparation of a dry bread having sufficient +consistency to require chewing. It is true that +the crusts of the bread made from this grain +answer these requirements fairly well, and there +is therefore no reason why this part of it should +not be used to any extent, provided it be prepared +from good meal. We should endeavor +to cook thin pones of the bread rather than the +thicker ones so common in the south. The objection +that corn-bread can only be masticated +with difficulty applies to the other preparations +of this cereal, such as egg-bread, muffins, etc., +and they are not, therefore, with the exception +of the crusts, to be looked upon as being the +best form of bread. Corn-cakes, like all batter-bread, +are to be mentioned only to be condemned. +Grits and hominy are soft and moist +and cannot be properly chewed, and are, therefore, +not to be recommended as good breads.<span class='pagenum'><a name="Page_112" id="Page_112">[Pg 112]</a></span> +Corn-starch preparations are likewise entirely +lacking in the elements required to make good +bread, and should only be used occasionally and +in small amounts.</p> + +<p><i>Disadvantages of Potatoes.</i>—Irish potatoes +are eaten almost as commonly in some portions +of the United States as are corn-products in +others, and therefore deserve the careful consideration +of the hygienist. While it is not believed +that, like the latter, potatoes give rise +to any definite disease, it is unfortunately true +that they are theoretically worse breads than +those made from the grain just referred to. In +whatever way cooked, they are moist and require +no chewing, and as a consequence many +persons with delicate digestions do not assimilate +them properly.</p> + +<p><i>Arrowroot.</i>—The preparations of arrowroot +are considered digestible, though here again +we find that such articles of diet are generally +moist and of not proper consistence to be +chewed, and they are, therefore, not as valuable +as are breads made from wheaten flour.</p> + +<p><i>Rice.</i>—Rice is used by a large portion of the +world's inhabitants. When cooked thoroughly<span class='pagenum'><a name="Page_113" id="Page_113">[Pg 113]</a></span> +and very dry, it is perhaps almost as good +bread as is that made from wheat. The starch +granules of the former, like those of arrowroot, +are somewhat smaller than those of wheat.</p> + +<p>If it were possible to keep rice-flour in good +condition, and if it could be made into light-bread, +it is likely that it would be superior to +wheaten flour, but this does not appear feasible.</p> + +<p>A peculiar and very fatal disease prevails in +the East, known as “kak-ke” or “beri-beri,” +which is now generally regarded as being the +result of eating decomposed rice. The writer +has seen one or two examples of what he considers +American beri-beri, but as our rice-eating +population is small, it is not likely that this +disease will ever become a serious problem in +the United States.</p> + +<p><i>Cereals or Breakfast-foods.</i>—Lastly we will +consider the so-called breakfast-foods, which +are neither more nor less than various preparations +of the different varieties of starch. They +are generally made from oats or corn-starch. +They are nothing more than bread, and as some +of them have been put through a sort of fermentation +it is difficult to understand how they<span class='pagenum'><a name="Page_114" id="Page_114">[Pg 114]</a></span> +could be regarded as being quite as wholesome +as the original products from which they were +made. This, however, is not the principal objection +to them. The real trouble lies in the +fact that they are, in the majority of instances, +served with cream and sugar. When we remember +what has already been said about +starches that are soft and cannot be chewed, +and of the ill effects of sweets on persons who +have any inclination towards dyspepsia, it will +be seen that these foods are not to be regarded +as being wholesome. The real reason that +would appear to explain the coming into existence +of these preparations is that they are mixed +with cream and sugar, which appeals strongly +to the “sweet-tooth” of the average person. +They are nothing but bread, and very bad bread +at that. The remarks made concerning breakfast-foods +apply with equal force to oatmeal, +which, as generally used, has the additional disadvantage +of containing particles of husk.</p> + +<p>In concluding this discussion on starchy foods +the writer desires particularly to call attention +to a very common error in the way they are +eaten. Mention has already been made of the<span class='pagenum'><a name="Page_115" id="Page_115">[Pg 115]</a></span> +fact that fats after being melted are by no +means so wholesome as in their natural state, +and produce, when heated with starches, a very +indigestible mixture. Thus, theoretically, it is +bad to use any great amount of lard, butter or +other fat in the preparation of breads, and it is +likewise undesirable to spread butter on heated +breads, as is so often done just before eating +biscuits, waffles and batter-cakes. The combination +is certainly a seductive one, and pleasing +to the taste of most persons, but this in no way +invalidates the fact that the mixture is exceedingly +indigestible.</p> + +<p><i>Pastries and Cakes.</i>—Peculiarly unwholesome +are pastries containing any considerable +proportion of fat, and also most varieties of +cake. With the exception possibly of hot batter-cakes +served with an abundance of butter +and syrup, cooks have so far produced no compound +so heinous and totally depraved as pound-cake. +Fruit-cake also stands high up in the list +of undesirable sweets. It certainly passes all +understanding why cooks should continue to persecute +the stomachs of a dependent world with +such highly obnoxious concoctions; the only excuse<span class='pagenum'><a name="Page_116" id="Page_116">[Pg 116]</a></span> +that can be given for them is that the mixtures +are palatable. Where a housekeeper feels +it necessary to prepare cake, she should select +some receipt free from butter or other fat, such +as angel-cake or sponge-cake, both of which +when properly made are exceedingly good to +the taste, and lack the undesirable quality of +containing fats. Explanation for the peculiarly +unwholesome character of food containing +melted grease lies probably in the fact that the +grains of starch under such circumstances must +be to a greater or less extent covered by a thin +layer of the fatty substances, and as a consequence +it is impossible for the saliva to penetrate +to the starch and perform its normal digestive +function.</p> + + + + +<h2><a name="CHAPTER_VII" id="CHAPTER_VII"></a>CHAPTER VII</h2> +<p><span class='pagenum'><a name="Page_117" id="Page_117">[Pg 117]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>MEATS, SUGARS AND MILK</h3> + + +<p>First in the list of foods the writer would +place those nitrogenous substances commonly +eaten that belong to the class of albumins. +That these substances are in reality the most +important of all food-stuffs there can be no +sort of question, since they, of all things eaten +by the human being, are alone absolutely essential +for his well being and even his existence. +They are the substances that almost exclusively +go to make up the muscle and tendons. Along +with the lime-salts they enter largely into the +composition of the bones and cartilages, brain, +spinal cord and nerves. Other foods are incapable +of taking the place of the albumins, so +that they are absolutely essential for normal +life in the human being.</p> + +<p>The amount of albumin necessary for the +normal adult has been variously estimated, the +tendency at the present time being to place the<span class='pagenum'><a name="Page_118" id="Page_118">[Pg 118]</a></span> +quantity needed somewhat lower than was at +one time done. It is probable that about two +ounces of pure albumins is somewhere near the +amount required in twenty-four hours by a +normal adult.</p> + +<p>It is well, since we are so dependent on foods +of this class, that we have two quite distinct +sources from which they may be taken. The +great bulk comes to us in the form of meats, including +poultry, game, oysters and fish of various +kinds, in addition to beef, mutton, and hog-meat +in its several forms. Of animal origin +also we have eggs, which are among the most +valuable of all foods of this class on account of +their high digestibility.</p> + +<p>From the vegetable world we get albumins +known as legumins, which differ somewhat +from those obtained from animal sources, +though taking their place in the economy in all +essential particulars. Unfortunately the legumins +are usually so mixed with starches and +other vegetable substances less digestible, that +it is necessary to take a large bulk of foods of +this latter class in order to secure anything +like the requisite amount of the former.<span class='pagenum'><a name="Page_119" id="Page_119">[Pg 119]</a></span></p> + +<p>Before taking up individually the various albuminous +foods, the writer would again direct +attention to the chapter on cooking, and would +strongly urge upon the reader the proper +methods of preparing nitrogenous foods therein +stated. Where the albumins are in a nearly +pure state, as in milk and eggs, they are slightly +more digestible when raw, but all meats should +be cooked until only the faintest tinge of red +remains if we wish to have them prepared in +the most wholesome way for those with delicate +digestions. Meats are, as a rule, most wholesome +when cooked “very done.”</p> + +<div class="blockquot"><p>It has long been the cry of sentimentalists that +no living being should die in order that man might +exist. Unfortunately for such theories, the stern +and unbending edict of nature has negatived views +of this kind ages before the altruistic philosopher +came on the scene, and we are daily constrained to +bow to this mandate of one of the primal laws of +existence. However much we might desire it otherwise, +it has been written that “only in death is there +life;” nor may any animal being disobey and continue +to exist. As has been already explained, the +human being cannot thrive on vegetable substances +alone; from them he may get a certain amount of +nitrogen in the form of legumin, but there is not +<span class='pagenum'><a name="Page_120" id="Page_120">[Pg 120]</a></span>enough to make up for the waste of this substance +that constantly goes on in the body.</p></div> + +<p>Theoretically it is of very little importance +which of the meats are selected to supply our +nitrogenous food, but it is unfortunately true +that such foods vary much in digestibility, and +it will therefore be necessary to consider them +separately.</p> + +<p><i>Beef.</i>—When tender and cooked to a proper +degree, beef is considered one of our most +wholesome of meats. Like other foods of this +kind, it should not be fried, but should be broiled +or roasted, and a certain amount of fat may be +eaten along with the lean portions without injury, +and in many persons unquestionably with +benefit.</p> + +<p><i>Mutton.</i>—Of all the coarser meats, mutton is +unquestionably the most digestible, and when +cooked in the same way as directed for beef is +eminently wholesome.</p> + +<p><i>Hog-meats.</i>—On account of the large portion +of fat between the muscle-fibers, hog-meat, particularly +when fresh, is not usually regarded as +being digestible. Some persons eat it with impunity, +but for the vast majority it should be<span class='pagenum'><a name="Page_121" id="Page_121">[Pg 121]</a></span> +taken only in small quantities. It should not be +fried. In the form of ham, hog meat is more +wholesome than when fresh, but even in this +condition many dyspeptics find much difficulty +in digesting it. The best method of cooking it +is to boil thoroughly. After being cooked in this +way and then broiled, it is most appetizing, and +is much more wholesome than when broiled +without being previously cooked. As bacon, +hog-meat enters largely into the dietary of a +great portion of the laborers of this country, +and there can be no doubt that on the whole it +answers the purpose of a staple food admirably. +It contains even more fat than nitrogenous +substances, and may therefore be looked upon +as a mixture of butter and meat. Dyspeptics +cannot eat it with impunity in many instances, +though it agrees far better with them than does +ham or the fresh meat. If it were generally +eaten boiled it would provoke less trouble than +when fried. At this point the writer would repeat +his warning concerning the indigestible +character of melted grease, of which the gravy +from bacon is a striking example.</p> + +<p>When “cured” in a somewhat different way<span class='pagenum'><a name="Page_122" id="Page_122">[Pg 122]</a></span> +hog-meat as “breakfast-bacon” is very generally +used throughout the civilized world, and is +one of its most wholesome forms. This when +broiled is both appetizing and wholesome, and +should form a part of the daily dietary of everyone +able to afford it.</p> + +<p><i>Poultry and Game.</i>—Among the more delicate +and most wholesome forms in which albumins +are taken we find poultry and game well +up toward the head of the list. Meats of this +character should be very thoroughly cooked +by being either baked, smothered or broiled.</p> + +<p><i>Fish.</i>—Fish of almost all kinds are wholesome +provided they be fresh and properly +cooked. The culinary artist prepares of them +most appetizing and nutritious dishes, and they +are therefore properly to be recommended as +among the best of the albuminous foods.</p> + +<p><i>Oysters and Clams.</i>—Oysters and clams are +usually considered somewhat apart from the +generality of the foods of this character. When +fresh they are wholesome and delicious when +eaten raw, and may be cooked in a great variety +of ways. The reader should be especially +warned that fried oysters are not so wholesome<span class='pagenum'><a name="Page_123" id="Page_123">[Pg 123]</a></span> +as when they are prepared by other methods, +for the reason that they are surrounded by a +batter containing quantities of melted grease.</p> + +<p><i>Eggs.</i>—Among the most delicate, digestible, +and nutritious of all foods we may place eggs. +Though somewhat more digestible when raw, +they agree, as a rule, even with the most fastidious +stomach, however cooked, even when hard-boiled. +Eggs lend themselves readily to the +formation of many delicious dishes, such as +omelets, soufflés, etc.; but unfortunately they do +not contain nutriment in a very concentrated +form, and where an adult is living on them +alone it requires from one and a half to two +dozen daily to furnish the necessary amount +of food.</p> + +<p><i>Fats.</i>—Under the term “fats” are included +all oily substances, such as butter, lard, olive +and cotton-seed oils, and to a great extent the +fat contained in meats. These substances are +closely related to starches and sugars, and undoubtedly +play a more or less similar rôle when +taken into the body as food. From the standpoint +of heat-producing capacity they more than +double, weight for weight, meats and starches,<span class='pagenum'><a name="Page_124" id="Page_124">[Pg 124]</a></span> +and are, therefore, instinctively highly prized by +dwellers in cold countries where much heat is +necessary. In warmer countries the necessity +for excessive heat-production in the body does +not exist.</p> + +<div class="blockquot"><p>While oily substances are certainly capable of adding +to the cushion of fat commonly found beneath +the skin in normal individuals, they are not looked +upon as being to any extent tissue-builders, resembling +in this particular the starches and sugars.</p> + +<p>When fats are to be eaten, care should be taken +that they be as fresh as possible, or, if this is not +feasible, they should be preserved in such a way as +to prevent their becoming rancid—a condition which +is the result of the formation of fatty acids, lending +a peculiarly unpleasant odor and taste, and producing +a decided decrease in food-value. This alteration +may be largely prevented by keeping fats in +a refrigerator at a low temperature, and may also +be greatly retarded by the addition of salt. In this +country butter is usually treated with a very considerable +amount of salt, but in Europe it is universally +served fresh. Within recent years facts +have been established that show that Americans use +an excessive amount of this substance—possibly causing +disease in some cases; and doubtless we would +be better off if we were to follow the European +practice.</p> + +<p>Oily substances when in good condition are certainly +of high value as foods, but should be taken +<span class='pagenum'><a name="Page_125" id="Page_125">[Pg 125]</a></span>more or less with an eye to the climate, and to the +season of the year. When placed on cold bread and +eaten along with it they are extremely palatable, and +may be taken in reasonable amounts with decided +benefit to the whole body. In temperate climates it +is generally estimated that about three ounces is a +desirable amount for the average adult. In this connection +it may not be out of place to mention that +the various preparations of cod-liver oil, advertised +so freely in the lay press, in some instances actually +do not contain a single particle of the substance that +they are supposed to be principally composed of; +and it may be further stated that there is no good +reason to believe that bulk for bulk oils of this kind +are in any way superior to those fats commonly +eaten. The writer often recalls the saying of a very +wise old physician of his acquaintance that “cod-liver +oil is nearly as good as butter.”</p></div> + +<p><i>Sugars.</i>—This term includes the large +number of different substances of a more or +less sweetish taste that belong to the group of +carbohydrates. They are closely related to the +starches, and it is generally assumed that they +play much the same part after being taken +into the body. Some of these are of animal +and some of vegetable origin—but except the +sugar found in milk, the only ones commonly +consumed are those derived from cane, beets,<span class='pagenum'><a name="Page_126" id="Page_126">[Pg 126]</a></span> +and fruits; the sugar from the first two is +known as cane sugar or dextrose, and that from +the latter as grape sugar or glucose. Like albumins +they may be eaten without having been +previously cooked, and are unique in that they +undergo no chemical change whatever as a result +of ordinary degrees of heat.</p> + +<p>While the consumption of sugars in all civilized +nations is rapidly increasing, there can be +no question that, irrespective of fruits, they are, +of all foods, the most frequent causes of digestive +disturbances. It is only within comparatively +recent times that mankind has possessed +means of separating sugars in any great bulk +from the plants containing them, and as a consequence +they have only entered prominently +into our every-day diet for a relatively short +period of time. Before this, it is true, they +were consumed to a greater or less extent in +various fruits, but the quantity was insignificant +as compared with the amount now universally +eaten. As a result of this we are now +confronted with a new dietetic problem. For +ages the human stomach has been accustomed +to deal with only small quantities of these substances,<span class='pagenum'><a name="Page_127" id="Page_127">[Pg 127]</a></span> +and developed accordingly a capacity +to digest them proportionate to the amounts +then eaten. Now, however, we constantly call +upon our digestive organs to deal with large +quantities of such foods, and it is not strange +that there has been more or less rebellion on +their part.</p> + +<div class="blockquot"><p>Experiments have shown that a small amount of +sugar assists in the normal chemical changes that +go on in the body, and it is, therefore, obvious that +nature intends us to take a certain quantity of it. +Moreover it is true that sugars while being burned +in the body give off much energy—mainly manifested +in muscular power; where then we are taking +active physical exercise foods of this kind are peculiarly +appropriate. It would, therefore, not be +wise for us to leave this food entirely out of the +dietetic list, but to use it only in small amounts—particularly +where we lead sedentary lives. Sugar +and alcohol play a more or less similar rôle in the +animal economy. It is well known that those who +do not use alcohol are peculiarly prone to consume +considerable quantities of sugar; and it is equally +a matter of common observation that those who +habitually take alcohol rarely eat sweets to any extent.</p> + +<p>When sugar is properly assimilated, as seems to +be done most easily by children, it is an excellent +food, but where sweets are over-eaten, and not properly +digested, they give rise to a great accumulation +<span class='pagenum'><a name="Page_128" id="Page_128">[Pg 128]</a></span>of gas in the intestine, and produce in many persons +a marked acidity of the stomach, frequently +accompanied by severe insomnia. Nothing so quickly +relieves such sleeplessness, caused by a “sour stomach,” +as allowing ten or fifteen grains of ordinary +cooking-soda to slowly dissolve in the mouth and +swallowing the saliva rendered alkaline in this way.</p></div> + +<p><i>Milk.</i>—Milk may be looked upon as an ideal +food, it being composed of water carrying in +solution the three great natural foods—albumins +in the form of casein, carbohydrates as +milk-sugar or lactose, and fat. Mixed in the +proportion in which they here occur, they are +most admirably adapted to the delicate digestive +apparatus of the infant—the relative proportion +of the different substances even gradually +changing as the assimilative powers of +the youthful organism increase; it is thus seen +that milk itself is not of constant composition, +even in the same animal, and that it alters in +such a manner as to meet best the needs of the +delicate being depending upon it for proper sustenance. +It is also the case that the composition +of milk varies in different animals—showing +again how admirably nature exerts its +powers in meeting desired ends.<span class='pagenum'><a name="Page_129" id="Page_129">[Pg 129]</a></span></p> + +<p>The lesson of practicable importance that we +learn from this is that the milk of one of the +lower animals is not in its natural state quite +suited to the delicate stomach of the growing +infant, and that if it be substituted for the +mother's milk it must be more or less altered, +depending upon the age of the child. It is particularly +important that sweet milk be taken +slowly, as otherwise large curds, difficult of digestion, +form as soon as it gets into the stomach.</p> + + + + +<h2><a name="CHAPTER_VIII" id="CHAPTER_VIII"></a>CHAPTER VIII</h2> +<p><span class='pagenum'><a name="Page_130" id="Page_130">[Pg 130]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>FOOD-VALUE OF VEGETABLES</h3> + + +<p>In recent times we hear much of vegetarianism, +which has its advocates among many highly +intelligent people, and which, as a consequence, +has achieved a certain vogue throughout the +civilized world. It is rarely the case, however, +that those who affect to practice this cult in +reality live exclusively on a vegetable diet. As +a rule it will be found that they are milk-drinkers, +and not infrequently add eggs to their dietary. +It is, of course, absurd to regard as vegetarians +those who simply avoid meat, since it is +true that the nitrogenous substances contained +in milk and eggs differ in no essential particular +from similar substances found in flesh of all +kinds.</p> + +<p>Experiments on a somewhat extended scale +have shown within recent years that young and +vigorous individuals at least may live and +thrive on a diet composed largely of vegetables;<span class='pagenum'><a name="Page_131" id="Page_131">[Pg 131]</a></span> +no one has yet shown that a strict vegetable +diet is that best adapted to the average individual, +and no competent authority on this subject +at the present time advocates a diet purely +of this kind. It is true that the vegetables +ordinarily eaten contain all of the elements +that are essential to the animal system, such as +starch, sugar, fat and albumins. Unfortunately, +however, the amount of the last-named +substance is usually so small in food-plants that +the quantity that would have to be eaten by a +normal individual taking active exercise would +cost considerably more than if a reasonable +proportion of animal food were included, and—which +is of even greater importance—the digestive +powers of the individual who attempted +to live only on food of this character would +be severely taxed, and, in the long run, probably +seriously impaired. Furthermore, vegetables +and fruits contain substances, usually in great +quantity, that are scarcely acted upon at all by +the digestive juices. Chief among the latter +is cellulose, which, while forming the great +bulk of the food of herbivorous animals, is +scarcely suited to the weaker digestive capacity<span class='pagenum'><a name="Page_132" id="Page_132">[Pg 132]</a></span> +of the human being; practically none of it is +converted to the uses of the body. It is thus +seen that in the average man or woman a dietary +consisting largely of vegetables would result +in the presence in the intestines of a greater +or less bulk of indigestible materials, which +could subserve no good purpose other than that +they would by their mechanical presence have +a tendency to cause the bowels to act; as is the +case with fruits, however, it is unfortunately +true that this large residue of undigested food, +in one way or another, often gives rise to considerable +irritation of the mucous membrane of +the intestine, and frequently produces dyspeptic +disturbances, among which looseness of the +bowels is common.</p> + +<p>This brings us to a consideration of the digestibility +of vegetables in general, which is always +the paramount consideration when dealing +with the value of any substance to be used +as a food. It has been before remarked that +young and vigorous persons seem to thrive on a +dietary largely of vegetable character, but the +case is certainly quite different with older people, +particularly where their digestive powers<span class='pagenum'><a name="Page_133" id="Page_133">[Pg 133]</a></span> +are impaired. In the latter we often find that +severe intestinal disturbances follow even after +moderate indulgence in vegetable foods—particularly +where they are served with vinegar, or +some other fruit acid. Another peculiarity of +foods of this kind that makes decidedly against +their digestibility lies in the fact that, being +soft and containing a large proportion of water, +they are scarcely ever properly chewed, and as +a consequence they are swallowed in comparatively +large masses without having been adequately +insalivated.</p> + +<p>Vegetables may be roughly classified as +legumes, roots and tubers, and green vegetables, +and will now be considered briefly in the order +named.</p> + +<p><i>Legumes,—Beans, Peas, Lentils, and Peanuts.</i>—With +the exception of the cereals, the +legumes are the most valuable of all vegetable +foods. Their nutritious properties are mainly +due to their relatively high percentage of nitrogenous +material, though they also contain starch +and fat. Hence these vegetables contain the ingredients +necessary to supply all the needs of +the human economy; unfortunately, however,<span class='pagenum'><a name="Page_134" id="Page_134">[Pg 134]</a></span> +when eaten alone in sufficient bulk to furnish the +nourishment required, they often—even in +healthy individuals—give rise after a little time +to dyspeptic disturbances.</p> + +<p>Of beans, a large number of different varieties +are in common use including string-beans +(or snap-beans), lima-beans, kidney-beans, red +beans, the frijole, and the Soya bean. String-beans +are exceedingly palatable, and are very +much prized as an article of diet by the peoples +of all countries. When gathered young and +thoroughly cooked while still fresh they are exceedingly +wholesome, and are very well assimilated, +when properly chewed, by even those +whose digestions are considerably impaired. +The other beans named are generally eaten dry +after having been removed from the pod in +which they grow. When they are soaked in +water until they become soft and then +thoroughly cooked they make an excellent food, +and, when not taken in too great quantities, are +fairly digestible. When cooked with onions, +parsley, and red pepper in proper proportions +they make a very delicious dish. In Japan the +Soya bean forms the basis for a kind of vegetable<span class='pagenum'><a name="Page_135" id="Page_135">[Pg 135]</a></span> +cheese which is eaten with rice, and furnishes +the nitrogenous materials in which the +latter is deficient. Peas are wholesome when +young and fresh and when properly cooked, and +as they come on in the early spring when other +fresh vegetables cannot be obtained, they furnish +a most acceptable addition to the dietary. +When old, after their skins become tough, they +cease to be digestible, and should not be eaten +except in the form of purees, during the preparation +of which the hull is removed.</p> + +<p>Lentils are scarcely eaten at all in America, +but are much prized in some portions of the +Old World, as the basis of soups.</p> + +<p>Peanuts belong to the group of legumes, +though, unlike the others that serve as food, +they grow beneath the surface of the ground. +They are highly nutritious, but are, unfortunately, +indigestible, owing largely to the high +percentage of oil that they contain. The latter +is extracted, and is sometimes sold as olive-oil; +in a somewhat different form it is made into +a sort of butter which is quite palatable.</p> + +<p><i>Roots, Tubers, and Yams.</i>—Sweet and Irish +potatoes, which constitute the most important<span class='pagenum'><a name="Page_136" id="Page_136">[Pg 136]</a></span> +members of this group, have already been discussed +under the head of breads. Of those that +remain, some few, as beets and artichokes, may +be regarded as related to those just referred to, +while others, such as carrots, turnips, radishes, +parsnips, etc., are generally reckoned among the +succulent tubers on account of the large proportion +of juice that they contain. Irrespective of +the beet, which furnishes a considerable portion +of the sugar of commerce, none of them may be +looked upon as foods of a very important character, +as they contain only relatively small proportions +of sugars, starches, and nitrogenous +materials. Beets, however, do contain a very +high percentage of that which makes potatoes so +popular,—about eighty-five per cent. of starches +and sugars, with only a trifle of nitrogenous +material. When young and tender they are +often eaten as a salad, either alone or mixed +with other vegetables, and are generally regarded +as being wholesome and highly nutritious. +They should not be eaten by dyspeptics +when pickled, on account of the vinegar.</p> + +<p>Artichokes are occasionally eaten, but are not<span class='pagenum'><a name="Page_137" id="Page_137">[Pg 137]</a></span> +nutritious, although they agree well with many +persons.</p> + +<p>Carrots, when young and fresh, are fairly digestible, +but like other vegetables are exceedingly +apt, particularly if old, to produce intestinal +disturbances in dyspeptics. They are not +very commonly eaten in the United States, but +where selected with care we would profit by +their more frequent use. They contain a small +percentage of starches, with an insignificant +proportion of vegetable albumin.</p> + +<p>Turnips are exceedingly unwholesome, contain +very little nourishment, and may be eaten +with impunity only by persons in vigorous +health. The same remarks apply to radishes, +and to parsnips.</p> + +<p><i>Green Vegetables.</i>—Vegetables of this class +are of much more value from the standpoint of +their agreeable taste, and the consequent stimulating +effect upon the appetite, than from the +nutritive materials that they contain. Some of +them are eaten cooked, while others are usually +consumed in a raw state. They are all much +less indigestible if eaten when quite young and<span class='pagenum'><a name="Page_138" id="Page_138">[Pg 138]</a></span> +fresh—drying seemingly having the effect of +producing alterations in them that predispose +to dyspeptic disturbances in those so inclined.</p> + +<p>Spinach is one of the most digestible of the +entire group, and is much eaten in all parts of +the world.</p> + +<p>Turnip-tops differ in no essential particular +from spinach. They have a somewhat bitter +taste, but when young and fresh are highly +palatable, and if thoroughly cooked cause comparatively +little intestinal trouble, but like +spinach they contain practically no nourishment. +The same may be said of the leaves of +various other plants commonly served as +greens, among them beet-tops, and dandelion-tops.</p> + +<p>Cabbages, many different kinds of which are +habitually eaten as food in civilized countries, +have comparatively little nutritive value, and +are, generally speaking, decidedly indigestible, +although young and vigorous persons, particularly +where they take abundant out-door exercise, +find no difficulty in assimilating the inner +portions of the fresh cabbage “head.” As in +the case with other vegetables, the soil and locality<span class='pagenum'><a name="Page_139" id="Page_139">[Pg 139]</a></span> +in which the cabbage is grown largely influences +its taste, and to some extent its digestibility. +It should never be given to infants. +Sauerkraut is a preparation of cabbage leaves +produced by adding salt, and later crushing +them with considerable pressure; after a time +alterations occur of a fermentative character, +and the product is generally regarded as more +wholesome than fresh cabbage.</p> + +<p>Cauliflower consists of masses of the somewhat +modified flowers of a plant closely related +to the cabbage, and is, when properly prepared, +palatable, and perhaps somewhat more digestible +than cabbage. Cole, and Brussels sprouts, +are plants of the cabbage family, and are perhaps +even more indigestible.</p> + +<p><i>Salad Plants.</i>—The leaves of the lettuce are +usually eaten raw, most commonly being +served as a salad in combination with oil and +vinegar, or lemon juice. That the leaves possess, +when treated in this way, a very palatable +taste all will perhaps agree, but they cannot be +said to be of any nutritive value, nor are the +acids just referred to conducive to their digestibility.<span class='pagenum'><a name="Page_140" id="Page_140">[Pg 140]</a></span></p> + +<p>On account of their somewhat pungent taste, +watercresses are used in many parts of the +world as ingredients of salads, but they are, of +all vegetables, the ones that are most liable to +transmit disease to man, for in addition to the +possibility of contracting in this way typhoid +fever, dysentery, cholera, and the ordinary intestinal +worms, the human being is apt to receive +with them the eggs of the flukes, and the +spores of the amœbæ that produce chronic tropical +dysentery. As they are probably never +grown under such conditions as to preclude the +possibility of this danger, it would be the part of +wisdom to absolutely refrain from their use.</p> + +<p><i>Onions, Leeks, Shallots, and Garlic.</i>—Vegetables +of this group are eaten either raw or +cooked, and of all those consumed in the former +state are least liable to transmit disease, owing +to the fact that they are nearly always thoroughly +peeled before being eaten. They have +the advantage, furthermore, that they may be +preserved for long periods of time in such a way +as to be fit for food, and when properly cooked +have a delicate flavor, and are quite wholesome +although furnishing little food for the body.<span class='pagenum'><a name="Page_141" id="Page_141">[Pg 141]</a></span> +Garlic is never eaten as a vegetable, but serves +as the basis for many of the delicate sauces for +which the French cooks are so justly celebrated.</p> + +<p>The tomato has been used as a food only +within comparatively recent times, it having +been formerly thought to be poisonous. Like +the onion it may be eaten either raw or cooked, +and if taken in moderation does not, as a rule, +produce any serious harm. When eaten in +greater quantities, both on account of the acid +that it contains and its relatively small proportion +of assimilable nutriment, the tomato is exceedingly +prone to cause intestinal disturbances, +and should rather be regarded as a fruit than a +vegetable. Growing at some distance from the +ground, it is rather less apt to convey diseases +than the majority of vegetables eaten in a raw +state.</p> + +<p>While celery is generally eaten raw, it furnishes +a palatable dish when cooked in milk. +It should not be eaten by dyspeptics or children, +particularly if raw. Similarly the cucumber has +a well-merited reputation for producing dyspeptic +disturbances. It is only eaten raw, is frequently +served as a salad, and should be used<span class='pagenum'><a name="Page_142" id="Page_142">[Pg 142]</a></span> +only when very young and fresh, and eaten only +by persons of sound digestion.</p> + +<p>Okra is much prized in the Southern States +as the principal ingredient of a very palatable +soup, but is not as a rule looked upon with favor +by the uninitiated. It is also much eaten boiled +and served with a little butter and pepper. +When fresh and young it is fairly digestible, +and furnishes a very agreeable addition to the +dinner.</p> + +<div class="blockquot"><p>In addition to those already referred to, there are +a number of vegetables that are very popular either +alone, or in combination as salads—particularly in +the South; among them are green peppers, parsley, +mint, capers, endive, and chicory. The remarks +already made concerning green vegetables apply +equally to these just mentioned, and it should here +again be particularly insisted upon that salads containing +acids are unwholesome for infants and children, +and should be used sparingly even by those in +health. None contains much nourishment.</p> + +<p>Among easily digestible vegetables asparagus probably +takes front rank, and in addition to this has the +merit of being exceedingly agreeable to the taste. +It possesses little nutritive value, but when young, +fresh, and well cooked, it may be taken even by +infants without harm.</p> + +<p>Rhubarb, or “pie plant,” is eaten stewed, and +<span class='pagenum'><a name="Page_143" id="Page_143">[Pg 143]</a></span>made into pie. It is said to be somewhat laxative, +and is decidedly more wholesome than many others. +The squash, when properly cooked is comparatively +wholesome, but contains little nourishment, and is +of no particular value as a food, and the pumpkin +is not much better, although useful during the winter +for making pies after the ordinary vegetables +and fruits are gone.</p> + +<p>Cranberries, when thoroughly cooked and separated +from the hulls, form the basis of a delicious jelly +that is widely eaten in the winter over all portions +of the United States. Like all sweets it is not entirely +wholesome for dyspeptics or infants, but as it +is usually eaten with meats and not in great quantities, +it may be looked upon as being one of the +most wholesome of all foods of this class. It does +not seem to have such a tendency to produce sour +stomach in many dyspeptics as is so frequently done +by other foods containing vegetable acids.</p></div> + + + + +<h2><a name="CHAPTER_IX" id="CHAPTER_IX"></a>CHAPTER IX</h2> +<p><span class='pagenum'><a name="Page_144" id="Page_144">[Pg 144]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>DANGER IN FRUITS AND PICKLES</h3> + + +<p>It is an error shared almost universally by +both medical men and the laity that fruits and +raw foods are wholesome. Everyone is familiar +with the fact that fruits produce intestinal +disturbances in children,—not only when +they are very young, but after their digestive apparatus +is fully developed. Rather curiously, +however, instead of ascribing the disturbances +that follow to the real cause, we generally dismiss +the matter with the assertion that “early +fruits are unhealthy,” or trace the resulting ill +effects to some other equally imaginary factor. +In reality the reason why diarrhœa and other +intestinal troubles so often occur after eating +fruits in the early spring is that the boy or girl +after a winter's fast greedily devours enormous +quantities of them when they first ripen, and +disturbances follow in proportion to the amount +and character of these substances taken.<span class='pagenum'><a name="Page_145" id="Page_145">[Pg 145]</a></span></p> + +<p>There can be no question that fruits, while +extremely palatable, usually produce trouble in +dyspeptics, and even in those who still possess +unimpaired digestive organs ill effects quite +constantly follow on the heels of the taking of +food of this character. Unfortunately, however, +the great majority of dyspeptics have +symptoms that in no way outwardly point +toward digestive errors; as common examples, +we might refer to the blackheads, pimples and +small boils, so frequently observed on the faces +of young boys and girls, or the rheumatic pains, +and, at a later time, the “Bright's disease,” that +occur in older people. When you tell such patients +that their trouble is indigestion, they are +often mildly indignant, and loudly protest that +they can eat anything with impunity; that they +never have heart-burn, feelings of heaviness +after eating, pains in the abdomen, or other +symptoms referable to the stomach and intestines. +We are rather disposed to be proud of +our digestive powers, just as we are of our bodily +strength, and nothing is more common than +for chronic dyspeptics to maintain that they +have never had indigestion in their lives,<span class='pagenum'><a name="Page_146" id="Page_146">[Pg 146]</a></span> +and to resent any insinuation to the contrary.</p> + +<p>Another popular error, almost universally accepted, +is that fruits are highly nutritious; as +a matter of fact they consist almost wholly of +water, and of materials that are utterly indigestible. +The latter substances pass through +the alimentary tract, therefore, in much the +same condition that they enter and serve no better +purpose than to promote, somewhat, activity +in the bowels. Nevertheless the writer does not +wish to be misunderstood as advocating total +abstinence from such a palatable class of foods; +no harm results in most people if they only take +perfectly ripe and fresh fruits in moderation +now and then; and these should be always eaten +after meals rather than before.</p> + +<p>The fruits that contain comparatively little +acid are, as a rule, more wholesome than those +that are rich in substance of this kind. For +example, perfectly fresh and ripe figs or peaches +may be taken by most persons with impunity +if they be eaten after meals, and at intervals +of at least two or three days. Acid fruits, particularly +lemons, seem to be peculiarly unwholesome;<span class='pagenum'><a name="Page_147" id="Page_147">[Pg 147]</a></span> +apples are prone to cause trouble and can +rarely be eaten without ill effects, however mellow +and palatable they may be. It sometimes +happens that persons take grape-fruit with less +harm than others.</p> + +<p>Closely akin to fruits in their deleterious action +on the digestive apparatus are sours in any +form whatever. Women, especially, indulge +freely and at irregular hours in foods containing +much vinegar, lemon-juice, etc.,—usually in +the form of pickles or salads. In healthy persons, +in moderation, foods of this character perhaps +produce no appreciable trouble, but nothing +is more thoroughly established than that +they act harmfully on the general run of dyspeptics, +such as most of us are to a greater or less +degree after thirty years of age. This leads to +the remark that here, as in everything else, we +must regard individual peculiarities—it being +true that one person can eat without ill effects +what may produce decided disturbances in +others, or suffer from excess when moderation +would entail no ill-effects.</p> + + + + +<h2><a name="CHAPTER_X" id="CHAPTER_X"></a>CHAPTER X</h2> +<p><span class='pagenum'><a name="Page_148" id="Page_148">[Pg 148]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>DRINKS—PROPER AND HARMFUL</h3> + + +<p>An immense amount of rubbish has been written +during the last few decades concerning the +supposed good effect of excessive water-drinking +on the human economy. Something like a +quarter of a century ago a London physician by +the name of Haig brought forward and strenuously +advocated the view that a large number +of minor ailments were the result of the presence +in the body of excessive quantities of uric acid; +applying the well known fact that the substance +just mentioned requires a large amount of +water to dissolve it he conceived the idea that +the proper remedy was to flood the body with +enormous quantities of liquids, and thus, as it +were, wash the offending substance out of the +system. So plausible did he make this theory +appear that it was accepted very largely by medical +men, who in turn taught it to the general +public. Within recent times it has been fortunately<span class='pagenum'><a name="Page_149" id="Page_149">[Pg 149]</a></span> +shown that Haig's theory was wholly +chimerical, and that quantities of uric acid +greatly in excess of the normal amount could +collect in the body, or might be injected into +the blood-vessels, without the least harm resulting; +thus, at one blow, this widely accepted +theory was annihilated, and there now remains +no sort of reason for attempting to remove uric +acid by excessive water-drinking, or by other +means.</p> + +<div class="blockquot"><p>It is fortunate that the uric-acid theory has been +disproved, for the excessive use of water is not only +unnecessary, but highly injurious to the digestive +organs, particularly when the fluids are taken at or +about meals. Experience has shown that excessive +stomach-acidity, which is the most common form of +indigestion, is in a large degree dependent on the +taking of liquids while eating, and that even in those +who are healthy any more than small quantities +cannot be looked upon as being wholesome. In +dyspeptics liquids seem to act in a hurtful way in +several different directions. For example, where +persons constantly take liquids while eating the necessity +of properly chewing the food is largely done +away with; in addition to this the mere presence of +water in the stomach seems to tend to the production +of increased acidity, for it has often been observed +by the writer that even where food was eaten dry +<span class='pagenum'><a name="Page_150" id="Page_150">[Pg 150]</a></span>indigestion would follow in many dyspeptics if +they took water just before or immediately after +eating.</p></div> + +<p>The only sensible advice that can be given in +this connection is that persons should take no +more liquids that they feel a desire for, and +they should avoid taking them in any quantity +about meal time. What has just been said concerning +water applies equally well to milk. +When taken alone it very frequently agrees with +patients much better than does solid food, but +when mixed with the latter is prone to produce +indigestion, just as does water. Fermented +milk in the form of buttermilk is a very popular +beverage in some parts of the world, but +it may be well doubted as to whether it deserves +the reputation for wholesomeness generally accorded +it; being a liquid, and at the same time +acid, it is peculiarly prone to increase acidity, +and is not tolerated by persons who suffer with +sour stomach. It should, however, be said that +it, on the other hand, seems to agree particularly +well with some people, and has been known +when taken alone, at least temporarily, to relieve +obstinate forms of indigestion.<span class='pagenum'><a name="Page_151" id="Page_151">[Pg 151]</a></span></p> + +<p><i>Coffee.</i>—The most universal beverage taken +at meal time in America is undoubtedly coffee. +Each morning countless thousands are cheered +and stimulated by its invigorating properties to +undertake their daily tasks, but, as is always the +case after taking drugs that have such action +the system has to pay the penalty in a reaction +following later, during which the capacity for +work is diminished. It is, however, true that +the effect last referred to is not of such importance +as to constitute in itself a serious objection +to the use of coffee, but other ill results +are rather prone to ensue that in many instances +change the aspect of the question entirely. In +a great many people, particularly after the first +vigor of youth has passed, coffee produces anything +but pleasant effects, and on some it seems +to act as a downright poison. Like all liquids +taken at meal time, it predisposes to acid indigestion, +particularly when it is sweetened. It +is likewise true that when it contains any considerable +quantity of cream the liability to +dyspeptic disturbances following its use are particularly +great—doubtless as a result of the considerable<span class='pagenum'><a name="Page_152" id="Page_152">[Pg 152]</a></span> +quantity of melted fats that it contains +under such circumstances.</p> + +<div class="blockquot"><p>From the foregoing it appears then that coffee +without either cream or sugar is less unwholesome +than when these substances are added to it, but even +when it is taken in this way it causes decided symptoms +of indigestion in many persons. The writer +is not of the opinion that the habitual taking of +coffee is to be commended, and would, therefore, +not advise its constant use; it, however, must be admitted—as +is the case with all other substances that +cause indigestion—that in many people, and particularly +in those who live out-of-doors and are actively +engaged in physical occupations, the use of coffee +seems to result in no harm. Like other substances +that cause indigestion in a concentrated form, coffee +when largely diluted is less apt to produce disturbances +of this kind; for example, a beverage consisting +of two-thirds of hot skimmed milk and one-third +coffee may be taken by many dyspeptics in +reasonable amounts without any particular harm. +Parents should be warned against allowing growing +children to drink coffee; it seriously interferes with +the normal chemical changes going on in their bodies, +and is almost certain to be followed in later life by +nervous dyspepsia.</p></div> + +<p><i>Tea.</i>—The stimulating principle of tea is +chemically so nearly like that of coffee that they +are generally considered as being one and the<span class='pagenum'><a name="Page_153" id="Page_153">[Pg 153]</a></span> +same. That they differ decidedly in their action +on the stomach and the body generally +there can, however, be no doubt. The stimulating +action of tea comes on more slowly than +that of coffee, and is correspondingly prolonged. +In most persons it is not so apt to produce nervousness, +nor is its action in preventing sleep +so pronounced. On the stomach it also produces +effects that are diametrically opposed to +those induced by coffee, since, instead of stimulating, +it seems actually to retard the secretion +of acids. It is, therefore, probably true that we +should look upon tea as a beverage with much +less disfavor than we do coffee—though, of +course, it should always be remembered that +there may be, and unquestionably are, many exceptions +to this judgment.</p> + +<div class="blockquot"><p>Probably no other daily article of food or drink +is so commonly prepared in an improper manner as +tea—which is all the more curious when we consider +that perhaps none other that requires heat for its +preparation is so easily made. It should be brewed +by simply pouring boiling water upon the leaves, +but the vessel containing the decoction should not +be placed over the fire while the tea is being prepared. +Of even greater importance is the necessity +of allowing the water to remain in contact with the +<span class='pagenum'><a name="Page_154" id="Page_154">[Pg 154]</a></span>leaves only a few moments—<i>never more than a +minute if we wish the tea to be good</i>. The reason +for the latter precaution lies in the fact that tea-leaves +contain a considerable amount of tannic acid, +and, as the longer the water and leaves remain together +the more of this substance is extracted from +the latter, it is not difficult to see that we should +be careful to allow only a brief contact between the +two; the presence of this acid is undesirable, not only +on account of the fact that it gives to the decoction +a bitter and unpleasant taste, but because it has a +tendency to cause digestive disturbances. It is seemingly +not generally known that there are many +varieties of tea, and that some of them are so superior +in flavor and bouquet to others that they +might well be entirely different substances. The +best of all (in the writer's opinion) are those that +are composed largely of leaves grown in Ceylon, +usually mixed with India tea. If we will demand +of our grocer a first-class Ceylon tea we will find +that a beverage may be made from it that will appeal +quite as much to the palate as a good coffee.</p> + +<p>Before dismissing this subject finally, some reference +should be made to ice-tea. This beverage is +exceedingly palatable when properly prepared, and +under such circumstances by no means deserves the +disfavor with which it is regarded by many. The +latter circumstance is entirely due to two things; +first, we find too frequently that it is the habit of +house-keepers to pour boiling water on the leaves +when the midday meal is cooked and to allow them +<span class='pagenum'><a name="Page_155" id="Page_155">[Pg 155]</a></span>to soak together until night, and second, the fact +that lemon-juice is very commonly added to the tea +before being drunk. The ice that the tea contains +has little or nothing to do with the dyspeptic disturbances +that frequently follow the drinking of cold +tea. If we will leave out the lemon and pour off the +water after it has been in contact with the tea leaves +for something like a minute, it will be discovered that +practically all of the ill effects usually ascribed to +this palatable beverage have been done away with.</p></div> + +<p><i>Alcohol.</i>—A discussion of beverages would +not be complete without some mention of those +containing alcohol. This at once brings us face +to face with the bitter controversy on this subject +that has been waged so long throughout +the United States, and which can only be considered +here from the standpoint of the effects +of alcohol on the human economy, and to draw +corresponding conclusions.</p> + +<p>That alcohol, even in very small quantities, +reduces the general strength and capacity for +work there can be no question, and in addition +we find from experiments carefully conducted on +the lower animals that the liability to infection +by various disease-producing germs is greatly +increased by the administration of even minute<span class='pagenum'><a name="Page_156" id="Page_156">[Pg 156]</a></span> +amounts of the drug. A man then who is a +habitual user of alcoholic drinks not only +thereby diminishes his capacity to labor effectually, +but at the same time renders himself +more liable to disease. No more striking example +of this could be brought forward than the +well established fact that persons who use alcohol +are exceedingly prone to consumption—so +true is this, indeed, that we might almost look +upon the drug as being practically the cause of +this disease in most instances. Of course the +bacillus of tuberculosis must be present in order +for the malady to develop, but we find that the +alcohol has prepared a soil for the growth of +the germ which would not otherwise exist. +This holds with equal force as regards other infectious +diseases.</p> + +<p>Again, it is true that maladies that result +from bad digestion and improper assimilation +are frequently produced by the habitual use of +alcoholic liquors. Gout and Bright's disease +are in the vast majority of cases the indirect off-spring +of habitual drinking. It should be noted—and +the distinction is of importance—that the +affections of a grave character most frequently<span class='pagenum'><a name="Page_157" id="Page_157">[Pg 157]</a></span> +produced by the alcoholic habit do not ensue as +a consequence of what could be rightly called +intemperate taking of the drug,—its moderate +use more commonly resulting in serious disease +than when it is taken in great excess.</p> + +<div class="blockquot"><p>The explanation of this probably lies, at least in +part, in the fact that the majority of drunkards +only take alcohol at greater or less intervals, and as +a consequence the system has time to recuperate between +sprees. The typical dipsomaniac goes weeks, +months, and even years without drinking at all, but +when he is seized by the desire for drink he throws +everything else aside and spends days and weeks in +a prolonged debauch; during this period he eats very +little, and as a consequence largely avoids the grave +dyspeptic disturbances that would otherwise inevitably +result. Alcoholics of this class acquire catarrhal +conditions of their stomachs, and if seized with some +acute disease, like pneumonia, during or just after +a spree, quickly die in a large proportion of cases, +but they do not develop gout or Bright's disease as +a rule, nor do they very commonly become consumptive, +as is the case with those who take the drug in +small quantities day by day. Furthermore, it would +appear that the grave disorders that so frequently +follow the long-continued use of alcohol cannot be +said to be the direct result of the use of the drug, +but ensue as a consequence of the stimulating action +of the alcohol on the appetite, leading to over-eating.<span class='pagenum'><a name="Page_158" id="Page_158">[Pg 158]</a></span> +Under such circumstances indigestion follows +from excessive over-feeding, and this is added +to by the naturally irritating effect of the alcohol +on the stomach. When this is continued through a +series of years, the assimilating power of the organism +gradually deteriorates, and we begin to meet +with chronic dyspepsia, acute Bright's disease, and +cirrhosis of the liver. Let no one then consider that +he is not misusing alcohol for the reason that he +only takes a drink before meals—it would be far +better if he were to go on a moderate spree occasionally.</p></div> + +<p>In this connection mention should be made of +the great evil of patent medicines containing, +and in reality essentially consisting, of alcohol. +A vast number of them are widely sold under +the misleading statement that they relieve catarrh, +cure diseases of the kidneys, and that they +act as tonics and general invigorants of the entire +system. Masquerading under one guise or +another they are sold to the unsuspecting public—prohibitionists +for the most part—who fondly +imagine that their glass of “bitters,” “liver-regulator,” +or “safe cure for the kidneys,” is entirely +harmless. Let all such be warned that +with scarcely an exception patent medicines of +this class are nothing more nor less than poor<span class='pagenum'><a name="Page_159" id="Page_159">[Pg 159]</a></span> +whisky containing some bitter to disguise the +taste, and that they are in fact taking a drink +when they use nostrums of this kind. The ultimate +effect of this kind of drinking is to produce +serious and grave diseases.</p> + +<p>This discussion of the effect of alcohol on the +human body would not be complete without calling +attention to the extraordinary fact that those +peoples to whom we owe our modern civilization +have from time immemorial, most of all others, +consumed the greatest amount of alcohol. Explain +it as we may, the fact remains that the +greatest achievements of the world were brought +about by a society in which a very large proportion +of its members were in the habit of more +or less constantly taking alcoholic beverages. +Naturally, the query is forced upon us whether +this drug may not have played some important +part in the great results achieved. Unfortunately, +no one can answer one way or another, +but our very ignorance should emphasize the importance +of looking at the question from every +side, and not jumping at conclusions before they +are warranted by facts. It is true that most of +our positive knowledge on this subject would<span class='pagenum'><a name="Page_160" id="Page_160">[Pg 160]</a></span> +condemn alcohol as being the greatest curse of +the ages, but it may be that it has played a +beneficent part in the affairs of mankind +through devious paths impossible to trace. Unquestionably +a drug, the taking of which assists +us in momentarily throwing our troubles +aside, must be of a certain positive value to +mankind. If only it possessed these good qualities +with none of its bad ones!</p> + +<p>Having considered very briefly the general effects +of alcohol on the system a few remarks +may be appropriately made concerning the several +beverages commonly consumed in the +United States for which it serves as a basis.</p> + +<p><i>Whisky.</i>—Under the term whisky will here +be included all of those stronger alcoholic beverages +that are the product of distillation. In +addition to those commonly designated as such +we may reckon brandy, gin, and rum, and at +the same time those subtle combinations called +mixed-drinks, for which they serve as a basis. +It will, perhaps, startle the average reader when +the statement is made that whisky and its near +relatives just referred to, particularly when diluted +by water, are by far the least harmful of<span class='pagenum'><a name="Page_161" id="Page_161">[Pg 161]</a></span> +all alcoholic drinks. Their bad reputation lies +in the fact that on account of their large percentage +of alcohol they are usually preferred by +drunkards, and that when consumed in excessive +amounts by those unaccustomed to their +use there often follow those frightful crimes +with which these particular forms of alcohol +are so odiously associated. The facts are, however, +that when taken in moderation they are +much less prone to produce indigestion than +wines or malt liquors, and where one is determined +to drink, they should unquestionably +receive the preference. It should not be understood +that the writer is in any way advocating +their use, but the facts of experience compel +him to state frankly that the least harmful of +all alcoholic beverages is whisky, or its near +relatives.</p> + +<p><i>Wines.</i>—There are a large number of fermented +juices of fruits that are known as wines. +They are either sweet or acid in taste, and both +are peculiarly prone to induce dyspepsia in +persons with delicate stomachs. Irrespective +of their delicate flavor, which, in many instances, +appeals strongly to the palate, the only<span class='pagenum'><a name="Page_162" id="Page_162">[Pg 162]</a></span> +virtue that they may be said to possess is that +they contain alcohol in small amounts; this, +however, is off-set entirely by their large percentage +of sugars and acids, causing them to be +much more unwholesome than plain whisky.</p> + +<p><i>Beers and Malt Liquors.</i>—It is very fortunate +that in those states of the American Union +that have recently enacted prohibition laws, +beer and other malt liquors are now being +widely sold under the plea that they are non-intoxicating +and that they are in no way unwholesome. +While it is true that the former +claim is in a measure correct, it is a fact well +understood by those who have given the matter +study that they are perhaps the most unwholesome +of all alcoholic beverages. Those in the +habit of using them are almost universally +under the impression that they are harmless, +and as the taste for them is easily cultivated, +those who once acquire the habit are very apt +to take them in greater or less quantities daily. +As a result of this, chronic digestive disturbances +are always sooner or later set up, and the +victim in the course of time often acquires a +gouty tendency, which is all the more dangerous<span class='pagenum'><a name="Page_163" id="Page_163">[Pg 163]</a></span> +for the reason that in America it scarcely +ever manifests itself in acute joint inflammations. +The patient gets into what has been +called a “lithemic” state, which is but another +name for gout, and sooner or later is exceedingly +apt to develop a chronic form of Bright's +disease. It is greatly to be deplored that some +of our professional national school-masters do +not address themselves to this subject rather +than to appealing to the worst passions of the +ignorant in attacking the great institutions of +our country, and in assailing the fundamental +principles of our government that come down to +us as a priceless heritage from the wise and +patriotic statesmen who first brought our nation +into life.</p> + +<p>In addition to the three great classes of alcoholic +beverages already considered there are +innumerable others, fortunately but little known +to the general public, and prized only by connoisseurs +in such matters. As we happily have +no problem confronting us in any way similar +to the absinthe-habit, so common in France, it +is not deemed necessary here to do more than +merely to refer to them.</p> + + + + +<h2><a name="CHAPTER_XI" id="CHAPTER_XI"></a>CHAPTER XI</h2> +<p><span class='pagenum'><a name="Page_164" id="Page_164">[Pg 164]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>IMPORTANCE OF GOOD COOKING</h3> + + +<p>Reference has already been made to certain +misconceptions concerning cooking diligently +circulated in recent years by various quacks. +The victim is advised that he must take large +quantities of raw eggs and milk, and at the +same time is instructed to eat a number of +other specially prepared articles furnished at +a stiff price and certified as being raw by the +“medical company” furnishing the “treatment.” +Since it is quickly discovered by those +who are entrapped by charlatans of this kind +that the only raw foods that they can take with +comfort and without disgust are milk and eggs, +they naturally practically live on these alone, +and as these foods are extremely digestible and +nutritious, improvement in the patient's condition +not uncommonly results.</p> + +<p>Nevertheless, it is unquestionably true that +the vast majority of foods are greatly improved<span class='pagenum'><a name="Page_165" id="Page_165">[Pg 165]</a></span> +in digestibility, and are rendered much more +palatable by thorough cooking. After being +properly cooked there develop in foods certain +flavors and odors that are highly appetizing, +and unquestionably aid in the subsequent digestion +of the same. With but few exceptions, +foods are so altered by heat that their proper +mastication becomes much easier, and cooking, +therefore, materially aids in reducing them to a +state in which they are much more readily acted +upon by the digestive juices. It should never +be forgotten, also, that cooking is of the utmost +importance from the standpoint of killing +bacteria and animal parasites that may be present +in food. If we were to adopt universally the +habit of eating everything raw, the general +mortality would certainly be considerably increased.</p> + +<p><i>Cooking of Starchy Foods.</i>—Nothing in the +whole art and science of preparing food for +the human being is of so much importance as +the proper cooking of starches. As a result +of the heat employed, certain chemical changes +are induced in the starch-granules, as a consequence +of which they are rendered digestible.<span class='pagenum'><a name="Page_166" id="Page_166">[Pg 166]</a></span> +It is of fundamental importance that at all +times and under all circumstances the cooking +of this class of foods should be as thorough as +is possible, for when this is not done digestive +disturbances are sure to follow, and much of +the food is actually wasted. There are but few +cardinal principles in the ordinary hygiene of +life that are so commonly neglected as this, +since it is the habit of a large proportion of the +American people to consume three times a day +masses of tenacious starch which has not been +acted upon by heat sufficiently to render it digestible.</p> + +<p>Of all the different methods of cooking +starches, by far the most common, and, therefore, +the most important, is the process called +baking. While it is not possible in this volume +to go into the subject with the thoroughness +that it deserves, the principal points deserve +some mention. They may be briefly stated as +follows:</p> + +<div class="blockquot"><p>(1) The flour must be made into a dough in which +are incorporated substances that produce a gas called +carbon dioxide, which, forming in innumerable small +bubbles throughout the mass, cause the whole to +<span class='pagenum'><a name="Page_167" id="Page_167">[Pg 167]</a></span>swell; when this is completed the bread is said to +have “risen.” Of course the object of this is to +produce a thorough breaking up of the sticky dough—with +the result that when the bread is finally +cooked it is light and fluffy, and can be readily masticated.</p> + +<p>(2) After the process just described has been +completed the bread should be thoroughly cooked, +for reasons which have already been explained.</p> + +<p>(3) After cooking has been accomplished the bread +should be thoroughly dried, either by keeping it hot +until this occurs, or, what is better, permitting it +to remain warm for a time and then allowing the +process to be completed in a natural way by putting +the bread aside for several days. It is necessary for +bread to be dried in order that it may be thoroughly +soaked in saliva during the process of chewing.</p></div> + +<p>If the principles above enunciated be properly +followed out, good wholesome bread will result. +There are, of course, many details connected +with the preparation of food known to +expert cooks into which it will not be possible +for us to go here, and for which the reader is +referred to any good cook-book.</p> + +<p>Some starchy foods such as rice and potatoes, +do not lend themselves readily to the production +of breads, and are consequently usually +cooked in some other manner. It cannot be<span class='pagenum'><a name="Page_168" id="Page_168">[Pg 168]</a></span> +too strongly insisted upon that they should be +rather <i>steamed</i> than boiled,—the process being +usually carried out by placing a small +amount of water with them and allowing it to +boil away; we should remember also that the +principles just insisted upon in connection with +making bread apply here with equal force—we +should cook thoroughly and serve both as +dry as is possible.</p> + +<p><i>Cooking of Meats.</i>—Here again it is necessary +to insist upon the necessity of thorough +cooking. The error has long prevailed that +raw meats are wholesome, but within recent +years it has been clearly demonstrated that this +old view is erroneous. The muscle-fibers that +constitute the bulk of the nourishment of meats +are separated from each other by a substance +which cannot be acted upon by the juices of the +stomach until it has been heated to a temperature +which results in the cooking of the entire +mass. It is true that the muscular substance +proper may be digested without heat—resembling +in this way the white of the egg, to which +it is chemically closely related; by scraping meat +with some dull instrument the muscle fibers may<span class='pagenum'><a name="Page_169" id="Page_169">[Pg 169]</a></span> +be separated in a more or less pure state—leaving +the substance that requires heat in order +to become digestible behind—and after having +been removed in this way, of course, may be +eaten in a raw or semi-cooked condition without +ill effects. In preparing meat it is not absolutely +essential that it be cooked until +thoroughly “done”—a slight tinge of red being +allowable.</p> + +<p><i>Healthful Recipes.</i>—In an <a href="#APPENDIX">Appendix</a> to this +volume will be found a series of recipes for +the preparation of common foods, for which +the author is indebted to Dr. Mary E. Lapham, +of Highlands, N. C. They will be found extremely +practicable for making not only very +palatable but thoroughly wholesome dishes; and +are earnestly recommended to young housewives, +who err through ignorance, as a rule, +rather than because of carelessness or of lack +of good materials. It has often been said that +the road to a man's heart lies through his +stomach. It would not be surprising to learn +that this aphorism fell first from the lips of +some wise woman who had observed that in a +great number of cases unhappiness in home-life<span class='pagenum'><a name="Page_170" id="Page_170">[Pg 170]</a></span> +had resulted primarily from lack of home-comfort, +and chiefly from unvaried, unappetizing +meals and table-service. Another point is well +worth remembering, especially by young married +women: a man whose home is pleasant and +comfortable is likely to spend as much of his +time there as he can—if it is otherwise, he will +seek some place that has these desirable qualities, +such as his club, or an arm-chair in some +corner saloon. Furthermore, a man who is not +only abundantly, but <i>nicely</i> fed, has far less desire +for the stimulants which lead to drunkenness, +than the man who is denied at home the +properly cooked and seasonably varied food +which his system craves. No better work in +the “Temperance cause” can be done than to +make an attractive home.</p> + +<p>These are facts which many a young housewife +needs to learn and keep in mind; and it is +for her benefit that Dr. Lapham has prepared +her simple but excellent cooking directions presented +in the <a href="#APPENDIX">Appendix</a>.</p> + + + + +<h2><a name="CHAPTER_XII" id="CHAPTER_XII"></a>CHAPTER XII</h2> +<p><span class='pagenum'><a name="Page_171" id="Page_171">[Pg 171]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>SEVEN AVOIDABLE DISEASES</h3> + + +<h4>MALARIA FEVER.</h4> + +<p>Malaria, in its various manifestations, has +ever constituted the principal obstacle to the +civilization of all tropical and semi-tropical +countries, and as a consequence vast tracts of +the richest and fairest portions of the world +have remained uncultivated and unredeemed +from their primitive savage state. Recent investigations +have shown that this disease can +be easily prevented if the matter is taken up intelligently.</p> + +<p>Malaria is a disease produced by a parasite +belonging to the very lowest order of animal +life—the <i>Plasmodium malaria</i>, which is conveyed +from man to man by that genus of +mosquitoes called the Anopheles. The parasite +attacks and destroys the red cells of the +blood, and produces a poison that causes the +symptoms characteristic of malaria.<span class='pagenum'><a name="Page_172" id="Page_172">[Pg 172]</a></span></p> + +<p><i>Course of the Disease.</i>—The most common +and well-recognized symptoms of malaria are +those that occur in that variety of the disease +which is known as malarial or intermittent +fever. In this type the patient—who may or +may not have at intervals for some days +noticed chilly sensations, a feeling of fullness +in the head, and general bodily depression—is +suddenly seized with a chill followed by a high +fever and subsequent profuse perspiration; +after these symptoms subdue, which generally +requires several hours, the patient returns to +a practically normal condition and feels, on +the whole, well until the next attack occurs. +These chills-and-fever paroxysms occur at various +intervals depending upon the character of +the parasite inducing them, the most common +form being that which produces a chill every +day. In some instances the malady comes on +more insidiously, there being no marked chills +but only periodical elevations of temperature.</p> + +<p>In the more chronic forms of the disease the +unfortunate victim is frequently subjected for +years to attacks of fever coming on at irregular +intervals, the patient being more or less of<span class='pagenum'><a name="Page_173" id="Page_173">[Pg 173]</a></span> +an invalid throughout the course of the disease. +In other instances the brain becomes affected, +producing very alarming symptoms; and +in quite a proportion of cases the malady ultimately +terminates in chronic Bright's disease.</p> + +<p><i>Treatment of the Disease.</i>—Most fortunately, +we have in quinine, when properly administered, +a medicine that in practically all instances acts +as a specific in this affection; but it should be +used only on the advice and under the directions +of a physician. In the more chronic +forms of the disease, combinations of arsenic, +with such tonics as nux vomica, iron, and small +doses of some of the preparations of mercury, +produce permanent cures where quinine has +failed. It is of the utmost importance that attention +be given to the treatment, as, so long as +the patient remains with the parasites in his +blood, so long is he a menace to his friends and +neighbors.</p> + +<p><i>Mode of Infection Through Mosquitoes.</i>—The +most brilliant triumph in modern medicine, +and one of the most creditable achievements +of human ingenuity, has been the absolute +demonstration that malaria is carried<span class='pagenum'><a name="Page_174" id="Page_174">[Pg 174]</a></span> +from man to man by means of the Anopheles +mosquito, and that the disease can, in nature, +be produced in absolutely no other way. This +is not a theory, but it is a fact which has been +demonstrated in its every detail beyond dispute, +and we are now happily in a condition to reject +our venerable notions concerning bad air, +miasma, etc.</p> + +<div class="blockquot"><p>Before describing the method by which infection +takes place, it is well to say a few words concerning +the mosquito that acts as a carrier of the disease, +which may be easily differentiated from other similar +gnats. The malarial mosquito has a body which is +placed parallel to and almost on the same plane with +the front portions of the insect, and as a consequence, +when at rest on walls or other objects, the back of +the body sticks out almost or quite at right angles +with the surface upon which it is resting. The back +portion of the common mosquito forms an angle with +the front part of its body, with the effect that both +ends of the insect point toward the object upon which +it rests. There are still other differences that clearly +differentiate the malarial from the common mosquito, +but the one given ordinarily serves to distinguish +between them. The malarial mosquito is pre-eminently +a house-gnat, being scarcely ever seen in the +woods or open, but may be found—oftentimes in +great numbers—in all malarial localities, lying quietly +during the day in dark corners of rooms or stables. +<span class='pagenum'><a name="Page_175" id="Page_175">[Pg 175]</a></span>This mosquito practically never bites in the day, but +will do so in a darkened room, if a person will remain +perfectly quiet; their favorite time for feeding +is in the early parts of the night and about +daybreak—all of which accounts for the fact, long +observed, that malarial fever is almost invariably +contracted at night. The malarial mosquito bites +and then goes back to some dark corner where it +remains quiescent for forty-eight hours, at the end +of which time it again descends to feed. Contrary +to the general opinion mosquitoes bite many times, +and frequently remain alive for months—the malarial +mosquito particularly living in cellars and attics +oftentimes throughout the entire winter.</p> + +<p>If one of these mosquitoes bite a person with +malaria, the parasites are sucked in along with the +blood and pass into the stomach of the gnat, making +their way ultimately into the body substance; here +the parasites undergo a series of multiplications, a +single one of them sometimes producing as many +as ten thousand young malarial parasites. After +the parasites have developed fully, which requires +eight days in warm weather, they make their way +to the venom-gland of the mosquito and there remain +until it bites, when they are injected into the +body of the individual attacked along with the poison.</p> + +<p>After getting into the human blood, each parasite +attacks a red-blood cell, bores into it, and grows at +the expense of the cell until it reaches maturity, at +which time it divides up into from seven to twenty-five +young parasites which are liberated and each in +<span class='pagenum'><a name="Page_176" id="Page_176">[Pg 176]</a></span>turn attacks a new cell. This process goes on until +a sufficient number of parasites are produced in the +individual to cause the symptoms of malaria, and the +new subject of the disease thereafter becomes a source +of danger to others in the vicinity through the intervention +of still other malarial mosquitoes.</p></div> + +<p><i>Malaria Avoidable.</i>—From the foregoing it +is seen that the proper way to avoid malaria +is so to screen houses that mosquitoes cannot +enter them. Persons in malarial districts +should not sit on open porches at night, and +should be careful to sleep under properly constructed +nets. If this be done, there is absolutely +no danger of anyone ever contracting the +disease. It will be well observed that these precautions +are not necessary in the daytime, as +the malarial mosquito rarely attempts to bite +during this period.</p> + +<p>It should be remembered by those who have +the disease that they are a constant source of +danger to people living in the vicinity, and +they should be doubly careful as long as the +disease persists to avoid being bitten by mosquitoes +at night. It is furthermore their duty +to vigorously treat the disease until the parasites<span class='pagenum'><a name="Page_177" id="Page_177">[Pg 177]</a></span> +are no longer present in their bodies, at +which time they cease to be a menace to others.</p> + +<p>Many children have malaria without showing +symptoms, and, if allowed to sleep without +being properly covered with a net, are very apt +to infect a large number of malarial mosquitoes; +the blood of children in malarial localities +should be examined from time to time, and +if the parasites be found, the children should be +given the proper remedies until a cure is effected.</p> + +<p>Particular attention should also be directed +to the fact that almost all Negroes in malarial +localities of the South harbor the parasites, +though very few of them show symptoms of +their attacks. It is, therefore, very important +that they be treated properly, and their white +neighbors should see to it, for their own safety, +that they do not sleep in houses unprotected +by nets.</p> + +<p>If the precautions herein detailed were properly +carried out, for even a few months, malaria +would practically cease to exist wherever this +was done, and would not recur unless individuals +from other places suffering from the disease<span class='pagenum'><a name="Page_178" id="Page_178">[Pg 178]</a></span> +were to come into the districts where the +Anopheles mosquito is present, and so give it +to the gnats—to be by them recommunicated to +humanity.</p> + + +<h4>TUBERCULOSIS.</h4> + +<p>Of all the enemies of mankind, tuberculosis, +in its various forms, takes the first rank. Of +protean manifestations, occurring in almost +every part of the body and producing diseases +of the brain, of the nerves, of the bones, of the +skin, and of all of the internal organs—pre-eminent +is the terrible malady we call consumption, +which is tuberculosis of the lungs. It has +been estimated that one-seventh of all the people +born into the world die as a result of this +malady in some one of its various forms, and it +is probable that one person out of every three +dying between the ages of fifteen and sixty +years, succumb to this disease. As a result of +the labors of thousands of patient, self-sacrificing +investigators—many of the most distinguished +of whom have died of this disease +while carrying on their work—the peculiarities +of this affection are now fairly well<span class='pagenum'><a name="Page_179" id="Page_179">[Pg 179]</a></span> +understood, and if we were to apply the knowledge +which we now possess in our attempts +to free ourselves from its ravages, there is no +question but that within a comparatively short +period of time the disease would practically +cease to exist.</p> + +<p><i>Character and Course of the Disease.</i>—Tuberculosis +is produced by a minute vegetable parasite +known as the <i>Bacillus tuberculosis</i>, a germ +which not only occurs in the human being, but +is widely distributed among the lower animals. +Tuberculosis of the lungs (to restrict ourselves +to this most important manifestation) generally +comes on insidiously, there being usually no +definite period from which the sufferer can date +the onset of the malady. In the early stages +there is usually loss of appetite and a pronounced +feeling of weakness followed by a +slight cough; the latter symptom frequently +leads patients to erroneously believe that their +trouble began with a bad cold, when as a matter +of fact, the catarrhal trouble of the throat and +bronchial tubes was originally produced by the +germs of tuberculosis—there being no such +thing as a cold changing into consumption. As<span class='pagenum'><a name="Page_180" id="Page_180">[Pg 180]</a></span> +the disease progresses the patient complains of +fever and chills, these symptoms being oftentimes +periodical, and lead to the belief that the +trouble is malarial fever: this mistake is very +common, and whenever such symptoms appear +a good physician should be immediately consulted. +The patient also suffers from exhausting +night-sweats in many instances, though this +is not invariable. A rapid loss of flesh is one +of the earliest and most common symptoms. +The symptoms above enumerated continue and +grow worse, and in quite a proportion of the +cases there is, in addition, spitting up blood, +which in some instances may be so pronounced +that it becomes a distinct hemorrhage. In the +more rapid or “galloping” forms of the disease +the patient frequently dies within a few weeks +or a month or so, while in the less severe types +the malady may persist for many years before +death occurs.</p> + +<p><i>Treatment.</i>—The treatment of tuberculosis +by drugs has proven an entire failure, but a +large number of persons afflicted with this disease +will recover, if placed under proper hygienic +conditions.<span class='pagenum'><a name="Page_181" id="Page_181">[Pg 181]</a></span></p> + +<p>The patient should be put on a porch or in +a tent, whether it be winter or summer, and +kept in bed at absolute rest as long as there is +any fever, and should be fed in abundance with +good, wholesome food. While this treatment +appears simple it should always be carried out +under the directions of a physician, as it is +only possible for those having a thorough +knowledge of the subject to give such directions +as would lead to a rapid cure of the patient.</p> + +<p><i>Modes of Infection.</i>—Hereditary tuberculosis, +notwithstanding a popular idea to the contrary, +is very rare, but there is no question +that those persons in whose family tuberculosis +exists are much more prone to contract the +disease than others. In just what manner the +germ of consumption gains entrance to the +human body, we are more or less uncertain, but +there are reasons for the belief that in many instances +they pass in by means of the inhaled +air; there is no doubt that in a small percentage +of cases the bacillus gains entrance to the +body through an abrasion of the skin or of some +mucous membrane; finally the bacteria are<span class='pagenum'><a name="Page_182" id="Page_182">[Pg 182]</a></span> +often taken in with the foods that we eat, or +by putting objects upon which the germs are +present into the mouth, or eating with hands +which have been contaminated and not washed. +Of the foods that contain the germs of consumption, +milk is unquestionably the most common, +as there can be no question that fully 25 per +cent. of our cows have this disease, and under +such circumstances their milk is usually infected +with the bacillus that produces the malady; +meats, likewise, often contain germs of this disease, +but, as they are usually cooked, no harm, +as a rule, results.</p> + +<p>Of quite as much importance as the introduction +of the germ into the body is the resisting +power of the individual at the time when this occurs, +since the disease can make no progress unless +the tissues have become susceptible through +lowered resistance. All things then that have +the effect of lowering the vitality of the body +act as predisposing causes to consumption; +such, for example, as <i>WANT OF PROPER +FOOD</i>, <i>LACK OF SLEEP</i>, <i>IMPROPER +CLOTHING IN COLD AND WET +WEATHER</i>, <i>AND LIVING IN DAMP AND</i><span class='pagenum'><a name="Page_183" id="Page_183">[Pg 183]</a></span> +<i>IMPROPERLY VENTILATED HOUSES</i>; +excesses, <i>PARTICULARLY THE TAKING +OF ALCOHOL</i>, conduce to the development of +the disease—long-continued inebriety being beyond +doubt the cause that most frequently leads +to consumption. It is a common error that alcoholic +stimulants tend to ward off consumption, +and it is absolutely certain that these substances +not only do not act in a curative way in those +who have already contracted the disease, but are +positively detrimental. In order then to avoid +consumption—and this is particularly of importance +for those in whose family there is a +predisposition to the disease—the individual +should live soberly, should try at all times to +obtain a reasonable amount of good food, +should sleep a sufficient number of hours, and +should be clothed properly, particularly in the +winter. Those who devote their time and +energy to the performance of their work—being +careful of course not to labor excessively—are +much more apt to escape consumption than +those who do otherwise. It is particularly of +importance that those who have a tendency towards +consumption should early learn, and<span class='pagenum'><a name="Page_184" id="Page_184">[Pg 184]</a></span> +throughout life practice, the habit of <i>BREATHING +THROUGH THE NOSE</i>: if this rule be +followed a large percentage not only of the +germs of consumption, but other bacteria as +well, are filtered out during their passage +through the nose and do not reach the lungs. +Cleanliness is also of much importance—a bath +taken each morning in moderately cold water being +conducive to health, not only as regards consumption +but other diseases as well. It is of +course necessary that dwelling houses should be +kept thoroughly clean.</p> + +<div class="blockquot"><p><i>Advice to Diseased Persons.</i>—In all cases where +a person observes in himself, or in those for whom +he is responsible, the symptoms already detailed, +it is his duty to at once consult an intelligent +physician, and if it be found that tuberculosis is +present, every precaution should be taken by the diseased +individual to prevent the further spread of +the malady. <i>IN SUCH A CASE THE SPUTUM +THAT IS CONSTANTLY BEING COUGHED UP +CONTAINS MYRIADS OF THE GERMS</i>, and it is +of the utmost importance in order to prevent other +persons in the neighborhood from being infected that +this <i>SPUTUM BE DESTROYED</i>. The patient +should at all times carry about with him either a +small receptacle into which the sputum can be expectorated,<span class='pagenum'><a name="Page_185" id="Page_185">[Pg 185]</a></span> +or a large cloth which would answer the +same purpose, and in either case the sputum should +be burned; if this be impracticable, it should be +placed in some good antiseptic, such as a saturated +solution of carbolic acid or a 1-to-1,000 solution of +corrosive sublimate in water. The patient's handkerchiefs +should be thoroughly boiled, and his clothing +should receive like treatment. Every precaution +should at all times be observed in order to prevent +the sputum getting onto the furniture or floors, as, +under such circumstances, it quickly dries and being +broken up into small particles is carried by means +of the air to other parts of the house.</p> + +<p>The patient should always remember that the +quicker he is placed under proper treatment the more +the chances of ultimate recovery; in the early stages +almost all of the cases of this kind are curable, but +later this is not often accomplished.</p></div> + + +<h4>TYPHOID FEVER.</h4> + +<p>Of all of the infectious diseases prevalent in +the United States, typhoid fever is one of the +most common and fatal. As a result of its +ravages a vast amount of invalidism, suffering +and financial loss is brought about each year, +and a frightful mortality results. It has for +some time been recognized that typhoid fever +is among the most preventable of all diseases, +and if our people would bestir themselves and<span class='pagenum'><a name="Page_186" id="Page_186">[Pg 186]</a></span> +carry out the comparatively simple rules that +are necessary for its prevention, the scourge +would, in a short time, practically cease to exist +among us.</p> + +<p><i>Character and Course of the Disease.</i>—Typhoid +fever, enteric fever, or abdominal typhus, +is an infectious disease believed to be caused +by a specific bacterial germ known as the <i>Bacillus +typhosus</i>. It develops, as a rule, quite +slowly, the first symptoms being loss of appetite, +headache, and a marked fatigue on slight +exertion. These symptoms gradually grow +worse, fever develops, and the patient oftentimes +suffers with chilly sensations; the temperature +gradually rises, and in the course of +from a few days to a week reaches a height of +102 degrees, 103 degrees, 104 degrees, or 105 +degrees F. In many cases no symptoms exist +that indicate trouble with the bowels, but in the +severe forms of the disease diarrhœa generally +comes on during the first week and continues +throughout the course of the disease.</p> + +<p>During the second week the symptoms above +detailed continue, becoming often more severe, +and there develops great nervousness and delirium.<span class='pagenum'><a name="Page_187" id="Page_187">[Pg 187]</a></span> +About this time there are frequently +observed over the chest, abdomen and thighs, +minute reddish spots resembling flea-bites; these +spots last for a few days and then pass away +and are followed by a fresh crop in other situations. +During this period of the disease inflammation +of the bronchial tubes frequently +comes on, and now and then pneumonia +develops. Bleeding from the bowels is +an occasional highly characteristic symptom of +the second week. When the disease follows a +normal course, the symptoms during the third +week begin gradually to abate; the fever lessens, +and the patient, though much emaciated, +gradually returns to a normal condition.</p> + +<div class="blockquot"><p>Unfortunately, however, the disease does not always +pursue this favorable course, for, in quite a +proportion of instances, the symptoms increase in +severity during the second or third week, the patient +becomes profoundly prostrated, the delirium deepens, +and death occurs. The hemorrhage from the bowels, +in some instances, is so severe that death is produced +even in comparatively early stages of the affection.</p> + +<p>In many instances, through indiscretion, usually +as a result of eating solid food, patients who are apparently +on the road to rapid recovery, relapse, and +the disease repeats the course already detailed.</p> + +<p><span class='pagenum'><a name="Page_188" id="Page_188">[Pg 188]</a></span>It is of importance to remember that now and +then so-called walking cases of typhoid fever occur, +the disease in these instances being characterized by +the fact that the symptoms are so slight that the +sufferer does not feel it necessary to go to bed. +However, in these mild cases, fatal hemorrhage from +the bowels is as frequent as in the severer types, and +as a consequence the patient should receive careful +attention. Moreover, it is of importance to remember +that from this mild form of the affection the most +malignant varieties of the disease may be contracted.</p> + +<p>The mortality in typhoid fever varies from five +to twenty per cent., depending upon the character +of the disease and the nature of the nursing and +treatment that the patient receives.</p></div> + +<p><i>Modes of Infection.</i>—It is clear that typhoid +fever is the result of the entrance into the body +of some minute form of germ-life, whether this +be the bacterium generally supposed to induce +the disease or not. This contagion is beyond +question a living something which multiplies +with great rapidity under proper conditions, +and, escaping from the bodies of those infected +with the disease, in one way or another, reaches +other individuals. It is beyond question true +that the virus passes from the body of those infected +by means of the urine and feces, and it<span class='pagenum'><a name="Page_189" id="Page_189">[Pg 189]</a></span> +is likely that the secretions from the mouth and +nose frequently contain the germs that cause +the fever.</p> + +<p>As the germs are certainly extraordinarily +minute, a very small amount of any of these excretions +might produce the disease in healthy +individuals if it were to get into their bodies +through water, milk, or any uncooked food, or +if it were to find lodgment about the nose or +mouth, or get upon the hands of other persons. +It should also be remembered that the virus +may easily get upon cooking-utensils, drinking-cups, +bed-linen, and other articles with +which we are constantly brought into close contact, +and that the disease might be transmitted +in this way. It is also true that the malady +may be carried from place to place by insects, +particularly flies; the latter may readily get +enough infectious material upon their legs in +various ways, and then, crawling over the food, +leave the deadly poison deposited upon it.</p> + +<p><i>Treatment of Typhoid Fever.</i>—As soon as +the symptoms appear, a physician should be +called and his directions faithfully and carefully +followed out. Nothing in this disease is<span class='pagenum'><a name="Page_190" id="Page_190">[Pg 190]</a></span> +of more importance than careful nursing, and +it is absolutely necessary that the patient receive +only liquid diet until the physician permits +other food.</p> + +<p>Wherever possible then, patients with typhoid +fever should be completely isolated, since, if +this is not done, other members of the family +are almost sure to contract the malady—a result +which almost everyone has seen who has +had any experience with the disease. Wherever +possible patients should be sent to a hospital, +but where this cannot be done they +should be placed in an outhouse, if practicable, +or in an isolated room, which should be +thoroughly disinfected after the patient's recovery. +No one should visit a typhoid-fever +patient, except when compelled to do so, and we +should be particularly careful to prevent children +from coming in contact with them, as it +has been shown that they contract the disease +much more readily than grown people. It is +also of importance that persons should not sit +for any length of time in the sick room, and, +above all, under no circumstances, should cooking +and eating be done there. The room in<span class='pagenum'><a name="Page_191" id="Page_191">[Pg 191]</a></span> +which the patient is placed should be furnished +only with those things absolutely necessary, and +it is particularly desirable that carpets and curtains +should be removed. It is well to wash the +floor each day with some antiseptic solution.</p> + +<p>Those persons who come in contact with typhoid +fever should wear outer clothing which +can be easily washed and boiled. After touching +the patient, or any of his clothing, the +hands should be at once thoroughly scrubbed +in an antiseptic solution. Of course, under no +circumstances, should the nurse eat or drink +from the same vessels that the patient does.</p> + +<p>None of the excretions from persons afflicted +with typhoid fever should ever be emptied until +thoroughly disinfected with creo-carboline or +strong lime-water, and under no circumstances +should these be poured out in the neighborhood +of springs or wells. Towels, handkerchiefs, and +clothing that comes in contact with the patient +should be thoroughly disinfected before being +sent to the laundry. This is best accomplished +by thorough boiling, but in cases where this can +not be at once carried out, it is advisable to +use some chemical antiseptic; of these, perhaps<span class='pagenum'><a name="Page_192" id="Page_192">[Pg 192]</a></span> +the best is creo-carboline, which may be employed +in a 1-500 solution in water; where this +solution is not obtainable, a 5-per-cent. solution +of carbolic acid in water will answer. It +should also be remembered that the water in +which typhoid-fever patients are bathed necessarily +becomes infected, and this should always +be thoroughly disinfected before being emptied. +These precautions should be carried out for +some time after the patient has recovered, as it +is well known that persons, under such circumstances, +for some time frequently contain the +poison in their evacuations.</p> + +<div class="blockquot"><p>After the patient recovers, the room should be disinfected +with formaldehyde gas obtained from the +substance known as “formalin.” This gas may now +be obtained from the formalin without the use of +heat in the following manner: When everything is +ready, and the room properly sealed, thirteen ounces +of permanganate of potash to each quart of formalin +are placed in a large vessel, the room being closed +immediately after the two substances are put together; +it is important that the permanganate be +placed in the vessel first. When this method is employed +a quart of formalin should be used to each +one thousand cubic feet of air-space in the room. +As the gas, by this process, comes off with great +<span class='pagenum'><a name="Page_193" id="Page_193">[Pg 193]</a></span>rapidity, it is not necessary to keep the room closed +more than about four hours. This method is to +be advised for the reasons that it acts more quickly +than the older one, and there is never danger of fire.</p> + +<p>In cases where houses are too open to permit of +disinfection by means of gas, the sick chamber should +be thoroughly washed with a solution of corrosive sublimate, +carbolic acid or some other good disinfectant.</p></div> + + +<h4>HOOK-WORM DISEASE.</h4> + +<p>It has been only recently recognized that a +large percentage of the invalidism and a great +number of the deaths yearly in the southern +portion of the United States are caused by a +very small intestinal parasite known as the +<i>Necator americanus</i>, or hook-worm. This parasite +has unquestionably existed over the area +just named since the advent of the Negro—recent +investigations having shown that the worm +is in all probability of African origin. This +hook-worm disease is probably the most common +of all the serious diseases prevalent in the +South, and as it is easily curable, and can be +readily prevented, there is no matter which +should be of greater interest to the people in +the infected regions, especially those who live +in villages or on farms.<span class='pagenum'><a name="Page_194" id="Page_194">[Pg 194]</a></span></p> + +<p><i>Character of the Disease.</i>—The animal parasite +called hook-worm closely resembles, externally, +the pin-worm which so often occurs in +children. The female, which is larger than the +male, measures somewhat more than half an +inch in length, and has the thickness of a knitting-needle; +the male is between a quarter and +three-eighths of an inch in length as a rule. +The parasite possesses around its mouth a row +of minute plates somewhat resembling hooklets, +by means of which it grasps hold of the mucous +membrane of the intestine and bruises it sufficiently +to cause the blood to flow; with this +blood the parasite nourishes itself. At the same +time the worm injects into the tissues a poison +which has much to do with the symptoms that +occur in the disease that it produces.</p> + +<p>These worms are usually present in great +numbers, there being as a rule from 500 to +2,000 of them, and as they unquestionably live +at least eight or ten years, the unfortunate +victim suffers for a long period of time as a result +of their presence. While living in the intestines +the females lay enormous numbers of +eggs which pass out with the feces, and under<span class='pagenum'><a name="Page_195" id="Page_195">[Pg 195]</a></span> +suitable conditions of temperature and moisture +there develops within each of them, within +from two to three days, a minute snake-like +embryo which bursts through the shell of the +egg and passes into the neighboring earth. +Here the embryos live for considerable periods +of time, and, ultimately, may infect other individuals, +or those from whom the eggs were +passed. There are at least two ways by which +these embryos gain entrance into the human +body. Some do so by getting into drinking-water +and being swallowed; but, extraordinarily, +they most frequently penetrate through +the skin. When this happens the parasite, in +passing through the skin, produces the disease +known as “ground-itch.” The vast majority +of the victims of this affection are children +with whose skin the embryo comes in contact +while they go barefooted during the summer +months.</p> + +<p><i>Course of the Disease.</i>—Having entered +through the skin, the embryos of the hook-worm, +moving by a circuitous route finally reach the +intestines, and, grasping hold of the mucous +membrane with their saw-like teeth, they begin<span class='pagenum'><a name="Page_196" id="Page_196">[Pg 196]</a></span> +to suck blood and grow until they reach +the size of the adult worm in about a month +or six weeks. Depending upon the number +which have gained entrance, and the susceptibility +of the individual, there now begins +to develop symptoms of profound anæmia; +the skin of the child becomes very pale, +and assumes a sort of yellowish hue, and in +cases where there is a severe infection, the +victim begins to suffer with shortness of breath +and dropsy. When this occurs the patient +sometimes dies, but more commonly death +results from contracting some other disease, +which, under ordinary conditions, would produce +no serious results. One of the most unfortunate +effects of this malady is that when +children become infected they cease to grow, +and frequently retain the appearance of early +youth even after they have reached full maturity +in years. These unfortunates are generally incorrectly +regarded as dirt-eaters. The symptoms +frequently last over a period of many +years, as in the intestines of these victims the +worms that originally infect them live certainly +eight or ten years, and during this period<span class='pagenum'><a name="Page_197" id="Page_197">[Pg 197]</a></span> +it is beyond question true that additions to the +original number are frequently received.</p> + +<p><i>Diagnosis and Treatment.</i>—There is no disease +that can be diagnosticated with more ease +and certainty; the eggs are present in the feces +in great numbers, and by means of a microscope +they can always be detected. In all cases +where the disease is suspected, a half-teaspoonful +of the feces of the person supposed to be +infected should be placed in a bottle and sent +to a competent microscopist for examination. +This is done free of charge at the laboratories +of most State Boards of Health in those parts +of the country where the malady exists. Whenever +an individual shows the symptoms above +detailed, an intelligent physician should at once +be called. We have medicines that act as +specifics, and the disease can always be cured +in a very short period of time.</p> + +<p><i>Preventive Measures.</i>—Of course the best +method of preventing this disease is to administer +to those already infected the proper +medicines, and cause the expulsion from the intestines +of the worms that lay the eggs.</p> + +<p>The indiscriminate scattering of the feces<span class='pagenum'><a name="Page_198" id="Page_198">[Pg 198]</a></span> +around the stables, so very common in many +districts, should be absolutely forbidden. +Around the house where individuals have lived +who have the disease every care should be +taken to prevent contact with the earth in the +neighborhood of places where the ground might +have become infected. It would be advisable +for children and others to wear shoes for at +least a year after the last individual having the +disease was cured; and as a precautionary +measure it should be insisted upon that properly +constructed privies or water-closets should +be at every house, and that they should be used +by everyone in whom there is a possibility that +the disease exists.</p> + + +<h4>DIPHTHERIA AND ITS TREATMENT.</h4> + +<p>Loeffler's discovery in 1884 of the germ of +diphtheria, and its relation to the disease of the +same name, established the specific infectious +nature of this malady, and demonstrated beyond +a doubt that membranous croup is not ordinarily +an independent affection, but is almost +always simply diphtheria of the wind-pipe. +The discovery of antitoxin, some time later, reduced<span class='pagenum'><a name="Page_199" id="Page_199">[Pg 199]</a></span> +the mortality of diphtheria from an average +of 30% to 10% in ten years; its use has also +shortened the course of the disease, and decreased +greatly the frequency of the paralytic +conditions that not uncommonly follow this +malady.</p> + +<p><i>Character and Course of Diphtheria.</i>—Diphtheria +is an affection caused by a bacterial microbe +which produces a poison that acts locally +upon the tissues invaded, and also, as a result +of its introduction into the general circulation, +brings about more or less profound effects on +the entire system.</p> + +<p>The period of incubation is from two to ten +days. The onset is generally characterized by +a rise of temperature from 100°F. to 104°F., +chilliness, headache, and pain in the back and +limbs. Albuminuria is common. The glands of +the neck often become swollen. In mild attacks +a slight sore throat is all that is complained of. +In the majority of cases the disease attacks the +throat and tonsils, and is characterized locally +by the appearance of a membrane, which is usually +gray or yellowish-white, elastic, and adheres +tightly to the surface upon which it lies.<span class='pagenum'><a name="Page_200" id="Page_200">[Pg 200]</a></span> +At times, however, the membrane is soft and +pliable, and is easily separated from the tissue; +such cases are frequently diagnosticated as follicular +tonsillitis. A bad cold is occasionally the +only symptom of the disease. The diagnosis +should always be confirmed by bacteriologic examination. +In some instances the wind-pipe is +primarily attacked, but when the disease affects +this part of the throat it is generally a consequence +of the extension of the membrane downward +from the region of the tonsils. In the former +case the diagnosis is somewhat difficult, as +cultures taken from the throat may not show +the presence of diphtheria bacilli, though material +that is coughed up may contain myriads of +the germs; in this phase of the disease interference +with respiration is the symptom most +to be feared. The mucous membrane of the +nose, eyes, ears and generative organs, may be +affected. Wounds are also liable to become infected +with this organism. In rare instances +the membrane may extend down into the bronchial +tubes and lungs, and has been found on +post-mortem examination covering the inside of +the stomach.<span class='pagenum'><a name="Page_201" id="Page_201">[Pg 201]</a></span></p> + +<p>As complications we may have broncho-pneumonia, +acute Bright's disease, inflammation of +the internal structures of the ears, bleeding +from the nose, inflammation of the valves of the +heart, and sometimes paralysis of this organ, +with death; the last named sequel of diphtheria +comes on during convalescence, usually from +two to four weeks after the subsidence of local +symptoms, and is due to inflammation of the +nerves that control the heart. Much less commonly +paralytic conditions of the palate, throat, +eye muscles and the nerves of taste occur, and +under rare conditions, paralysis of the lower +extremities. Paralysis of some kind follows in +from ten per cent. to fifteen per cent. of the +cases, and appears with equal frequency after +the mildest as well as following the most severe +cases.</p> + +<p><i>Mode of Infection.</i>—The germs of diphtheria +may be carried in articles used by persons with +the disease, or they may be communicated by +direct contact. The micro-organism is found in +the secretions from the mouth, throat, or nose, +and in particles of detached membrane. Bedding, +utensils, etc., used in the room where a patient<span class='pagenum'><a name="Page_202" id="Page_202">[Pg 202]</a></span> +has diphtheria, are liable to carry the +germs if taken from the sick-room, and consequently +should be always properly disinfected +before being removed. Milk-bottles carried +into the sick-room, or handled by persons caring +for the patient, should never be returned to +the dealer without being disinfected. Cats, +and less frequently dogs, may contract the disease +and convey it to those with whom they +come in contact. Unrecognized mild cases are +a frequent means of spreading the disease, as +also is a too early release of patients after recovery. +It is a much safer method of procedure +to require at least two negative examinations +before releasing a patient from quarantine, +as during convalescence the germs may be +entirely absent on one day and a few days later +be quite abundant. The bacilli may remain in +the throat from a few days to several years +after the disease is apparently entirely well, and +under such circumstances the persons carrying +them become quite as great, if not a greater, +menace to those with whom they came in contact +as they were during the height of the disease. +A thorough disinfection of the room and<span class='pagenum'><a name="Page_203" id="Page_203">[Pg 203]</a></span> +everything used about the sick person should +be carried out after the patient is released. +Complete isolation should be observed during +the illness, and as long as the bacilli remains in +the throat.</p> + +<p><i>Treatment.</i>—Diphtheria antitoxin is the specific +treatment of this malady, and should be +given early in the disease. The chances of recovery +decrease in proportion to the length of +time existing between the onset of the affection +and the time of administration of the drug. +Antitoxin may be repeated in six hours after +the initial injection if improvement is not noticed, +but ordinarily twenty-four hours should +elapse between doses. It is well to remember +that it is safer to give too much antitoxin than +too little. The initial curative dose varies from +2,000 to 5,000 units, according to the age of the +patient and the severity of the disease. When +a case is seen late it is often advisable to begin +with a large dose,—it being good practice under +such circumstances to use at once as much as +10,000 units or even more. The average case +requires from the beginning to the end of the +treatment a total of from 10,000 to 20,000 units,<span class='pagenum'><a name="Page_204" id="Page_204">[Pg 204]</a></span> +but occasionally 50,000 or even 100,000 units +may be necessary. There are very few risks in +giving antitoxin. In a series of 50,000 cases +treated with it only two deaths occurred sufficiently +early after the injections to warrant the +belief that this unhappy result was produced by +the drug. It is worth remembering that asthmatic +cases bear the administration of antitoxin +very poorly; a marked and sometimes serious +embarrassment of respiration, with cyanosis, +unconsciousness, and general collapse may follow +its use, but recovery is usual in such cases.</p> + +<div class="blockquot"><p>A condition known as anaphylaxis or hypersensitiveness, +which at present is being much studied, may +sometimes occur in the human being. This hypersensitiveness +is manifested by the extraordinary peculiarity +that any number of doses of antitoxin may be +given provided they are administered within a period +of less than ten or twelve days. On the other hand +a single minute dose may induce this state after the +period named, and, as we never know whether a patient +is going to develop it or not, it becomes a question +as to the safety of giving a second injection after +ten or twelve days have elapsed following the administration +of the initial treatment. As it is true that +this hypersensitiveness once established in animals +may continue throughout life, it becomes a question +as to whether or not it is quite safe to administer antitoxin<span class='pagenum'><a name="Page_205" id="Page_205">[Pg 205]</a></span> +to an individual who has had the drug given +him at some prior time, and we are not as yet in a +position to definitely determine the risks that are involved +in such a procedure. There is no reason to +doubt that this hypersensitiveness is much less marked +in man than in the lower animals, and there can be +no question that it much less commonly develops, but +notwithstanding this it would be the part of prudence +to avoid a second administration of the drug after the +interval referred to in all instances where this seems +possible. Anaphylaxis is thus seen to bear an important +relationship to what is commonly called the +“immunizing treatment” to prevent diphtheria, +which consists in giving a moderate dose of antitoxin +to a person immediately after exposure to the disease. +Under such circumstances a degree of immunity is +undoubtedly secured, but this passes off in the course +of a few weeks, and the patient then becomes just as +susceptible as he was before. Should he now contract +diphtheria, we would be confronted with the possibility +that the treatment by means of antitoxin might +possibly produce serious and even fatal results.</p> + +<p>Occasionally rashes occur several days after the inoculation, +but such disturbances are insignificant except +for the immediate discomfort experienced. Antitoxin +concentrated by the Gibson method has reduced +to a considerable extent the number of cases in which +rashes occur.</p></div> + +<p>Treatment other than by antitoxin is symptomatic. +Where the disease occurs in the wind-pipe,<span class='pagenum'><a name="Page_206" id="Page_206">[Pg 206]</a></span> +it may be necessary to pass a tube into its +upper opening to allow the patient to breathe, +and in other instances the wind-pipe is itself +opened from the outside in order to permit a +sufficient amount of air to enter the lungs to +maintain life.</p> + +<p>It is of the utmost importance that patients +be kept in bed until all danger of complications +has passed. Death from heart-failure several +weeks after the diphtheria in the throat is well, +is not an uncommon result of the disease, and is +especially prone to follow even the slightest exertion. +Patients under such circumstances +have been known to die from raising themselves +up in the bed.</p> + + +<h4>CEREBROSPINAL MENINGITIS.</h4> + +<p>Meningitis, or spotted fever, is one of the +most terrible and fatal of all diseases, every +case proving fatal in some local epidemics.</p> + +<p>Although the cause of the disease has been +known for a number of years, the exact method +by which the germ that produces it spreads +from man to man was until quite recently entirely +unrecognized, and even now it cannot be<span class='pagenum'><a name="Page_207" id="Page_207">[Pg 207]</a></span> +said that the whole matter has been demonstrated.</p> + +<p><i>Character and Course of the Disease.</i>—Cerebrospinal +meningitis is produced by a minute +vegetable (bacterium), the <i>Micrococcus intracellularis</i>. +This germ does not appear to occur +normally in any of the lower animals, nor +has it been found in the outer world, and is +therefore to be regarded as distinctly a human +parasite. It is very fortunately a germ of low +vitality, as it develops only at about blood heat, +and when expelled from its normal dwelling-place +in the human body it dies very quickly.</p> + +<div class="blockquot"><p>The accompanying illustration shows how these +bacteria appear under the microscope; the drawing +was made from fluid taken from the spinal canal +of a patient suffering from cerebrospinal meningitis. +These germs get within the skull and spinal canal, +and produce violent inflammation of the coverings +of the brain and cord; these membranes are called +“meninges,” hence the name “cerebrospinal meningitis.” +Within a short time after their entrance pus +is produced, and the condition becomes practically +one of abscess around the brain and spinal cord.</p></div> + +<p>In almost all cases the disease is preceded by +a slight catarrhal condition of the nose and<span class='pagenum'><a name="Page_208" id="Page_208">[Pg 208]</a></span> +throat, the symptoms being those of an ordinary +cold. The symptoms that point to the covering +of the brain being attacked come on with great +suddenness; there is usually a chill, followed by +intense headache, vomiting, restlessness, with +great dread of noises and bright light; in many +cases reddish spots appear beneath the skin, +and these are usually tender on pressure. In +some cases the muscles of the neck become +very stiff, and contract so that the head is +drawn backward. The temperature is somewhat +irregular, but is always above normal in +the beginning, and sometimes goes very high; +the pulse as a rule is normal, or but little accelerated. +After the patient remains in this condition +for a period varying from a few hours to +several days, he generally becomes unconscious, +and in a comparatively short time dies. In +some cases the symptoms after starting off very +violently quickly subside, and the patient makes +a comparatively rapid recovery. In other instances +the disease begins more mildly, the patient +having more or less of the usual symptoms, +but not so severely as is ordinarily the case; in +such cases the patient may die, after lingering<span class='pagenum'><a name="Page_209" id="Page_209">[Pg 209]</a></span> +weeks or months; or may make a protracted recovery, +frequently with partial paralytic conditions +that permanently remain.</p> + +<div class="blockquot"><p>Unfortunately we possess no specific for this disease. +Recently there has come into vogue a treatment +by a serum supposed to have antitoxic power against +this disease, but its exact value is, as yet, by no means +settled; it must be used early if any good is to be +expected from it. In addition to the antitoxin all +that can be done is to keep the patient quiet with +anodynes, and to minister to his comfort in every way +possible. Ice applications to the head sometimes alleviate +the intense headache. As the disease is practically +an abscess around the brain and cord, perhaps +the most rational treatment would be to open up the +skull and let the pus drain away.</p></div> + +<p><i>Mode of Infection.</i>—As this disease is one +that is due to a specific germ it is obvious that it +cannot exist without the presence of this organism; +the malady is therefore infectious, and +must necessarily be to a certain extent contagious, +notwithstanding the fact that it is generally +thought not to be so. The reason that the +affection has not been thought to be contagious +may be explained by the following facts: Recent +investigation has shown that in many, if +not all, instances of this disease, the germ may<span class='pagenum'><a name="Page_210" id="Page_210">[Pg 210]</a></span> +be found in the nose and throat, where, as has +already been explained, it sets up a condition +resembling an ordinary cold. In all probability +the infection takes place in the nasal cavity +first, and the germ ultimately finds its way to +the coverings of the brain. Now there is every +reason to believe that in many, and probably in +a great majority of instances, the germ goes no +further than the mucous membrane of the nose, +and the patient merely has as a consequence +what he considers an ordinary cold. It is clear, +however, that if another individual, who was +very susceptible to this germ, should contract +the disease from this person, he might have the +meningeal form of it. In other words, it is probably +true that the vast majority of people who +are attacked by this organism simply get colds +as a consequence, and only now and then does a +person get meningitis as a result. This explains +why the disease does not ordinarily appear +contagious.</p> + +<p>The facts above stated are of much importance +in combating the spread of this disease. +People who are exposed to those having meningitis +should be exceedingly careful not to get<span class='pagenum'><a name="Page_211" id="Page_211">[Pg 211]</a></span> +upon their persons any of the secretions that +come from the patient, and during periods of +epidemics those who observe a bad cold coming +on should promptly consult their physicians, +and do everything to prevent the development +of all catarrhal conditions in their noses.</p> + +<p>During epidemics persons with colds should +be very careful not to allow other people to +become infected from them. As cold and wet +are undoubtedly predisposing causes to colds +it is well for everyone to shun such exposure +during periods when meningitis is prevalent; +debilitating influences, such as alcoholic excess +and lack of sleep, should also be avoided.</p> + + +<h4>HYDROPHOBIA.</h4> + +<p>This disease, as it occurs in man, is practically +always conveyed by the bite of some animal, +the dog being the usual offender. The poison is +present in the saliva of the diseased animal +and is transmitted through wounds made by its +bite.</p> + +<p>As observed in the dog, there are two types +of the disease,—one the “furious,” the other +the “paralytic.”<span class='pagenum'><a name="Page_212" id="Page_212">[Pg 212]</a></span></p> + +<div class="blockquot"><p><i>In the furious type</i> the animal first appears to +be restless and somewhat excited. He seeks dark +places and apparently prefers to be by himself. In +this stage of the disease the dog's appetite is good +and may be excessive; he responds to orders although +his attention can be attracted only for a moment at +a time. As the malady progresses the animal becomes +more and more restless, and develops a desire +to tear those things about him into pieces. There +is described a peculiar bark at this stage of the disease; +instead of ending as it ordinarily does, it is +prolonged and terminates in a higher pitched note +simulating a cry. This is supposed to be very characteristic +at this stage of the affection. The appetite +gradually diminishes, food is refused, and swallowing +becomes difficult. As the symptoms gradually +progress the dog shows signs of delirium and +begins to wander. As a rule, he goes about with his +tail hung, mouth wide open, and with a wild look in +his eyes, biting as he goes, anything that happens to +be directly in his path; seldom does he turn aside +to disturb anything or anybody. In the later stages +of the disease paralysis generally develops, beginning +in the hind legs and soon involving the body. If +the animal be now carefully observed it will be seen +that he cannot swallow. There is no dread of water, +as the name “hydrophobia” implies, and as is commonly +thought, the animal often attempting to drink, +but owing to the paralysis of the muscles of the +throat this is impossible. Inability then to swallow +either water or solid food is one of the surest and +<span class='pagenum'><a name="Page_213" id="Page_213">[Pg 213]</a></span>most reliable signs of rabies. Weakness becomes very +marked, and the animal finally lies down in a stupor +and dies. The entire course of this type may last +from six to ten days; generally it is four or five.</p> + +<p><i>The paralytic type</i> of the disease occurs in fifteen +or twenty per cent. of the cases. The onset is, as a +rule, the same as that observed in the furious type. +Instead, however, of the dog beginning to wander, +as previously mentioned, the animal becomes paralyzed, +the paralysis first affecting the muscles of +the jaw, later of the tongue. As is the case in the +furious type of the disease, the animal loses the power +to swallow both solids and liquids, but has no fear +of water. The mouth remains wide open, the tongue +protruding, and an abundant amount of thick saliva +exudes. The animal remains quiet, does not attempt +to bite any animal or individual. Death occurs on +the second or third day of the disease.</p></div> + +<p><i>Precautions.</i>—When an individual is bitten +by an animal either supposed or known to be +rabid, the wound should be immediately cauterized +with some caustic, preferably concentrated +nitric acid. This should be applied without +fear because it is safer to use too much than +too little. In case this is not available any +strong caustic may be used. Punctured wounds +should be laid open with a knife and the surfaces +freely cauterized. It should not be forgotten<span class='pagenum'><a name="Page_214" id="Page_214">[Pg 214]</a></span> +that the slightest scratch from the tooth of a +rabid animal may lead to the development of +hydrophobia in man, and it therefore behooves +all persons bitten by dogs to take every precaution +possible. Even though the animal at +the time may appear to be healthy, some strong +antiseptic should be applied to the wound, +and the animal carefully watched until all possibility +of his having the disease has passed. +Many persons have died from slight wounds +inflicted by animals appearing at the time to +be perfectly well.</p> + +<p>Attention should also be directed to the fact +that wounds where the teeth of the animal pass +through the clothing are not so dangerous as +those where no such protection intervenes. +Bites about the face and head are much more +frequently followed by rabies than those inflicted +on the extremities, and, of course, where +wounds are deep the chances of infection are +much greater; where injuries of the latter kind +are inflicted it is practically out of the question +to thoroughly cauterize them, and the patient +should immediately receive the Pasteur treatment. +It is probable that if thorough cauterization<span class='pagenum'><a name="Page_215" id="Page_215">[Pg 215]</a></span> +be not done within five minutes that it cannot +be relied on to prevent the development of +the disease; where there is any doubt the only +safety lies in the Pasteur treatment. Where +a person is bitten by a dog supposed to be rabid +the animal should be caught, if possible, and +kept carefully isolated for at least ten days; +should it appear well after the expiration of +this period no fear need be felt as to the results +of its bite, but if it should die the head should +be cut off, packed in ice, and sent to some +laboratory for examination.</p> + +<p><i>Under no condition should the animal be +killed, as the best possible proof of the harmlessness +of its bite would lie in its continuing to live.</i></p> + +<p><i>Treatment.</i>—Since the epoch-making researches +of Pasteur, laboratories have been installed +in various parts of the world for the +purpose of making a vaccine by means of which +it is possible, by gradual immunization, to prevent +the development of hydrophobia in persons +bitten by rabid dogs. This is done by a series +of injections of a weak virus prepared according +to the directions of Pasteur. <i>It should always +be remembered that no harm can come</i><span class='pagenum'><a name="Page_216" id="Page_216">[Pg 216]</a></span> +<i>from the treatment whether the patient was bitten +by a rabid dog or not, and that in all cases +of doubt no hesitation should be felt in resorting +to it.</i></p> + + + + +<h2><a name="CHAPTER_XIII" id="CHAPTER_XIII"></a>CHAPTER XIII</h2> +<p><span class='pagenum'><a name="Page_217" id="Page_217">[Pg 217]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>HYGIENE OF THE SICK ROOM</h3> + + +<p>Far too little attention is generally accorded +to the proper care of the sick,—the prevailing +opinion being that the royal road to recovery +under the circumstances is opened up only +through the taking of drugs, and that provided +the appropriate ones be given in sufficient quantities +recovery will result. No greater mistake +is possible. As a matter of fact, there are very +few diseases for which we have medicines that +act in a specific manner, and far more is usually +to be hoped for from good nursing. Fortunately +the general public is beginning to recognize +the truth of the statements just made. +It has only been a short time since the trained +nurse was unknown except in the larger medical +centres, but now her presence and beneficent +influence is being felt from one end of the +land to the other, and her importance is destined +to increase with the onward march of<span class='pagenum'><a name="Page_218" id="Page_218">[Pg 218]</a></span> +time; she is undoubtedly the greatest advance +that we have made in medicine during the last +decade.</p> + +<p>Where persons are ill they should always be +attended by a trained nurse if possible, but if +this is out of the question a few suggestions as +to the sick room and its hygiene should certainly +not be omitted from any book dealing with rural +sanitation.</p> + +<p><i>Ventilation and Warmth.</i>—The sick room if +possible should be located on the sunny side +of the house, and should have fire in a fireplace +if the weather be cold. It is of the utmost consequence +that the room have windows and doors +by means of which it can be at all times thoroughly +ventilated. At all seasons of the year a +room on the lowest floor of the house is more +satisfactory, since it is warmer in the winter +and cooler in the summer. The room should +not be uncomfortably cold, though it is much +better to have the temperature too low than to +have the air stuffy. In most diseases ventilation +is of supreme importance, and should be +secured at any cost. Where, however, it is +compatible with thorough ventilation, a temperature<span class='pagenum'><a name="Page_219" id="Page_219">[Pg 219]</a></span> +of about 70°F. is generally considered +most desirable.</p> + +<p>Before a patient is moved into a room all +superfluous furniture should be taken out, particularly +carpets and hangings of all kinds. It +is likewise of the utmost importance that all +insects, particularly flies, be excluded by proper +screening.</p> + +<p>The patient's bed should be narrow, and a +mattress is much to be preferred to a feather +bed. The mattress should be protected by a +rubber sheet or newspaper pads; oil-cloth +cracks and wrinkles too badly to be of service +for this purpose. The rubber sheet should of +course be kept under the sheet nearest the mattress. +The cover should consist of a sheet +which is long enough to fold back at the head +over the other covering for some distance, and +blankets should be used for warmth in preference +to quilts. The bed should be kept scrupulously +clean, and the linen and covering should +be removed when soiled. The nurse should see +to it that bread-crumbs do not remain in the +bed.</p> + +<p>In removing soiled bed-clothes the following<span class='pagenum'><a name="Page_220" id="Page_220">[Pg 220]</a></span> +plan is the one usually adopted. The patient +is moved to one side of the bed as near the edge +as possible, and the sheet beneath him loosened +at the head and the foot and on the opposite +side; it is then rolled up toward the patient and +pushed well up under him, leaving the side of +the bed opposite to that upon which he is lying +bare; upon this the new sheet is placed, which +is then tucked under the edges of the mattress, +and the patient rolls or is pulled back over on it. +The soiled sheet is then removed and the edges +of the fresh one pulled over the portions of the +bed still uncovered, and secured in the usual +way.</p> + +<p><i>General Precautions.</i>—The room should also +be kept scrupulously clean; all sweepings +should be burned. Soiled linen and all excretions +from the patient should be promptly removed, +and if the latter need not be preserved +for the inspection of the physician, should be at +once disinfected and properly disposed of. +Milk and other food should not be left in the +sick room; and soiled glasses and dishes should +be removed and washed at once in boiling water.<span class='pagenum'><a name="Page_221" id="Page_221">[Pg 221]</a></span></p> + +<p>Persons who are ill should not be allowed to +have company. There is nothing more important +in connection with the looking after patients +with infectious diseases than this precaution. +The writer has often seen in the country +districts patients with typhoid fever and other +infectious diseases surrounded by the neighbors +from miles around,—the entire company often +eating and drinking in the room occupied by the +afflicted person. The strain that results on the +patient from a practice of this kind might well +in many cases have fatal consequences, and +there is no question whatever that many diseases, +particularly typhoid fever, are scattered +in this way from house to house and from one +community to another.</p> + +<p>The diet should be given regularly and should +consist strictly of only such things as are allowed +by the physician.</p> + +<p>All medicines should be given absolutely according +to directions, as otherwise having a doctor +is worse than useless.</p> + +<p>All patients should have a daily bath, special +attention being given to their hair, teeth, mouth<span class='pagenum'><a name="Page_222" id="Page_222">[Pg 222]</a></span> +and nails. In many cases it is necessary to +wash the patient's mouth frequently with some +antiseptic wash. This should only be done on +the expressed instructions of the doctor.</p> + + + + +<h2><a name="CHAPTER_XIV" id="CHAPTER_XIV"></a>CHAPTER XIV</h2> +<p><span class='pagenum'><a name="Page_223" id="Page_223">[Pg 223]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>EMERGENCIES AND ACCIDENTS</h3> + + +<p>Few things are of greater importance, and +nothing is more neglected than instructing +school-children how to act in emergencies. +Particularly is such knowledge of value in the +country. In cities the need of understanding +matters of this kind is not so great, since it is +usually possible to secure at short notice some +one capable of dealing with any situation that +may arise. Children very quickly grasp knowledge +of this character, and opportunities frequently +offer for an actual demonstration of +the proper remedies in the case of accidents. +When the instructor speaks of cuts and burns +they at once understand what is meant.</p> + +<p>The most serious result of our neglect in +this particular is that our children pass through +life with the most meagre knowledge of the +proper way in which to meet accidents of all +sorts, for where they are not taught during<span class='pagenum'><a name="Page_224" id="Page_224">[Pg 224]</a></span> +their school days they, for the most part, remain +ignorant of matters of this kind throughout +their maturer years. It is much to be hoped—though +this is somewhat of a digression—that +the old unscientific and senseless system of +teaching, which persists even in the present +time to a considerable degree, may in the future +give way to a more rational and practical plan +of instruction—one that will deal with perceptible +needs rather than abstractions.</p> + +<p>The most common emergencies will now be +taken up and considered in detail.</p> + +<p><i>Drowning.</i>—The subject of drowning is one +of especial interest in rural districts, since it +is here that accidents of this kind are most apt +to occur, and skilled attention is most difficult +to obtain. It is of the utmost importance to +remember that people may be resuscitated after +having been under the water for considerable +periods of time, and we should, therefore, look +upon no ordinary cases as hopeless until the +proper restorative measures have failed.</p> + +<p>On removing the body from the water we +should not waste time by attempting to drain +the water from the victim's mouth, as the<span class='pagenum'><a name="Page_225" id="Page_225">[Pg 225]</a></span> +amount of this substance that enters the air-passages +under such circumstances is so trifling +that it may be entirely disregarded. The +drowned person should be placed face down +upon the ground with the head slightly turned +to the left, and we should begin at once with +artificial respiration.</p> + +<p><i>Artificial Respiration.</i>—This is accomplished +by the operator kneeling between the separated +legs of the patient and placing his hands on the +small of his back, the thumbs nearly meeting at +the middle of the spine, and the other fingers +spread out over the lower portion of the chest; +the operator then sways his body downward +and forward slowly, counting three during the +movement, then quickly swinging backward releasing +the pressure on the patient's chest; +again count three and repeat the original movement. +The pressure should be brought to bear +from twelve to fourteen times a minute, and +the movement should be kept up until the patient +begins to show evidences of being restored, +or until it is quite evident that life is extinct.</p> + +<p>This system of artificial respiration was originated +by Professor Schafer, as the head of a<span class='pagenum'><a name="Page_226" id="Page_226">[Pg 226]</a></span> +commission appointed by the British Government, +and is now universally regarded as being +by far the most satisfactory of all such methods.</p> + +<p>In the accompanying figures are shown the +positions assumed by the patient and operator +while carrying on artificial respiration.</p> + +<p>It should be remembered that the victims of +accidents of this kind suffer considerably from +lowering of the temperature of the body as a +consequence of the long exposure to water, and +we should, therefore, also direct our attention +toward bringing about an immediate reaction +by means of warm blankets and hot bottles, and +by vigorous rubbing of the patient's body.</p> + +<p><i>Danger from Wounds.</i>—Wounds may be produced +by a great variety of objects, but chiefly, +of course, by cutting instruments. Where they +are caused by duller objects, producing more or +less tearing and bruising of the tissues, they +are more apt to be followed by infection with +disease-producing germs than where smoothly +cut, and consequently require greater care in +treatment. Germs sufficient to produce death +may be introduced into the body by the most +minute wound; it is for example well known<span class='pagenum'><a name="Page_227" id="Page_227">[Pg 227]</a></span> +that fatal consequences have resulted from the +bites of various insects, and the writer has personally +seen a case where a pin-prick was followed +by lockjaw and death. Such facts teach +us that we should be careful in avoiding wounds +of all kinds, and, that after they have been received, +they deserve attention, however insignificant +they may appear to be.</p> + +<div class="blockquot"><p>Wounds resulting from objects more or less covered +with dirt are particularly dangerous, since under +such circumstances the germs of lockjaw are apt to +be introduced into the body, and fatal consequences +not uncommonly ensue. It is astonishing how frequently +the disease just referred to follows where a +barefooted child sticks a dirty splinter or a rusty +nail into its foot, and it cannot be too strongly urged +that it is the duty of the parent in such instances +to call in a competent physician at once. The reason +that injuries of this kind are so apt to be followed +by lockjaw is that the germ that produces the +disease lives practically everywhere in the earth—being +especially common in the rich soil of gardens +and other highly fertilized earths; and the germs +are so minute that thousands of them might be present +on the point of a pin without being visible to +the naked eye. The bacilli of lockjaw do not grow +at all where exposed freely to the oxygen of the +air, and as a consequence of this fact we rarely see +the disease that they produce developing after slight +<span class='pagenum'><a name="Page_228" id="Page_228">[Pg 228]</a></span>superficial wounds; much more commonly the malady +results from a wound made by some penetrating object, +such as a splinter of wood, a nail, or a pin.</p> + +<p>The lesson that these facts teach is that where +wounds are small and deep it is the part of wisdom +to cut them open freely in order that they may be +cleansed as far as is possible, and at the same time +allow the air to obtain free access to their deepest +portions; a wound of this kind should not be sewn +up, but should be left open and allowed gradually +to heal up.</p> + +<p>The reason why lockjaw so frequently follows +wounds from the premature explosion of fireworks +is that the paper used in fire crackers, etc., often +contains the germs of the disease and is driven +deeply into the tissues. In view of the very considerable +mortality that yearly occurs among the +children of this country it seems incomprehensible +that our legislatures—which commonly exhibit such +an uncontrollable desire to regulate their neighbors +in every possible way—should not long ago have +placed the ban on fireworks of all kinds.</p></div> + +<p><i>Treatment of Wounds.</i>—The treatment of +wounds necessarily depends to a considerable +extent on their character and general severity: +there are certain practices, however, that apply +in all cases, and should, therefore, be resorted +to wherever injuries of this kind occur. Where +the wound is superficial the bleeding is as a<span class='pagenum'><a name="Page_229" id="Page_229">[Pg 229]</a></span> +rule trifling in character, and very quickly stops +of its own accord. In other cases, particularly +where deep, larger blood-vessels may be severed, +and if they be of any considerable size, +the hemorrhage will not cease until the subject +becomes exceedingly weak, and in some instances +the bleeding will go on until death results. +Where bleeding is profuse, it may generally +be assumed that one of the larger vessels +has been cut, and under such circumstances it +should be compressed until skilled assistance +arrives. There is a popular but very erroneous +impression that arteries can only be stopped by +tying; as a matter of fact any one possesses +sufficient strength in the fingers to pinch them +enough to stop the hemorrhage. If possible, +the operator should get his finger down into the +wound, after which he can quickly discover the +exact point where pressure stops the bleeding. +One who is unaccustomed to surgical practices +would, of course, hesitate at doing this, but it +cannot be too strongly urged that a procedure +of this character produces little or no pain after +the finger is first introduced, and that no one +should be deterred by foolish squeamishness<span class='pagenum'><a name="Page_230" id="Page_230">[Pg 230]</a></span> +from immediately doing that which in many instances +can only save the life of the victim.</p> + +<div class="blockquot"><p>Where arteries are evidently bleeding—which may +be inferred from the spurting character of the hemorrhage—a +tight bandage above the seat of the wound, +if on one of the extremities, will often be followed +by a cessation of the bleeding, and where only small +vessels are cut, a bandage tightly applied over the +wound itself may accomplish a similar result. Under +such circumstances the reader should be warned +that it is not safe to leave a limb tightly bandaged +in this way for any considerable length of time, as +complete death of the part below may result. Where +then a ligature is placed above or over a wound, it +should be loosened cautiously every twenty or thirty +minutes, and should be left off for a time. If the +wounded artery begins to bleed, one should resort to +local pressure upon it with the finger for five or ten +minutes, after which the bandage may again be applied.</p></div> + +<p>As soon as all bleeding has ceased, the wound +should be thoroughly washed out by means of +water that has been boiled and allowed to cool; +the operation may be greatly assisted by using +a rag or a piece of cotton that was boiled in the +water. If there be grease or other dirt that +does not readily come away soap may be freely +used.<span class='pagenum'><a name="Page_231" id="Page_231">[Pg 231]</a></span></p> + +<p>After the wound has been thoroughly +cleansed, some sort of antiseptic had better be +applied. Unquestionably the best of all of +these is tincture of iodine, a small amount of +which should be poured directly into the wound. +A saturated solution of carbolic acid in water +is also a fairly good disinfectant, and may be +employed where the tincture of iodine cannot +be obtained. A solution of corrosive sublimate +in water—one part of the former to one thousand +parts of the latter—is much used as an +antiseptic by surgeons, but when placed directly +in wounds has a tendency to cause much irritation, +and is by no means so efficient as either of +the disinfectants just referred to. In the +country it is an old custom to use turpentine, +or resins from several different species of +pines; these are fairly efficient antiseptics, and +should be employed where it is impossible to +obtain those that are better. It should always +be remembered that thorough washing out +with boiled water and soap is in itself a procedure +that will remove a considerable proportion +of any germs that may have got into<span class='pagenum'><a name="Page_232" id="Page_232">[Pg 232]</a></span> +the wound, and that if carefully done, it is almost +as efficient as the best antiseptic.</p> + +<p>After the wound has been thoroughly +cleansed by water and antiseptics, it should +then be bandaged with a cloth that has been +previously boiled and dried, if no regular surgical +dressing is at hand. Every precaution +should then be taken to prevent it being reopened. +Collodion is sometimes used over +small wounds, and is quite efficient in that it +forms a coating over any surface upon which +it is placed that is impermeable to both air +and water. Small wounds that have been +thoroughly cleansed and disinfected with tincture +of iodine may be safely and satisfactorily +closed by means of the substance just +mentioned, but it should never be forgotten that +the germ of lockjaw—which is the one, ordinarily, +most to be dreaded in such injuries—lives +and grows best in the absence of the +oxygen of the air, and that a covering of collodion +would materially assist in the development +of this dreadful disease.</p> + +<p>In those instances where pus forms in +wounds, they should be at once reopened and<span class='pagenum'><a name="Page_233" id="Page_233">[Pg 233]</a></span> +allowed to drain. It very often follows after +cuts—particularly if they be not properly +cleansed—that a scab forms on the outside, +holding beneath a greater or less amount of pus. +The presence of the latter can generally be inferred +by a wound presenting a red and angry +appearance around its edges, and from swelling +and pain. As soon as such a condition is +observed, the scab should be thoroughly soaked +in water and removed, and it is then necessary +that the wound be kept open and allowed to +drain freely until it heals up from the bottom. +A failure to observe precautions of this kind +may result in blood-poisoning, and finally even +in death. After a wound begins to suppurate +it does little good to put antiseptics into it, +as they cause considerable irritation, and under +no circumstances do they put an end to the pus +formation. Open drainage of the wound, and +keeping up the general health of the patient, +are the only means that we possess of successfully +combating conditions of this kind.</p> + +<p>Inasmuch as we possess an antitoxin that unquestionably +has the power of preventing lockjaw, +if given sufficiently early, it is the part of<span class='pagenum'><a name="Page_234" id="Page_234">[Pg 234]</a></span> +wisdom to administer at once a sufficient dose +of this substance to any child who has received +a penetrating wound from some dirty object, or +from the explosion of fire-crackers. Statistics +show that under such circumstances lockjaw +may be prevented in almost all cases. If we +wait until the disease develops, the antitoxin is +of no value.</p> + +<p><i>Care of Sprains.</i>—The seriousness of sprains +is very generally underestimated, and as a consequence +many persons go through life with +ankles that are abnormally weak, and even +painful in bad weather, and in which there is a +tendency to swell and become exceedingly +troublesome after a slight wrench. In all true +sprains there is more or less actual tearing of +the ligaments that bind the joint together, and, +if the injury be not properly treated and the +joint thoroughly supported, complete recovery +in many instances never takes place.</p> + +<p>As soon as a sprain occurs the injured joint +should be immersed in water just as warm as +can be borne, and hot water should be from +time to time added in order to keep the temperature +sufficiently high. The bath should be continued<span class='pagenum'><a name="Page_235" id="Page_235">[Pg 235]</a></span> +for several hours—the longer the better. +Thus the pain and swelling will be greatly reduced, +and the tenderness which, in the beginning, +is so excruciating, will largely disappear. +The next step is to properly support the injured +parts in order that unnecessary movement may +be prevented, thus avoiding further tearing of +the ligaments. This may be accomplished by +means of various splints—the most popular being +those made of plaster of Paris, or silicate of +sodium, either of which will require the services +of a physician in order to have them +properly applied.</p> + +<div class="blockquot"><p>Within recent years a treatment has come much +into vogue, which is exceedingly satisfactory, and +has the advantage that it does not require the service +of an expert in order to have it properly carried out. +This consists in the application of strips of adhesive +plaster to the skin over the seat of the injury and +for some distance both above and below the joint +affected. Ordinary sticking-plaster is not the best +for this purpose, though in an emergency it might +be used; much better is the so-called mole-skin plaster, +which is much thicker, and does not require +moistening before being applied. The plaster should +be torn into strips about three-fourths of an inch +wide and twelve to eighteen inches long. Where the +<span class='pagenum'><a name="Page_236" id="Page_236">[Pg 236]</a></span>ankle is the seat of the trouble, a strip is firmly applied +to the back of the foot, beginning just behind +the toes, and is brought around the ankle and carried +up on to the calf of the leg—thus partially +winding the plaster around the leg. The first strip +having been applied, another is put on in a similar +way, the edges of the latter overlapping those of +the former. This is continued until one side of the +ankle is fairly well covered, after which we may +begin operations on the opposite side, carrying the +strips around the leg in such a way as to meet and +overlap those first put on. This process is continued +until the entire joint is completely covered with the +plaster. It is of the utmost importance that the +foot be put in a natural position before we begin to +apply the plaster, as, otherwise, it will be left in a +constrained and uncomfortable position, which will +do away largely with the good effects of the splint. +Where carried out in the proper way it is in the +highest degree astonishing to see how perfectly the +joint is supported, with the effect that the use of +the injured limb may be immediately resumed. The +writer recalls having seen a young lady with a frightful +sprain, who could not bear to touch her foot to +the floor, improve to such an extent under the treatment +as outlined that she was able to go to a ball +and dance through the evening on the day the injury +occurred.</p></div> + +<p>Not only does the immediate resuming of the +use of an injured limb, when treated in this<span class='pagenum'><a name="Page_237" id="Page_237">[Pg 237]</a></span> +way, appear not to be injurious, but the ultimate +recovery seems actually hastened. After +a day or so it is well to remove the plaster splint +first applied and put on another, as the former +has by this time usually ceased to fit the injured +joint—owing to the diminution in the +swelling. The splint may be changed three, +four, or even five times, if deemed necessary, +though two or three applications generally +amply suffice. <i>This or some other splint +should be kept on the injured joint for at least +a month or six weeks, as otherwise complete recovery +frequently fails to occur, with the permanent +weakening of the joint as a consequence.</i></p> + +<p>Of course it is always desirable to have a +physician apply the splints for a sprain where +this is feasible, but with a little care it may be +done by any intelligent person who will observe +closely the directions given. The plaster should +be put on moderately tight, but the utmost +care must be exercised in not carrying this to +an extreme, as in such cases serious results +might ensue. In order that it may be determined +as to whether or not the splint is too +tight, it is advisable to watch the patient's toes<span class='pagenum'><a name="Page_238" id="Page_238">[Pg 238]</a></span> +for some hours after the plaster is put on, and +should they be found to be very cold, and particularly +should they begin to show a dusky discoloration, +it is evidence that the strips are exerting +too much pressure, and they should be +at once removed. Under such circumstances, in +a half an hour or so, the splint could be reapplied +with safety.</p> + +<p>The mole-skin plaster, which is used in making +the splint just referred to, may be obtained +in rolls of any width from all druggists; and as +the plaster keeps practically indefinitely, it +should be in the medicine-closet of everyone +living at a distance from skilled medical aid.</p> + +<p>After a sprained ankle the patient should +wear shoes that come well up above the injured +joint, and they should be laced tightly until +some time after all symptoms of trouble have +disappeared; it would be on the safe side to +wear shoes of this kind from six months to a +year, depending upon the severity of the injury.</p> + +<p><i>Treating Bruises.</i>—Bruises are not usually +followed by serious consequences if properly +treated. They result from injuries that tear<span class='pagenum'><a name="Page_239" id="Page_239">[Pg 239]</a></span> +the tissues beneath the skin to such a degree +that hemorrhage from many minute blood-vessels +occurs in the injured part. In the course +of a few hours they often present a truly alarming +appearance, being swollen and greatly discolored, +but they are not as a rule followed by +any permanent ill results. Where bruises are +slight no treatment of any kind is required, as in +a short time the effused blood is absorbed, and +the part returns to a normal condition. Where +more severe it is not a bad practice to cover +them with flannels wrung out from hot water, +the same being renewed from time to time, and +the applications kept up for from six to twelve +hours. Usually at the end of this time the +soreness and swelling will have considerably +abated, and the injured tissues quickly return to +a normal condition.</p> + +<p><i>The reader should be warned that under no +circumstances should the skin be opened, even +though it may be quite obvious that there is a +bluish mass of blood immediately beneath.</i> +Where this mistake is made, infection of the injured +tissues with the germs that produce pus +inevitably results, and as a consequence the patient<span class='pagenum'><a name="Page_240" id="Page_240">[Pg 240]</a></span> +suffers with a discharging wound for a +considerable period of time. In rare cases +germs get into the injured parts without the +skin having been opened, and there results +under such circumstances a condition which +closely resembles that of an ordinary abscess. +The probability that this undesirable complication +has arisen is shown by the swelling becoming +greater and more painful some days after +the injury has occurred, and under such circumstances +a good physician should be at once consulted, +as it will be necessary to make an incision +into the diseased area.</p> + +<p><i>Soothing Burns.</i>—One of the most common +and painful of injuries are burns. Small superficial +burns require no particular treatment. +Where, however, they are of sufficient severity +to merit attention, the simplest and best of all +treatments is to immerse the diseased part in +cold water, and here it should remain at least +some hours, or until competent medical aid can +be secured. Medical treatment of injuries of +this kind is not particularly satisfactory, +though there are some drugs that may be used +with more or less benefit. Chief among them is<span class='pagenum'><a name="Page_241" id="Page_241">[Pg 241]</a></span> +picric acid, which may be applied by means of +a cloth wrung out of a one per cent. solution of +this substance in water. Another treatment +which has some merit, and which has long enjoyed +a certain vogue among both medical men +and the laity, is a combination of equal parts of +lime-water with either olive or linseed oil; this +is called carron oil and is applied in the same +way as the picric acid solution. All three of +the remedies referred to act largely by preventing +the access of air to the burned surface, and +they, therefore, may be replaced by any bland +and non-poisonous substance which accomplishes +like results.</p> + +<p><i>Accidents from Heat and Cold.</i>—The climate +of the United States is characterized by extreme +variations—there being over almost its +entire extent during the winter months a series +of “cold waves,” during which excessively low +temperatures are often experienced,—particularly +in the northern and western portions of +the country. During the summer, on the other +hand, we have almost everywhere periods during +which the temperature goes very high—often +accompanied by excessive atmospheric<span class='pagenum'><a name="Page_242" id="Page_242">[Pg 242]</a></span> +moisture. As a consequence of these extremes +in temperature it could only be expected that +we would often experience bad effects, so that +serious illness, and even death, occasionally result.</p> + +<p>Of the two extremes, excessive heat is much +the more dangerous, and is by far more frequently +followed by fatal results—particularly +in crowded cities. Fortunately for the dwellers +in rural districts the precise conditions under +which excessive heat is followed by serious consequences +are not so frequently encountered as +in the more populous centers, and as a result +we find that serious ill effects from high temperatures +are by no means so common in the +former as in the latter. There are, however, +two quite well defined and distinct morbid conditions +that are the result of high temperatures, +and inasmuch as they differ in their symptoms +as well as in their treatment, it will be +necessary to consider them separately.</p> + +<p><i>Sunstroke.</i>—Sunstroke is characterized by a +rapid onset, the patient usually complaining of +an uncomfortable sense of burning heat and a +feeling of dizziness and depression. Nausea,<span class='pagenum'><a name="Page_243" id="Page_243">[Pg 243]</a></span> +vomiting, and diarrhœa are common, frequently +an intense headache, and sooner or later a muttering +delirium. The patient's skin is dry and +hot, the face is flushed, and the eyes suffused, +and a thermometer will show a bodily temperature +of from 105° to 110° or even 112°F. In +fatal cases it is usually some hours before the +patient dies, though sometimes he succumbs +almost instantly.</p> + +<p>When attacked, the patient should at once be +removed to some shady place, and should be +held in a sitting posture against any suitable +object that may be at hand. The clothing +should be loosened at once, and every endeavor +should be directed towards lowering the temperature +of the victim. This is best done by +pouring ice-water or the coolest water that can +be secured freely over the entire body of the patient. +This treatment should be continued until +the temperature approaches the normal—the +vigor of the measure employed gradually decreasing, +as the patient shows signs of getting +better. Improvement is shown by a gradual +return of consciousness.</p> + +<p><i>Heat-Prostration.</i>—Like true sunstroke, heat-prostration<span class='pagenum'><a name="Page_244" id="Page_244">[Pg 244]</a></span> +comes on with an extreme suddenness. +The patient becomes suddenly dizzy, and +sinks to the ground in a state of collapse. The +skin is pale and cool, the pulse limp and weak, +and the thermometer shows the temperature to +be somewhat below normal. The patient should +be laid on the ground in a cool, shady place, +and stimulants at once given. By far the most +efficient of them is a hypodermic injection of +morphine and atropine, to which strychnine in +appropriate doses may be added.</p> + +<p><i>Guarding against Sunstroke and Heat-Prostration.</i>—Excessive +heat is the basis of both of +these conditions, but there are many contributing +causes which play a more or less important +part in their production. Notwithstanding +the fact that they are regarded as being +different, and that the treatment and symptoms +of the two conditions vary widely, there +can be no doubt that certain depressing influences, +in every way similar, play an important +part in their causation.</p> + +<div class="blockquot"><p>Foremost among such influences alcohol claims +first place, and unquestionably not only predisposes +to all diseases brought on by heat, but lends much +<span class='pagenum'><a name="Page_245" id="Page_245">[Pg 245]</a></span>greater gravity to an attack—the drunkard rarely +recovering from true sunstroke, and frequently dying +from the much less dangerous heat-prostration. +It is said that the latter condition is particularly +prone to occur after freely indulging in beer or other +malt liquors. Not only does alcohol predispose to +these morbid states, but other influences that depress +the general vitality are more or less apt to predispose +to the production of both, such as loss of sleep, +overwork, worry, excessive eating, and insufficient +food. The danger is greater when there is excessive +moisture in the air, so that at such times we should +particularly avoid excesses of all kinds, and as far as +possible, keep out of the direct rays of the sun.</p></div> + +<p><i>Frost-bite.</i>—In the extreme northern and +northwestern portions of the United States +frost-bite is not uncommon in winter. The part +attacked becomes suddenly bloodless, presenting +much the appearance of the skin after +death. The victim is usually not aware of the +fact as at first there is no pain. As soon as a +condition of this kind is observed,—and in cold +countries persons are quick to inform the victim +when they notice it,—the place should be +vigorously rubbed with a piece of ice, or with a +handful of snow, and this should be continued +until the circulation again returns as evidenced<span class='pagenum'><a name="Page_246" id="Page_246">[Pg 246]</a></span> +by the parts becoming reddened. A rapid +warming of the affected parts is not advisable, +the result being not unlike that of a burn.</p> + +<p><i>Chilblains.</i>—Many persons suffer during the +winter from chilblains—this being a state in +which more or less pain and itching is produced +in a part as the result of poor circulation. +Such a condition is usually the result of +a combination of cold with the affected part +being more or less compressed, and as a consequence, +we find that troubles of this kind are +more frequently in the feet—particularly where +tight shoes are worn. The remedy for troubles +of this character is to wear loose-fitting shoes, +and to thoroughly protect the parts by appropriate +woolen socks. It is particularly of importance +to change the socks often, since as +soon as they become moistened with perspiration +a tendency to a recurrence of the trouble +is very great. Drugs are of no particular use +in conditions of this kind. Chilblains are more +commonly suffered in Europe than in America. +One young American lady in Paris acquired +them one winter, and “knowing no better,” as +she told the writer, cured herself by “boiling<span class='pagenum'><a name="Page_247" id="Page_247">[Pg 247]</a></span> +the chilblains”—soaking her feet in the hottest +water she could endure. The affliction did +not return; and the novel recipe was delightedly +followed by all the art-students of +the neighborhood.</p> + +<p><i>Blisters.</i>—Small blisters on the feet are not +uncommon as the result of wearing tight, or ill-fitting +shoes. Wherever possible, they should +be quickly relieved from all compression, and +should under no circumstances be opened.</p> + +<div class="blockquot"><p>The treatment is very simple and quite efficient, +provided it be instituted while the skin is still intact, +and consists simply in placing over the affected +area a small piece of mole-skin plaster, which should +extend for a short distance out on the normal skin +surrounding the blister; the same sort of plaster +should here be used as was recommended for supporting +sprained joints, and is an article so useful +that it should be kept in every house. Where blisters +have ruptured, the better plan is to apply some +antiseptic, like tincture of iodine, and after having +allowed it to dry, stick on some plaster as already +directed. If no antiseptic be at hand the plaster +should be used any way, but it should be frequently +removed in order to see that no suppuration is +occurring beneath. Small blisters, the result of +burns, may be treated in a similar way with good +results.</p></div> + +<p><span class='pagenum'><a name="Page_248" id="Page_248">[Pg 248]</a></span><i>Tooth-ache.</i>—Tooth-ache is a condition for +which there is no excuse in the present state of +knowledge. As soon as decay begins in a tooth +it should receive the attention of a competent +dentist, and where this is done a true tooth-ache +never occurs. Where one has been so neglectful +as to permit the exposure of the nerve +of a tooth, he can only be saved from much suffering +by going at once to a dentist. In the +meantime, various measures may be adopted +to diminish the pain. A piece of cotton dipped +in dilute carbolic acid and thrust into the cavity +will almost immediately relieve the suffering +for the time being. Oil of cloves, or a mixture +of this substance with chloroform, applied in +a similar way will bring about a like result. +The reader cannot be too often reminded of the +fact that bad teeth not only cause much suffering, +but likewise lead to many digestive disturbances, +and as a consequence little could be +of more importance to the health of the body +than to see to it that they be kept in perfect +order. Where teeth are knocked out, they will +often grow back and render good service for<span class='pagenum'><a name="Page_249" id="Page_249">[Pg 249]</a></span> +many years afterwards if replaced immediately +in their sockets.</p> + +<p><i>Bites of Animals.</i>—Wounds of this character, +particularly those produced by dogs and cats, +are not at all uncommon. Where it is definitely +known that the animal is not rabid, the +treatment should be that of punctured wounds,—to +the chapter on which the reader is referred +for further information.</p> + +<p>Where there is reason to suspect that the +animal has hydrophobia, it should be, if possible, +at once confined, and watched for developments. +Under no circumstances should it be +killed. If the animal is rabid, it will be unable +to eat or drink, and will die in the course of a +few days; should it survive not the least fear +need be felt as to it having had hydrophobia, as +no instance is on record where the disease was +followed by recovery. For further information +on this subject, the reader is referred to +the special article on hydrophobia (<a href="#Page_211">page 211</a>).</p> + +<p><i>Hiccough.</i>—Hiccough is a condition caused +by a spasm of the diaphragm. All methods for +the relief of this somewhat annoying condition<span class='pagenum'><a name="Page_250" id="Page_250">[Pg 250]</a></span> +are based upon the idea of having the patient +hold his breath as long as is possible. The +remedy is best applied by the sufferer holding +his breath and leaning as far backward as is +possible, and in the meanwhile distracting the +attention by pointing the index finger of one +hand towards the nose, and bringing the former +toward the latter as slowly as is possible. +Sticking the tongue out and holding the breath +at the same time will often relieve hiccough, +or if the victim can be induced to sneeze the +distressing symptom will at once cease. The +<i>slow</i> swallowing of a few sips of water will frequently +put an end to the trouble.</p> + + + + +<h2><a name="CHAPTER_XV" id="CHAPTER_XV"></a>CHAPTER XV</h2> +<p><span class='pagenum'><a name="Page_251" id="Page_251">[Pg 251]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>WHAT TO DO WHEN POISONED</h3> + + +<p>The vast majority of cases of poisoning occur +in children, and are, almost without exception, +due to carelessness of their elders, and therefore +preventable.</p> + +<p>As soon as it is recognized that anyone has +swallowed a poison of any kind, a competent +physician should be summoned with the utmost +haste, and in the meantime much may be done, +in most cases, to minimize the effects of the +substance taken. The patient should at once +be urged to drink as much water as is possible, +in order that the poison may be diluted, and +every effort should be made to induce vomiting; +this may often be brought about as soon as the +stomach is full of water, by tickling the throat +with the finger, or with any other object that +can be readily introduced through the mouth. +As quickly as possible, some warm water<span class='pagenum'><a name="Page_252" id="Page_252">[Pg 252]</a></span> +should be secured, to a quart of which either +a teaspoon of salt or mustard should be added, +and the patient urged to drink until the stomach +is thoroughly distended; following this, particularly +where aided by tickling the throat, +vomiting may be generally induced, with the +effect, of course, of expelling a greater or less +proportion of the poison from the stomach. If +it be known that the poison is an <i>acid</i>, ordinary +cooking soda should be added to the water that +the patient drinks, as in this way all acid substances +are at once neutralized.</p> + +<p>If the patient has taken an <i>alkaline</i> poison, +he should immediately be given diluted vinegar, +or water into which the juice of lemons or +oranges has been squeezed; such harmless acids +neutralize poisonous alkaloids just as harmless +alkalies antidote poisonous acids.</p> + +<p><i>Arsenic poisoning</i> usually results from the accidental +swallowing of rat-poison or some insecticide, +as Paris green, or else some sort of +green dye, many of which contain salts of arsenic +in some form. An emetic should be at once +given, to be followed by the whites of several +eggs dissolved in a small amount of water;<span class='pagenum'><a name="Page_253" id="Page_253">[Pg 253]</a></span> +sweet milk may also be administered with benefit.</p> + +<p>Accidental poisoning by <i>phosphorus</i>, results +usually from children eating the heads of +matches, and it is rarely the case that enough +of the substance is taken to produce serious results. +The poison, however, is a deadly one if +taken in sufficient quantity, and where it is +found that substances containing it have been +swallowed the most energetic measures should +at once be resorted to. Warm water containing +mustard or some other emetic should at +once be given, and this should be followed by +whites of eggs and sweet milk. It is well also +to try to get rid of any of the phosphorus that +might remain in the stomach by giving the patient +some saline purgative like Epsom salts.</p> + +<p>Where <i>carbolic acid</i> has been taken, the fact +can be readily determined by noting the characteristic +smell of this substance on the patient's +breath, and by observing that the mouth +and throat present a more or less whitish appearance. +The treatment to be of any avail, +should be of the most energetic character. The +patient should at once drink largely of water,<span class='pagenum'><a name="Page_254" id="Page_254">[Pg 254]</a></span> +and vomiting should be induced as quickly as +possible. Either milk or the white of an egg +should then be given. Ordinary quick-lime, or +even plaster from the walls of the house, may +be stirred up in water and administered to the +sufferer, as both have a distinct value in antidoting +the effects of this poison. Burns of the +skin with carbolic acid are rarely followed by +serious consequences. As soon as the accident +occurs the part should be thoroughly washed +with water, and if at hand a little alcohol may +be rubbed over the part; the affected tissues +return to a normal condition in the course of a +short time in the vast majority of cases.</p> + +<p><i>Strychnine poisoning</i> is comparatively rare, +except when this substance is given with suicidal +or murderous intent. Water should be +given, immediately followed by an emetic. A +mass of crystals of permanganate of potash +as big as a pea may be administered in a glass +of water, if this substance be at hand. After +the poison has been absorbed nothing is usually +of any avail if the amount was originally +sufficient to produce death.</p> + +<p>One of the commonest forms of poisoning is<span class='pagenum'><a name="Page_255" id="Page_255">[Pg 255]</a></span> +from <i>opium</i> in the form of morphine, paregoric +or laudanum. When this happens the stomach +should be washed out by water frequently, even +where the drug was administered hypodermatically. +This is best accomplished by causing +vomiting by warm water to which a small +amount of mustard has been added. The patient +should be given strong coffee or tea at +frequent intervals, and artificial respiration +should be practiced. Where it is possible to +obtain it, permanganate of potash in a watery +solution should be given, enough of the chemical +being used to make the water a deep purple +color; this may be frequently repeated, as the +substance is not poisonous in ordinary doses, +and destroys morphine and other alkaloids of +opium very rapidly.</p> + +<p><i>It should never be forgotten that infants and +children are poisoned by comparatively very +small doses of opium, and consequently nothing +containing any derivative of this substance +should be given them except on the advice of a +competent doctor.</i></p> + +<p>Many soothing syrups advertised for the relief +of the minor ailments of children contain<span class='pagenum'><a name="Page_256" id="Page_256">[Pg 256]</a></span> +opium, and there can be no doubt that many +deaths have occurred as a consequence of taking +such nostrums.</p> + +<p><i>Mushroom poisoning</i> in this country is relatively +rare, but there are quite a number of +popular notions on this subject that are totally +incorrect, chief among which is the idea that +there is a difference between mushrooms and +toad-stools, the former being generally regarded +as edible, and the latter poisonous. As +a matter of fact, those conversant with this +subject make no distinction between the two, +using the terms toad-stool and mushroom as +interchangeable. It is likewise a common error +to suppose that we possess any tests by +which the poisonous toad-stools can be told +from those that are wholesome. Although a +skilled student of the subject can almost at +a glance determine which are poisonous and +which are not, it is hazardous in the extreme +to consume those selected by one who is inexperienced. +As a matter of fact, for all practicable +purposes, there is only one species that is +generally eaten,—the <i>Agaricus campestris</i>, or +meadow mushroom. This grows for the most<span class='pagenum'><a name="Page_257" id="Page_257">[Pg 257]</a></span> +part in open fields, and in many parts of the +world may be gathered in great number throughout +the warmer seasons immediately following +rains. This mushroom has also the great advantage +that it is the only one of the edible +species that can be cultivated.</p> + +<p>Just as we have only one common mushroom +that is ordinarily eaten, there is only one common +species of these plants that is highly +dangerous,—the <i>Amanita phalloides</i>, which contains +one of the most deadly poisons known—and +one for which we possess no adequate +antidote. This mushroom is very common, being +frequently seen along the roadside, and at +the edges of fields; it also grows in forests, and +is occasionally encountered in treeless areas.</p> + +<div class="blockquot"><p>It presents a rather attractive appearance, being +rather large, and having a glistening white cap with +a long stem, around which there may always be seen +a distinct collar; on carefully removing the soil +from around its roots, it will be seen that its stem +is surrounded just below the surface of the earth +by a sheath-like structure, the so-called “death-cup,” +which, together with the peculiarities already mentioned, +clearly stamp this mushroom as being one +of the most deadly of all known natural objects. +In addition to the rather inviting appearance of this +<span class='pagenum'><a name="Page_258" id="Page_258">[Pg 258]</a></span>toad-stool, its flavor is agreeable, thus in every way +insidiously inviting, it would seem, the unwary to +their doom. Less common than the species just considered +is another closely related fungus known as +the <i>Amanita muscarius</i>, or fly-agaric; this handsome +mushroom presents the same peculiarities of structure +exhibited by the <i>Amanita phalloides</i>, but differs from +it in the fact that the tip of its cap is scaly, and is +of a reddish-yellow color. The fly-agaric is quite as +poisonous as its more common relative, and is equally +to be shunned. The reader should be warned that +even handling either of the fungi just considered +may result in poisonous symptoms—probably as a +consequence of multitudes of the tiny spores of the +plants being carried into the nose and mouth by the +air.</p></div> + +<p>Some hours after eating the <i>Amanitas</i>, the +patient is taken with vomiting, diarrhœa, +cramps, and extreme prostration; in children, +convulsions may occur. Most unfortunately +evidences of this poisoning do not usually develop +until some hours after eating it. As a +consequence, a considerable amount of the +poison has usually been absorbed into the body +before the victim is aware that anything is +wrong, and it, therefore, becomes impossible, as +a rule, to greatly help matters by attempting to +remove the offending material from the stomach<span class='pagenum'><a name="Page_259" id="Page_259">[Pg 259]</a></span> +by emetics. Notwithstanding this it would be +proper to administer warm water, into which a +small amount of mustard had been stirred, in +order to assist nature by washing out of the +stomach whatever portions of the fungus might +remain. When exhaustion begins to appear, it +should be combated with doses of aromatic +spirits of ammonia, and by the external application +of heat. As it is believed that atropine +possesses some antidotal powers to the poison +of the <i>Amanitas</i>, this substance should be injected +hypodermatically in the usual dose as +quickly as possible, and an experienced physician +should be called at once.</p> + +<p><i>Ivy Poisoning from Touch.</i>—One of the two +species of <i>Rhus</i>, is exceedingly common in all +portions of the United States, producing a +severe inflammation of the skin when handled, +or even in some persons by merely being near +the plants or in the smoke of a fire where they +are burning. There are two varieties of the +<i>Rhus toxicodendron</i>, one being the shrub commonly +called <i>poison oak</i>, and the other a climbing +vine generally known by the name of poison +ivy. The <i>Rhus venenata</i> grows in swampy localities<span class='pagenum'><a name="Page_260" id="Page_260">[Pg 260]</a></span> +all over the United States, and is +known as poison-sumac, swamp dog-wood, +poison-elder, and poison dog-wood. About +twenty-four to forty-eight hours after the exposure, +the skin begins to itch, and this is +shortly followed by an inflammation accompanied +by the formation of numerous small +blisters, and still later by scaling. It should +not be forgotten that the berries and other portions +of these plants are poisonous when taken +internally, giving rise under such circumstances +to vertigo, faintness, dilation of the pupils, +trembling, confusion of the senses, and, in some +instances, convulsions. Should it be discovered +that anyone has been exposed to poisoning by +these plants, the skin should be washed as +quickly as is possible with alcohol, or some substance +like whisky that contains it; where this +cannot be obtained, hot water and soap should +be liberally applied—the object, in either case, +being the removal of as much of the poison as is +possible. After the irritation of the skin has +begun, the parts may be bathed in a one per +cent. solution of carbolic acid, to be repeated +every few hours, as the necessities of the case<span class='pagenum'><a name="Page_261" id="Page_261">[Pg 261]</a></span> +may demand. Lead-water is also frequently +used with benefit, lime-water also appears to be +of use, but the various powders and salves sold +in stores rarely help the patient much. The +best thing after all is soap and water as hot as +it can be borne; and ordinarily the itching and +inflammation will disappear in four or five +days, followed by scaling.</p> + + +<h4>VENOMOUS SNAKES AND SNAKE BITES.</h4> + +<p>Much popular misapprehension exists on +the subject of snakes, both as to the results +of their bites and the appropriate treatment +under such circumstances. It is not generally +understood that a very large percentage of our +American snakes are entirely harmless—the +poisonous ones being decidedly more the exception +than the rule.</p> + +<p>Within the confines of the United States there +exist only two families of venomous serpents. +By far the most numerous are three genera of +viperine snakes, including the rattlesnakes and +moccasins; all of these have a pit-like depression +between the nose and eyes, and hence are +called <i>pit-vipers</i>. In the southern portion of<span class='pagenum'><a name="Page_262" id="Page_262">[Pg 262]</a></span> +our country there are two species of a colubrine +genus closely related to the dreaded cobra of the +East, one of them being called the coral-snake +or harlequin snake, and the other, which occurs +in the southwest, is known as the Sonoran coral-snake.</p> + +<p>While there are three genera of vipers in +America, two of them are so closely related, and +present characteristics that are so similar that +the ordinary observer would regard them as being +identical, and inasmuch as the character of +their poison seems in every way similar, for +practical purposes it would seem desirable to +include them under one head; in both genera, +the species have rattles on the tips of their tails, +the more common being the ordinary rattlesnakes +(genus <i>Crotalus</i>), of which there are +twelve species in the United States, and the +ground-rattlesnakes (genus <i>Sistrurus</i>), of which +there are two species.</p> + +<p>Closely related to the rattlesnakes are the true +moccasins, of which there are two species, one +being the cotton-mouth or water-moccasin +(<i>Ancistrodon piscivorus</i>), and the other the<span class='pagenum'><a name="Page_263" id="Page_263">[Pg 263]</a></span> +highland moccasin, pilot-snake or copper-head, +(<i>Ancistrodon contortrix</i>).</p> + +<p>The two species of poisonous colubrine serpents +already referred to are known respectively +as the <i>Elaps fulvius</i>, and the <i>Elaps euryxanthus</i>, +both of which occur in the southern portions +of the United States. These snakes are +fortunately of a very mild disposition, and +rarely attempt to bite, even when handled. That +their poison is exceedingly deadly is attested by +the fact that out of eight instances where it was +known that persons were bitten by them, six +died, and they should, therefore, be looked upon +as among the most deadly of North American +serpents. Mention should be made of the fact +that there are at least six harmless reptiles that +resemble the coral-snakes very closely, and as a +consequence of the former being mistaken for +the latter, the assertion has been frequently +made by the ignorant that our elapine serpents +are harmless.</p> + +<p>A short description of the really deadly reptiles +encountered in this country that would +enable even the novice to distinguish them from<span class='pagenum'><a name="Page_264" id="Page_264">[Pg 264]</a></span> +those that are harmless would seem not inappropriate +here, for where a person is bitten by +a snake it becomes at once a matter of vital importance +to determine, if possible, its true character. +Most non-venomous serpents will viciously +bite when cornered, and while they may +produce slight wounds, with a small amount +of bleeding, such injuries are entirely devoid +of danger, and need occasion no fear on the +part of the victim. There now follows a brief +description of our venomous snakes, by means +of which it will be easy for any one to distinguish +them from their innocent relatives.</p> + +<p><i>True Rattlesnakes.</i>—There are twelve species +of these reptiles in the United States, all +of which, with but two exceptions, live west of +the Mississippi. They vary very greatly in +color, but the common eastern forms generally +have alternate transverse yellow and brownish-black +marks over their bodies. All possess rattles. +The body of the snake is thick in proportion +to its length, and the head, which is more +or less diamond-shaped, is much larger than, +and is quite distinct from the neck. The pupils +of the eye are elliptical—a peculiarity which<span class='pagenum'><a name="Page_265" id="Page_265">[Pg 265]</a></span> +the pit-vipers alone possess of all the North +American snakes. Between the eye and nose +there is a comparatively deep depression or pit +which gives to this group of snakes their name. +There are two large, exceedingly sharp fangs +in the front of the mouth, in the position of a +dog's canine teeth, that are folded up against +the roof of the mouth when the snake is in repose;—being +brought forward in a position for +stabbing as the serpent strikes. The scales on +the under surface of the body back of the anus +do not divide along the middle line into two +rows, as in harmless snakes.</p> + +<p><i>Ground Rattlesnakes.</i>—There are two species +of the pygmy or ground-rattlesnakes. They attain +to a length of only about twenty inches, +and present the general characteristics of the +true rattlesnakes, with the exception that the +rattle is small, consisting of but one single button +at the end of the tail. These serpents are +exceedingly vicious, and usually bite without +warning. Contrary to the general opinion, however, +the wounds they inflict are rarely, or never, +followed by serious consequences in man. One +species is southern. The other occurs from<span class='pagenum'><a name="Page_266" id="Page_266">[Pg 266]</a></span> +Ohio to Nebraska, where it is called massasauga.</p> + +<p><i>Cotton-Mouth Moccasin.</i>—The largest specimens +of the cotton-mouth moccasin attain to a +length of about six feet. The full grown reptile +is of a dingy brownish-black color, but the +young are pinkish, with coppery bands running +transversely across the body. With the exception +that this reptile has no rattles, it answers +in its general peculiarities to the description +already given of its near relatives the rattlesnakes. +The cotton-mouth moccasin is semi-aquatic, +being found around the edges of +streams and other bodies of water.</p> + +<p><i>The Copper-head, or Highland Moccasin.</i>—This +serpent is found from Florida and Illinois +to southern Massachusetts; also in parts of +Texas. The largest specimens have a length of +about three feet. They resemble the cotton-mouth +moccasin in their general peculiarities, +being, however, somewhat lighter in color. The +head has a coppery tinge, from which the snake +gets its name, while the body is of a brownish +color, with transverse Y-shaped bands of reddish-brown. +Its favorite habitat is rocky hill-sides<span class='pagenum'><a name="Page_267" id="Page_267">[Pg 267]</a></span> +and the banks of mountain water-courses.</p> + +<p><i>Coral-snakes.</i>—The two coral-snakes resemble +each other very closely, and are long +slender serpents, whose heads are quite small, +and scarcely differentiated from their bodies. +The pupils are round, and the head has no pits. +They possess two short permanently erect +fangs, which are by no means so well developed +as those of the viperine reptiles—though perhaps +capable of inflicting more deadly wounds +than any of the latter,—with the possible exception +of the diamond-back rattlesnake of the +extreme southern portion of the country. Their +coloration is exceedingly beautiful, and when +properly interpreted, entirely characteristic. +From the head to the tail their skins exhibit alternate +rings, or encircling bands of black, red +and yellow—each band of the two former colors +being bordered by yellow; <i>in other words there +are as many yellow stripes as there are both +black and red together</i>. Stress is laid upon the +characteristics just mentioned, for the reason +that half a dozen species of harmless serpents +that greatly resemble them may, without exception,<span class='pagenum'><a name="Page_268" id="Page_268">[Pg 268]</a></span> +be differentiated from the true coral-snakes +by the fact that there are as many <i>black bands +as both red and yellow</i>. Where a snake has been +killed, it is of course quite easy to determine +whether or not it is venomous by a search for +the fangs, which are never present in the non-poisonous +reptiles. Fortunately, the coral-snakes +are only found in the extreme southern +portion of the United States, live under ground +for the most part, and are rarely encountered.</p> + +<p><i>Treatment of Snake-Bite.</i>—As soon as a person +has been bitten by a poisonous serpent, a +tight bandage, or ligature of any kind, should +be applied above the wound if the injury has +been received on any of the extremities,—which +is fortunately the case in the vast majority of +instances. The part bitten should be at once exposed, +and search made for the point of entrance +of the fangs. It should be particularly +noted as to whether there are one or two +wounds, as it is true in about one-half of the +cases that only one fang enters the flesh,—in +which case, of course, the probabilities of serious +consequences resulting are largely diminished. +With a pocket-knife or other sharp instrument<span class='pagenum'><a name="Page_269" id="Page_269">[Pg 269]</a></span> +the wound should be enlarged, and, if +possible, someone should be persuaded to suck +the wound; this should not be done by one with +decayed teeth, as under such circumstances the +poison might be absorbed and produce unpleasant +consequences. A doctor should be summoned +as quickly as is possible, but it must be +confessed that in the present state of knowledge, +unless he should happen to possess—which +he probably will not—some antitoxin for +the particular snake doing the damage, his services +will likely be of no great value.</p> + +<div class="blockquot"><p>It has been asserted by some that very large doses +of strychnine are directly antidotal to snake venom, +but more recent experience does not tend to confirm +this view; still there is no harm in making the trial, +and if the services of someone capable of giving +the injections can be secured, the treatment is certainly +worth the trial. The immediate injection into +the tissues around the wound of a one-per-cent. +watery solution of chromic acid or potassium permanganate +is thought to be of value by destroying +the poison, but in order to be efficient it must be +administered within a short time after the bite has +been received. Should the patient's condition become +serious, and the breathing finally stop, artificial +respiration may be resorted to. As soon as the remedies<span class='pagenum'><a name="Page_270" id="Page_270">[Pg 270]</a></span> +suggested have been tried, it is time for us to +go back to the ligature, which cannot be suffered +to remain around the limb indefinitely, as by cutting +off the blood-supply it will sooner or later produce +death of the tissues. From time to time we should +slowly loosen the bandage, thus allowing a little of +the poison to pass into the body, and at the same +time permit the entrance of a small quantity of +blood into the tissues of the limb beyond the ligature; +the bandage should of course be tightened at the +end of a half a minute, and it should be alternately +loosened and tightened every half hour until the patient +is considered to be out of danger.</p></div> + +<p>The reader cannot fail to have observed that +nothing has been said concerning the use of +alcohol in the treatment of snake-bite, and the +matter is only here referred to for the purpose +of condemning it as being unsound in theory +and bad in practice.</p> + +<div class="blockquot"><p>The idea that this drug is of value in snake bite +doubtless originally arose from the fact that those +bitten by poisonous serpents were depressed, and, as +in the past alcohol was considered the best of all +stimulants, it is not surprising that its use was generally +considered to be essential. As we now know, +however, that alcohol is a depressant rather than a +stimulant, and as numerous experiments carried out +on animals have clearly shown that it does harm in +<span class='pagenum'><a name="Page_271" id="Page_271">[Pg 271]</a></span>snake bite rather than good, there is every reason +why we should cease to endanger the lives of those +already poisoned by adding to the trouble by using +this drug. There is but little doubt that many more +persons have been killed by the alcoholic treatment +for snake bites than have died from the effects of +snake venom. Inasmuch as there is a deep-rooted +superstition among most people that alcohol is the +panacea for snake bite—and such notions die hard—it +may be well to say that all of the authenticated +cases of this character that have occurred in this +country have recently been collected, with the result +that it was shown that only about one man in ten +dies who is bitten by a venomous serpent, and it is, +therefore, quite easy to understand why alcohol has +maintained its reputation as being an antidote in +such cases—the chances being nine to one in the victim's +favor without any treatment whatever.</p></div> + +<p>As soon as the patient's needs are attended +to, it is well to find if the snake that inflicted +the wound was killed, and an examination of it +should at once be made as by determining the +size and character of the reptile an accurate +forecast to the probable results may be made. +In many instances it will be found that the snake +was not venomous, it having made only a few +scratches which are of no more consequence than +the prick of a brier. If it be found that the serpent<span class='pagenum'><a name="Page_272" id="Page_272">[Pg 272]</a></span> +inflicting the wound belongs to one of the +groups already referred to, the probabilities of +a serious result will depend upon the size and +character of the snake, and also to a considerable +degree on whether one or both fangs entered +the victim's body. A full grown diamond-back +rattlesnake, which may attain the extreme +length of eight feet, is perhaps the most dangerous +of all the American poisonous reptiles, +though a fully grown coral-snake may be regarded +as almost, if not quite as, deadly. Next +to these a large sized cotton-mouth moccasin +is perhaps most to be dreaded, to be followed, +depending upon their size, by the other varieties +of rattlesnakes, the copperheads, and finally +the ground-rattler. The larger the serpent inflicting +the wound the greater is the result to +be dreaded; naturally it also follows that the +larger the individual bitten the less the danger.</p> + + + + +<h2><a name="APPENDIX" id="APPENDIX"></a>APPENDIX</h2> +<p><span class='pagenum'><a name="Page_273" id="Page_273">[Pg 273]</a></span></p> +<span class="totoc"><a href="#toc">Top</a></span> +<h3>RECIPES FOR COOKING COMMON FOODS<br /> +By <span class="smcap">Dr. Mary E. Lapham</span></h3> + +<h4>PREPARATION OF MEATS</h4> + + +<p><i>Roast Beef.</i>—The problem of roasting beef is to +have it sufficiently cooked in the center without hardening +and over-cooking the outside. Burned edges +and a raw center testify to a lack of intelligence.</p> + +<p>The English way of baking beef is to allow nine +minutes to the pound for a rib-roast and eight minutes +for a sirloin. Sprinkle pepper and salt over the meat +and sprinkle with flour. Pour a little boiling water +into the pan and bake in an oven hot enough to crisp +and brown peeled raw potatoes cooked in the same +pan. Do not forget to baste often. This method +gives a rich flavor to the beef and the gravy, but the +outside is apt to be cooked too hard while the inside +is not enough cooked. Too hot a fire tends to make +meat tough and dry.</p> + +<p>The French have a safer way, especially for small +roasts. The beef is cooked in a cool oven—so cool +that a peeled, raw potato will cook tender without +browning. Allow about an hour and a quarter for a<span class='pagenum'><a name="Page_274" id="Page_274">[Pg 274]</a></span> +four-pound rib-roast. In this way the heat penetrates +to the center without hardening the outside. When +properly done the outside is very little more cooked +than the inside, and the roast throughout is tender, +rare, and juicy, with no hard-burned edges. This +way of baking makes inferior beef more tender and +juicy than the English way. It has the disadvantage +of not leaving any gravy in the pan. When baked +after the English method the fat fries out into the +pan, and a delicious, rich, brown gravy may be made +by adding flour and water. Strain the juice through +a fine sieve and allow to stand a few minutes so as to +be able to skim or pour off all the grease. Do not +serve gravies with half an inch of pure grease on top. +It does not require a scientific education nor a herculean +effort to remove the grease.</p> + +<p><i>Pot Roast.</i>—If the beef is of an inferior quality, +the best way to cook it is in a heavy iron kettle, preferably +with a sloping bottom. Sprinkle the meat +with salt and pepper; place a little fat in the bottom +of the kettle—enough to keep the meat from sticking—and +allow the roast to brown slowly for half an +hour. Now put a pint of boiling water in the pot. +Cover very closely and let it simmer on the back of +the stove for about four hours, adding small quantities +of hot water as necessary, and turning often. +When cooked take up the meat; skim the fat from +the gravy and thicken with flour.</p> + +<p><i>Hamburg Steaks.</i>—Another way of preparing inferior +cuts of beef is to make Hamburg steaks. Chop +the meat in fine pieces. Season with salt, pepper and<span class='pagenum'><a name="Page_275" id="Page_275">[Pg 275]</a></span> +a little onion juice, and shape into thin cakes. Put +three or four slices of fat salt pork into a frying-pan, +and when brown remove it and place the steaks in +the fat. Fry four minutes; turn, and fry three more, +and serve on a hot platter. Put a tablespoonful of +flour into the fat and stir until brown. Gradually +add a cupful of water or preferably milk and boil +three minutes; season well, pour over the meat, and +serve immediately.</p> + +<p><i>Broiled Beef.</i>—Broiling is the simplest, easiest, and +most delicious method of cooking meats, but, as a rule, +ignorance instinctively turns to the frying-pan, and +broiling is unknown in many homes. This is partly +due to not knowing how to manage the fire. It seems +so much easier to fry on top of the stove than to plan +beforehand an adequate preparation of the coals. It +is necessary to have a bed of clear, hot coals with no +smoke. Have the steak cut three-quarters of an inch +thick; place in a wire broiler; put over the coals and +cover with a baking-pan. Turn every minute or two +until the meat is sufficiently cooked. When done, +place on a hot platter, and season well with salt, pepper, +and butter. Serve immediately. It should take +about ten minutes to cook a steak or thick mutton +chop.</p> + +<p><i>Fried Beef.</i>—If beef must be fried, have a hot fire; +heat a thick iron frying-pan and grease it just +enough to keep the meat from sticking. Have the +meat three-quarters of an inch thick; place in the hot +pan and turn as soon as it is well seared. Turn often +until done and then season well and serve at once.<span class='pagenum'><a name="Page_276" id="Page_276">[Pg 276]</a></span> +There should be no gravy in the pan; all the juices +should be in the meat.</p> + +<p><i>Beef Hash.</i>—Take equal parts of beef and cold potatoes, +chopped moderately fine. Chop a small onion +and fry in plenty of butter until brown; add the meat +and potatoes and just enough milk to keep from sticking. +Cook for half an hour, stirring frequently. +Serve with thin, dry toast or toasted crackers. +Poached eggs are a very nice addition.</p> + +<p><i>Veal.</i>—Veal, when properly cooked, is delicious and +delicate. Like pork it should be cooked slowly for a +long time to develop its full flavor. Unfortunately +it is usually half-cooked, tough, and insipid. The +housewife who can cook veal properly has a distinct +advantage over her less fortunate neighbor.</p> + +<p><i>Leg Roast of Veal.</i>—Take out the bone and fill the +space with stuffing made as follows: Take one half-cupful +of chopped fat pork, or unsmoked bacon, and +fry with a finely chopped onion until delicately brown. +Add two cupfuls of bread crumbs; season with salt +and pepper and moisten with a little milk. Tie the +veal closely; sprinkle with pepper and salt; rub thoroughly +with flour and cover with buttered paper. +Into the baking-pan put a generous number of thin +slices of unsmoked bacon, an onion and half a can +of tomatoes. Add just enough boiling water to steam +the veal. Cook gently in a moderate oven, allowing +twenty-five minutes to the pound, and baste very frequently, +turning the meat about every half-hour. +When done, put it on a hot platter in the warming +oven, and add enough water to make the requisite<span class='pagenum'><a name="Page_277" id="Page_277">[Pg 277]</a></span> +amount of gravy. Thicken with browned flour, strain, +and pour over the roast.</p> + +<p><i>Fried Veal.</i>—Fried veal steak or cutlets are delicious, +but very difficult to prepare properly. As a +usual thing veal cutlets are either half raw, or cooked +until dry and hard. When properly cooked veal +should be spongy, soft, and velvety. The chops +should be not quite a half inch thick. Melt a little +lard in a hot frying-pan; sprinkle some salt and pepper +on the veal and fry quickly until brown on both +sides. Then cover tightly, and place on the back of +the stove and steam until thoroughly tender. It requires +from forty to forty-five minutes to fry veal.</p> + +<p><i>Broiled Veal.</i>—The veal should be cut thin, broiled +quickly until brown, and seasoned with salt, pepper, +and melted butter, to which a little chopped parsley +and lemon juice have been added. Serve on a hot +platter and eat at once. If the veal is fat, tender and +nicely broiled, it is almost as good as game.</p> + +<p><i>Veal Stew or Pot-pie.</i>—Cut the meat from a knuckle +of veal into pieces not too small; put them into a pot +with some small pieces of salt pork, and plenty of +pepper and salt; pour over enough hot water to cover +it well, and boil until the meat is thoroughly done. +While the water is still boiling drop in, by the spoonful, +a batter made as follows: Two eggs well beaten, +two and a half or three cupfuls of buttermilk, one even +teaspoonful of soda, and flour enough to make a thick +batter. Cover the pot, and as soon as the batter is +well cooked serve it.</p> + +<p><i>Veal Stew.</i>—This is an exceedingly nutritious, economical,<span class='pagenum'><a name="Page_278" id="Page_278">[Pg 278]</a></span> +and appetizing dish. Cut the veal into small +pieces about an inch square; add three or four thin +slices of salt pork; one or two onions and potatoes +cut up fine, and a little turnip, carrot, parsley and +celery, if you have them. Cover well with boiling +water and cook over a brisk fire until the meat is tender +and the water pretty well cooked away. This will +require about an hour. Cover the meat well with +fresh milk; season to taste with pepper, salt, and a +generous quantity of butter; let the mess simmer on +the back of the stove about twenty minutes, and serve +it in a hot covered dish.</p> + +<p><i>Jellied Veal.</i>—Jellied veal gives the impression of +an expensive preparation, and yet nothing is cheaper +or simpler. Put a knuckle of veal into a pot that +can be tightly covered; season well with two or three +slices of unsmoked bacon, the heart of an onion, salt, +pepper and a little butter, adding just enough water +to steam the meat thoroughly (replenishing it from +time to time as needed), and cook over a slow fire +until tender—probably about four hours. When done +there should be about two teacupfuls of broth. Prepare +three cold hard-boiled eggs. Cut the veal into +pieces the size of a walnut. Now choose a dish just +large enough to hold the meat, the eggs and the +broth. Slice the eggs and place a few pieces on the +bottom of the dish. Now put in a layer of veal; then +more egg and continue in this way until the veal is +used. Strain the broth over the veal and set it away +in a cool place, preferably on ice, until quite firm. +When about to serve it, loosen by slipping a knife,<span class='pagenum'><a name="Page_279" id="Page_279">[Pg 279]</a></span> +warmed in water, between the meat and the dish. +Garnish with parsley or lettuce, and serve with salad +of any kind.</p> + +<p><i>Roast Pork.</i>—Pork should be thoroughly cooked in +a medium hot oven. For the leg or the shoulder allow +twenty-five minutes to the pound. For the spareribs +allow fifteen minutes. Sprinkle the spareribs +well with salt, pepper, sage, and a little chopped +onion, or bake a few onions in the same dish. Put +a little water in the pan and add to it as it cooks +away. The leg, the loin, and the shoulder may be +stuffed with well-seasoned sage stuffing. To make +this, cut a few strips of fat pork into small dice and +fry over a slow fire. Add a finely chopped onion and +cook until brown. Crumble as many slices of dry +bread as you will need, and fry with the onion and +pork over a slow fire until nicely browned. Moisten a +little with milk or cream, and fill the space left by removing +the bones. Sew tightly together and bake +thoroughly. Peeled, raw potatoes are very nice baked +in the same dish with the pork. A medium sized +potato will require a little over an hour to bake in a +moderate oven. Apple sauce, sauerkraut, or cabbage +cooked with a little vinegar, are nice to serve with +pork.</p> + +<p><i>Broiled Pork.</i>—Very thin slices cut from a leg of +pork, or the cutlets, or the chops, are extremely nice +and delicate when broiled. They must be cut thin; +the coals must be bright and hot; and the meat turned +very often. Serve on a hot platter.</p> + +<p><i>Fried Pork.</i>—For frying, pork should not be cut<span class='pagenum'><a name="Page_280" id="Page_280">[Pg 280]</a></span> +over a half an inch thick: Cook slowly from forty +minutes to an hour, with the pan closely covered, to +keep in the steam. Pork requires a long, slow process +to develop its flavor and tenderness. Nearly everyone +cooks it too fast, and for too short a time. When +thoroughly steamed and nicely seasoned with salt, +pepper, sage and a little onion, well fed pork is as +toothsome and dainty as turkey. Make a brown gravy +and pour over the meat. Serve with apple sauce.</p> + +<p><i>Boiled Pork.</i>—Take a leg of pork, or a shoulder, and +remove the bones. Tie closely together and let it cook +slowly in a tightly covered pot for half an hour, adding +a little fat if necessary to keep the meat from +sticking. Now sprinkle with salt, pepper and sage. +Put two whole onions in the pot, and just enough boiling +water to thoroughly steam the meat. Place it on +the back of the stove and cook over a slow fire for four +or five hours until thoroughly tender and velvety. +When done put on a hot platter in the warming-oven. +Thicken the gravy with flour, adding a little water or +milk if necessary, then let it boil for five minutes and +strain. When properly cooked this is delicious cold, +and almost as good for salad as chicken or turkey. +If desired, peeled raw potatoes may be browned in the +pot with the meat. These will take about an hour to +cook.</p> + +<p><i>Curing Ham and Bacon.</i>—To have good ham and +bacon the meat must first be properly cured so that +the lean part is pink, tender and soft to the touch, +while the fat is clear and white. In many country +homes the lean meat is about as tough, hard, and indigestible<span class='pagenum'><a name="Page_281" id="Page_281">[Pg 281]</a></span> +as sole leather. A good recipe for curing is +as follows: For every gallon of water take two pounds +of coarse salt and one-half ounce of soda. Boil all +together and skim well, and, while hot, pour over the +meat. Put in a cold dry place with a stone to keep +the meat well below the water. After three weeks, +hang the meat and let it dry for two or three days before +smoking.</p> + +<p><i>Broiled Ham.</i>—Nothing is more appetizing for supper +than broiled ham, served with mashed potatoes, +milk toast, or a poached egg on dry toast. Cut the +ham as thin as possible, and broil quickly over hot +coals, turning constantly until the fat begins to +shrivel. Have everything else ready so that it can be +eaten immediately. Cold cabbage salad is nice with +this.</p> + +<p><i>Boiled Ham.</i>—If quite salty, soak the ham twenty-four +hours. Put it in a large kettle with a generous +supply of water, and allow twenty-five minutes to the +pound for boiling. Take the pot from the fire and +let the meat remain in the water until nearly cold. +Sprinkle with pepper and rub thoroughly with brown +sugar; put the ham and the fat from the liquor into +a baking-pan and brown for about an hour in the +oven. Cut as thin as possible when serving.</p> + +<p><i>Frying Ham.</i>—Cut the ham in the thinnest possible +slices, with a large, sharp knife. Have the frying-pan +hot, and cook the meat just enough to give the fat +a delicate brown, turning frequently. To cook ham too +much is to make it tough, hard, dry, and indigestible. +Put the ham on a hot platter in the warming oven.<span class='pagenum'><a name="Page_282" id="Page_282">[Pg 282]</a></span> +Add a cupful, or more, of fresh milk to the grease and +thicken with flour. Serve with boiled potatoes. Instead +of making a gravy, eggs may be fried in the fat. +To do this nicely the fat must not be burned. The +eggs should be dropped in one by one, allowing them +plenty of room to spread out. Cook slowly and with +a spoon baste the yolks with the hot fat until they +sear, being careful not to cook the egg too hard. +These eggs are very nice served on thin, dry toast, or +one may be placed on each slice of ham.</p> + +<p><i>Fried Bacon.</i>—Cut the bacon into very thin slices, +and cook in a hot frying-pan just long enough to turn +the fat to a delicate brown. If cooked too long it is +hard and indigestible, besides losing its delicacy of +flavor. A very nice way to cook bacon, instead of +frying it, is to roll the slices up into curls, skewer +them with toothpicks, and place them in a baking-pan +on the grate of a hot oven until they are slightly +brown. Serve on dry toast. They should be eaten +at once.</p> + +<p><i>Broiled Bacon.</i>—Bacon can be broiled like ham. A +very nice way to serve it, especially for an invalid, +is to toast it before the fire; split a hot biscuit and +make a sandwich with the bacon. Bacon toasted this +way and eaten when very hot has a peculiarly appetizing +flavor.</p> + +<p><i>Unsmoked Bacon.</i>—Cut in thin slices; roll in flour +or meal; dust lightly with pepper; fry over a moderately +hot fire until delicately brown and crisp, and +put on a warm platter in the warming closet. Add +sufficient fresh milk to the fat to make the requisite<span class='pagenum'><a name="Page_283" id="Page_283">[Pg 283]</a></span> +amount of gravy. Season with a little salt and pepper, +and thicken with flour. Do not pour over the +meat. Serve in separate dish.</p> + +<p><i>Boiled Mutton.</i>—Mutton should be cooked very much +like beef,—just enough to leave a faint pink, but not +enough to make it hard and develop a strong taste. +For boiled mutton allow ten minutes to the pound. +Add a little rice to make the meat whiter and tenderer. +Cover with boiling water and cook rapidly for fifteen +minutes; then place on the back of the stove where +it will simmer nicely for two hours. Young turnips, +boiled with the mutton are a very nice addition.</p> + +<p><i>Mutton Cutlets.</i>—The chops should be thick. +Grease the bottom of a hot frying-pan just enough +to keep the chops from sticking; place over a hot fire, +and turn the meat constantly to keep it from burning +until the center is a faint pink. Season with salt, +pepper, and melted butter to which a little lemon juice +and parsley may be added.</p> + +<p><i>Roast Mutton.</i>—The French roast mutton in a slow +oven in order that the heat may penetrate to the center +without injuring the outside. Allow twenty minutes +to the pound, or, if a very large roast, twenty-five +minutes may not be too much, providing the oven +is not too hot. Season with salt and pepper, and put +a generous supply of boiling water in the pan. Baste +frequently, and turn the meat every half hour. Place +two or three peeled raw potatoes in the pan, and watch +them; if they begin to brown, the oven is too hot. +The potatoes should keep pace with the mutton, and<span class='pagenum'><a name="Page_284" id="Page_284">[Pg 284]</a></span> +when the latter is half done the former should be +cooked to the same degree.</p> + +<p><i>Broiled Mutton Chops.</i>—The chops should be cut an +inch thick. Trim off the fat and scrape the bones. +Roll in a little melted butter or oil, and broil over a +hot fire, turning constantly until just pink within. +Have ready a mound of hot mashed potatoes and lay +the chops around it. Pour a little melted butter over +them and serve with green peas.</p> + + +<h4>PROPER COOKING OF CEREALS.</h4> + +<p>Starchy foods in any form must be well cooked. +Gluey, slimy oatmeal, full of hard lumps of half-cooked +grains, the whole forming a raw, horrid mass, +is very different from the smooth, well cooked, easily +digestible, oatmeal prepared by a good cook. Rolled +oats are more easily cooked than oatmeal, as they are +already prepared. For four people, put a quarter of +a teaspoonful of salt into four cups of <i>hot</i> water and +stir in slowly one cup of rolled oats, being careful not +to allow lumps to form. Cook for an hour in a double +boiler.</p> + +<p><i>Hominy.</i>—Hominy is seldom well cooked. It is +often lumpy and raw, and yet has a burned taste +which comes from being cooked in too little water, +while if too much is used it goes all to soup and can +never be made good. Salt a quart of boiling water, +and very carefully stir into it a cup of hominy. Stir +often and add a little water from time to time if it +gets too dry. Cook until every grain is thoroughly +done.<span class='pagenum'><a name="Page_285" id="Page_285">[Pg 285]</a></span></p> + +<p><i>Rice.</i>—Rice is rarely well prepared, the greatest +trouble being to get each grain well cooked without +making it mushy. When properly cooked each +grain will be firm and distinct, and at the same time +soft and tender. Wash half a cupful of rice thoroughly, +put it in a quart of boiling salted water, and +let it boil for half an hour; then drain it thoroughly +and steam it in a colander for an hour.</p> + +<p><i>Corn-Bread.</i>—Corn-bread should be something +like rice: every particle thoroughly cooked and soft, +and yet not sticking together, so that the inside is +dry and crumbly while the outside is crisp and +nutty. The thinner corn-bread is baked the more +perfectly it cooks. It should not be more than an +inch thick and preferably less. A cannon-ball of +raw meal, with only the thinnest of surfaces decently +baked, is an insult to a man's intelligence +as well as to his digestion. This is the way to prepare +it properly. Sift a teaspoonful of baking +powder into a pint of corn meal. Mix in a piece of +butter the size of a walnut and add sweet milk until +you get a dough that can be kneaded into a cake. +Bake in a hot oven until brown and well done. A +little richer corn-bread is made by heating a pint +of sweet milk and pouring it over a pint of corn-meal. +Melt a piece of butter the size of a walnut, +beat two eggs, add a little salt, and mix well into +the meal. Put in a shallow dish, and bake about a +half hour in a quick oven.</p> + +<p><i>Biscuits.</i>—Biscuits should be thin, crisp, delicately +browned and free from flour. The inside of a biscuit<span class='pagenum'><a name="Page_286" id="Page_286">[Pg 286]</a></span> +should be flaky and dry. Thick, soggy, heavy +biscuits impose a severe task upon digestion. Make +the biscuits about two inches in diameter, and +three-quarters of an inch thick. Bake them brown +on both the top and the bottom. It is much easier to +make light, wholesome biscuits with baking-powder +than with soda. Buttermilk biscuits are very delicate +and palatable, but not quite so certain to turn +out well. If soda is not properly used you will have +a yellow, evil-smelling compound, or else there will +not be enough soda to make the biscuits rise, and +they will be dangerously heavy. To make soda-biscuits +sift one level teaspoonful of soda, one half-teaspoonful +salt, and one quart of flour together three +times so as to get the soda thoroughly well mixed in. +Now rub two tablespoons of lard into the flour and add +enough buttermilk to make a soft dough. Roll out +into a sheet, cut into small thin biscuits and bake +in a hot oven until well browned. Baking-powder +biscuits are made in the same way, by using two teaspoonfuls +of baking-powder in place of the soda, and +sweet milk instead of buttermilk.</p> + +<p><i>Yeast.</i>—Put three hops in a pot containing two +quarts of cold water. Place on the stove and see that +it boils twenty minutes. Have a pint of flour in a +large bowl and mix into it a tablespoonful of sugar, +one of salt and a teaspoonful of ginger. Strain the +water from the hops into this, stirring constantly. +Allow it to cool. When lukewarm put in a cup of +yeast or a yeast-cake.</p> + +<p><i>Rolls.</i>—At night take one half-cup of lukewarm<span class='pagenum'><a name="Page_287" id="Page_287">[Pg 287]</a></span> +water, one half-teaspoonful of salt, three-quarters of +a cup of yeast, and enough flour to make a thin +batter. In the morning add to this a pint of milk, +a teaspoonful of sugar, a half-cup of butter and beat +in flour until it is no longer sticky. Set it in a warm +place to rise and when well up knock back. Repeat +this process, and when it comes up the third time +make it into rolls. Let it rise once more and then +bake it.</p> + + +<h4>METHODS WITH CHICKEN.</h4> + +<p>The simplest and easiest way to cook chicken is +to fry it. A poorly fed chicken is better stewed. +For baking and broiling the chicken must be fat. +In whatever way the chicken is cooked there is +danger of its being tough, dry, stringy, and tasteless. +Plain, artless, boiling results in insipidity. Quick, +superficial frying means tough stringy fibres; and a +hot oven frequently dries the meat until it is not fit +to eat.</p> + +<p><i>Fried Chicken.</i>—All housewives think they can fry +chicken, but the results are vastly different, according +to the way it is done. You may have a tender, +rich, delicious morsel, or tough masses of meat, +stringy, tasteless and almost impossible to chew. Of +course the condition of the chicken has a great deal +to do with the results. A tender, well-fed chicken +will fry far better and much more quickly than a +thin, scrawny one. The thinner the chicken the +greater the necessity for care in cooking it. It +must be cooked slowly, over a moderate fire, in<span class='pagenum'><a name="Page_288" id="Page_288">[Pg 288]</a></span> +a tightly covered pan, until it is perfectly tender. +Melt a little fat in the frying-pan; flour, salt, +and pepper the pieces of chicken and fry them in +the fat until nicely browned on both sides. Now +cover closely and place on the back of the stove where +the chicken will steam for half an hour. When tender +take up on a hot platter and put in the warming +oven. Make a rich, brown gravy and pour over it.</p> + +<p><i>Boiled Chicken.</i>—Chickens may be boiled whole or +cut into pieces. To boil whole place a few pieces of +unsmoked bacon in a stew-pan that is deep enough +to hold the chicken and can be tightly covered. Cook +slowly for an hour without adding water, turning +it often until it is evenly browned. Now add a small +onion, some raw peeled potatoes not larger than an +egg, and a little boiling water. Cook over a brisk +fire for three-quarters of an hour. Salt and pepper +the chicken and put it and the potatoes in a baking-dish +in a hot oven while making the gravy. A couple +of hard-boiled eggs chopped very fine, and a little +chopped parsley, improve the gravy.</p> + +<p><i>Baked Chicken.</i>—A properly baked chicken is +tender, juicy, and has a rich flavor, while one improperly +baked is tough, dry, stringy, and tasteless. +To bake a chicken properly the oven must not be +too hot; the chicken must be repeatedly basted, and +cooked until it is tender, but not until all dried up. +Stuffing the chicken improves the flavor. To make +the dressing, melt enough of any kind of wholesome +fat in a hot frying-pan to keep the bread crumbs +from sticking, and fry in it a large onion, chopped<span class='pagenum'><a name="Page_289" id="Page_289">[Pg 289]</a></span> +fine, until it is tender. Place the dry bread-crumbs +into the fat, and cook for half an hour over a slow +fire, stirring often to keep from sticking, until the +crumbs are slightly browned and well dried. Season +with salt, pepper and a little celery-salt, and moisten +with just enough milk to make it stick together. +Always taste the dressing to see if it is properly +seasoned. A well-fed chicken can be baked more +rapidly than a thin one. If the chicken is thin add +plenty of fat to the water in the baking-pan; cover +closely and cook slowly and carefully until it is +tender, turning very often; if it is fat and well-fed +put plenty of wholesome grease in the baking-dish, +and without covering it, cook in a hot oven, basting +frequently. A young, fat chicken will bake in an +hour. An older fowl may require two or three +hours. It is a good plan to allow the chicken plenty +of time and then, if done too soon, to cover it closely +and keep it warm on the back of the stove. Use +just enough water while baking to keep the fat from +sputtering. If the water is cooked out towards the +end, and the chicken is thoroughly basted, the skin +will take on a rich, thick glazing that is highly creditable +to the skill of the cook. Delicious gravy can be +made of the fat by adding milk and thickening with +flour.</p> + +<p><i>Smothered Chicken.</i>—Use a frying-size chicken. +Split it down the back and rub with a little salt. +Put it in a pan with a slice of bacon and a pint +of water. Cover the pan closely and let it simmer +on top of the stove from one to two hours, or until<span class='pagenum'><a name="Page_290" id="Page_290">[Pg 290]</a></span> +the chicken is thoroughly tender. When done +sprinkle with flour and baste well. Add a small +tablespoon of butter, and put in the oven and cook +until brown.</p> + +<p><i>Broiled Chicken.</i>—A young, tender, fat chicken is +better broiled than any other way. It has a finer +flavor; is tenderer, more juicy and more easily +digested; in fact broiled chicken is one of the most +delicious dishes that can be served. There is no +earthly use, however, in trying to broil a chicken that +is not fat and nice. If the chicken is a little too +old to broil whole the breast will still be tender. +Flatten the chicken by pounding it. Have a bed of +clear, bright coals and a hot gridiron well greased to +prevent sticking. Cover with a baking-dish and +turn often, allowing the bony side to stay down +longer than the other side. From fifteen to twenty +minutes should be enough, but it is always best to +test with a fork by pulling the fibres apart to see +that they are not raw. As soon as the raw look has +disappeared the chicken is done. The least over-cooking +injures the flavor. Serve on a hot platter. +Pour over a little melted butter, seasoned with lemon +juice and chopped parsley.</p> + +<p>To bake or boil a turkey proceed the same as for +chicken, simply allowing more time. An eight-pound +turkey will require three hours to roast.</p> + + +<h4>MAKING GOOD SOUPS.</h4> + +<p><i>Vegetable Soups.</i>—The simplest and most easily +prepared soups are those made from peas, beans,<span class='pagenum'><a name="Page_291" id="Page_291">[Pg 291]</a></span> +tomatoes, asparagus, celery, carrots, onions, and +potatoes. They require neither meat nor any previous +preparation, but can be made and eaten at once. +These soups are somewhat paradoxical because they +are both cheap and rich; deliciously simple and simply +delicious. Take enough of any of these vegetables +to furnish sufficient soup after they have been +rubbed through a strainer and thinned with milk +or cream. Cook the vegetables thoroughly until perfectly +soft, so that they can be easily rubbed through +a coarse strainer. Add enough milk to this purée +to make it about the thickness of cream. Season with +salt, pepper, and a little celery-salt, and serve with +bits of bread browned crisp in the oven.</p> + +<p>When the vegetables can be got fresh from the +garden nothing is more delicious than these soups, +and in winter, canned peas and dried beans make +excellent substitutes. In making potato purée two +onions boiled with the potatoes improve the flavor. +Potato soup without onion is tasteless; a little celery +boiled in with the potatoes and onion, makes it still +nicer. Tomato soup is also better slightly flavored +with onion and a little carrot. A little cold boiled +rice, simmered for a half-hour in the soup after the +milk has been added, is an excellent addition. These +soups are also delicious when made rather thin with +milk and then thickened by putting the well-beaten +yolks of two eggs into the hot soup-tureen, and stirring +vigorously while adding the soup; this last soup +must be served at once, as it cannot stand after the +eggs are added.<span class='pagenum'><a name="Page_292" id="Page_292">[Pg 292]</a></span></p> + +<p><i>Meat Soups.</i>—These soups should always be made +the day before required in order to thoroughly remove +the fat, which cannot be done until it hardens +on the top of the soup. Nothing is more disgusting +than greasy soup. The foundation for an infinite +variety of soups is made by boiling about a pound +of meat in three pints of water. After the meat is +cooked to pieces strain it out and keep the well-skimmed +liquor, or “stock,” as it is called, in a +stone jar in a cool place. It should form a jelly, +and in order to prepare a different soup for each +day, it is only necessary to heat some of the jelly and +flavor it differently. For instance: Chop fine one +small onion to each person and fry it in butter, or +in some of the grease taken off the soup, until tender +and slightly brown. Pour over enough stock and let +stand for half an hour. Serve with a little grated +cheese. Cabbage soup is made in the same way except +that it takes longer to cook the cabbage. Instead +of one vegetable several may be used. Turnips, +cabbage, onions, and carrots in about the same proportion, +chopped fine and fried tender, without any +water, and added to the soup, make what is known in +France as Julienne soup.</p> + + +<h4>EGGS IN SEVERAL FORMS.</h4> + +<p><i>Coddled Eggs.</i>—The most delicate way to cook an +egg is to coddle it. Put six into a vessel that will +hold two quarts. Fill with boiling water, cover +closely, and let it stand in a warm place for ten +minutes. If you desire them better cooked let them<span class='pagenum'><a name="Page_293" id="Page_293">[Pg 293]</a></span> +stay in the water longer. If you want to do but one +egg, put it in a quart of boiling water, cover and let +stand five minutes.</p> + +<p><i>Shirred Eggs.</i>—To shirr an egg break it into a +saucer or any small dish that has been well greased. +Put into a hot oven and leave until glazed. Season +and serve at once.</p> + +<p><i>Scrambled Eggs.</i>—Heat a teaspoonful of milk to +each egg in a sauce-pan not more than a quarter of an +inch deep and about the right size to hold the quantity +of eggs desired. Add a little salt, pepper, and butter. +When hot put in the eggs, and as they lie on +the bottom of the pan, scrape off with a spoon letting +the raw part take the place of those portions already +cooked, and continue this until a creamy custard is +formed. Be careful not to cook the eggs so long that +this custard is changed to a hard mass.</p> + + +<h4>PROPER COOKING OF VEGETABLES.</h4> + +<p>The general tendency in cooking vegetables is to +use altogether too much water so that they become +soaked and tasteless. The ideal way to cook most +vegetables is to use as little water as possible; just +a little in the bottom of the pot so that the vegetables +will not stick and burn, but steam through in their +own juices until thoroughly tender and full of their +own flavor. The fire should not be too hot; the pot +should be tightly covered; a sufficient amount of +butter must be added when the vegetable is about +half done; and plenty of time given to allow it +to simmer and steam until thoroughly flavored.<span class='pagenum'><a name="Page_294" id="Page_294">[Pg 294]</a></span> +Onions, beans, carrots, and cabbage are most delicate +when chopped fine, cooked until tender in a +very little water, seasoned with salt, pepper, and +butter, covered with milk, and allowed to stand on +the back of the stove for twenty minutes until the +flavor is thoroughly developed.</p> + +<p><i>Boiled Potatoes.</i>—Potatoes should not be peeled +before boiling, but should be thoroughly washed and +rinsed. They should be put in an abundance of +boiling water, well salted, and covered tightly. +When tender pour off all the water, cover the pot +with a towel and let it stand on the back of the stove +for ten minutes.</p> + +<p><i>Baked Potatoes.</i>—If baked potatoes stand they lose +their flavor. A baked potato, eaten as soon as done, +is sweet, dry and mealy. Allow them to stand even +for ten minutes and the flavor is lost, and they become +wet and tasteless. A pleasant change is to +peel the potatoes before baking. These must be +eaten as soon as they come from the oven or they lose +their crispness.</p> + +<p><i>Beans.</i>—Nothing is more valuable for winter food +than beans. They give as much strength as beefsteak +and are far less expensive. Soak them in +plenty of water over night; add a generous piece of +unsmoked bacon; let simmer on the back of the stove +until they are tender and the water is well cooked +away; cover with milk, and either let them stand +on the back of the stove until the milk is thickened, +or put them into a shallow baking-dish and bake +until nearly dry. Serve either hot or cold.<span class='pagenum'><a name="Page_295" id="Page_295">[Pg 295]</a></span></p> + + +<h4>SOME CAPITAL DESSERTS.</h4> + +<p><i>Apple Pudding.</i>—Peel and slice enough apples to +nearly fill your pudding-dish, sugar to taste, and +grate over them a little nutmeg. Also add a little +water. Now make a batter as follows: Three +quarters of a cup of sugar; a piece of butter the size +of a small egg, one half-cup of milk, one egg, a +pinch of salt, a teaspoonful of baking-powder, and +one and one-eighth cups of flour. This is an extremely +nice, wholesome pudding, which can be +served with either cream or hard sauce.</p> + +<p>To make hard sauce take a half-cup of butter and +cream it with a fork; add a cupful of sugar and +beat until nicely mixed and creamy. Flavor to taste +and sprinkle a little nutmeg over it.</p> + +<p><i>Cottage Pudding.</i>—One cupful of sugar, one tablespoonful +of butter, one half-cupful of milk, two +eggs, one and one-half cupfuls of flour, and one teaspoonful +of baking-powder. For the sauce, take +three and a half cupfuls of boiling water and stir +in it a cupful of sugar, and a tablespoonful of either +flour or corn-starch rubbed smooth with a little cold +water. Cook well for two or three minutes; take +the pan from the fire, add the butter and flavor as +you prefer.</p> + +<p><i>Batter Pudding Boiled or Baked.</i>—One quart of +milk, six eggs beaten separately, six tablespoonfuls +of flour worked gradually into the yolks of the eggs, +and a pinch of salt. Bake or boil about three-quarters +of an hour. Serve with sauce.<span class='pagenum'><a name="Page_296" id="Page_296">[Pg 296]</a></span></p> + +<p><i>Cream of Corn-starch.</i>—One quart of milk, four +eggs, one half-cupful sugar, four tablespoonfuls of +corn-starch dissolved in a little milk. Into a pint +of the milk put the sugar, and place on the stove +to heat. When very hot gradually stir in the corn-starch +and beat well. Have ready the whites of the +eggs, and beat them into the milk; flavor as preferred. +Take the other pint of milk, the four yolks +and four light tablespoonfuls of sugar, and place +them over the fire, stirring constantly. This makes +a nice custard. Just before serving pour the custard +over the pudding.</p> + +<p><i>Caramel Custard.</i>—One egg for each person; also +one teaspoonful of milk for each person. Put the +yolks and milk together with a tablespoonful of +sugar to each egg. Have ready some caramel, and stir +in enough to give a decided flavor. Put this into +cups or baking-dishes, and set in a pan of hot water +on top of the stove for twenty minutes; then in the +oven until the custard sets. Serve cold. For the +caramel, take two cupfuls of sugar (preferably +brown) and put it in a frying-pan with a teaspoonful +of water. Cook until well burned. Add a cup of +water, and, when cold, put it in a bottle or fruit-jar. +This quantity will last a long time.</p> + +<p><i>Brown Betty Pudding.</i>—Take a cupful of grated +bread-crumbs, two cupfuls of finely chopped, tart +apples, half a cupful of brown sugar, a teaspoonful +of cinnamon, and one tablespoonful of butter. Butter +a deep pudding-dish, and put a layer of apples on +the bottom; then sprinkle with sugar, cinnamon and<span class='pagenum'><a name="Page_297" id="Page_297">[Pg 297]</a></span> +bits of the butter. Put in another layer of apples, +and proceed as before until all the ingredients have +been used. Cover the dish and bake for three-quarters +of an hour in a moderate oven; remove the +cover now and brown the pudding. Serve with sugar +and cream.</p> + +<p><i>Rice Pudding.</i>—One cupful of boiled rice (better +if still hot), three cupfuls of milk, three-quarters of +a cup of sugar, a tablespoonful of corn-starch, and +two eggs; add flavoring. Dissolve the corn-starch +with a little of the milk, and stir it into the rest of +the milk; also add the yolks of the eggs and the +sugar beaten together. Put this over the fire and +when hot add the rice. Stir it carefully until it begins +to thicken, then take it off and add the flavoring. +Put it into a pudding-dish and bake in the oven.</p> + + +<h3>THE END</h3> + + + + +<h2><a name="INDEX" id="INDEX"></a>INDEX</h2> +<div class='center'> +<table border="1" cellpadding="4" cellspacing="0" summary="Index TOC"> +<tbody> +<tr><td><a href="#A">A</a></td><td><a href="#B">B</a></td><td><a href="#C">C</a></td> +<td><a href="#D">D</a></td><td><a href="#E">E</a></td><td><a href="#F">F</a></td> +<td><a href="#G">G</a></td><td><a href="#H">H</a></td><td><a href="#I">I</a></td> +<td><a href="#K">K</a></td><td><a href="#L">L</a></td><td><a href="#M">M</a></td> +<td><a href="#N">N</a></td><td><a href="#O">O</a></td><td><a href="#P">P</a></td> +<td><a href="#Q">Q</a></td><td><a href="#R">R</a></td><td><a href="#S">S</a></td> +<td><a href="#T">T</a></td><td><a href="#V">V</a></td><td><a href="#W">W</a></td> +<td><a href="#Y">Y</a></td></tr> +</tbody> +</table> +</div> + +<p><span class='pagenum'><a name="Page_299" id="Page_299">[Pg 299]</a></span></p> + +<a name="A" id="A"></a><h4>A</h4> +<ul> +<li>Accidents, <a href="#Page_223">223</a>.</li> +<li>Acid, carbolic, for <i>Rhus</i> poisoning, <a href="#Page_260">260</a>; +<ul class="ix"> + <li>in wounds, <a href="#Page_231">231</a>;</li> + <li>poisoning by, <a href="#Page_253">253</a>;</li> + <li>of fruit, <a href="#Page_133">133</a>, <a href="#Page_146">146</a>;</li> + <li>picric, <a href="#Page_241">241</a>;</li> + <li>uric, <a href="#Page_149">149</a>.</li> +</ul></li> +<li>Acrodinia, <a href="#Page_9">9</a>.</li> +<li><i>Agaricus campestris</i>, <a href="#Page_256">256</a>.</li> +<li>Air, <a href="#Page_181">181</a>.</li> +<li>Air-space, <a href="#Page_45">45</a>.</li> +<li>Albumin, <a href="#Page_105">105</a>.</li> +<li>Albumins, <a href="#Page_98">98</a>, <a href="#Page_104">104</a>, <a href="#Page_117">117</a>, <a href="#Page_131">131</a>.</li> +<li>Alcohol and its effects, <a href="#Page_155">155</a>; +<ul class="ix"> + <li>for <i>Rhus</i> poisoning, <a href="#Page_260">260</a>;</li> + <li>of no value in snake-poisoning, <a href="#Page_270">270</a>;</li> + <li>predisposes to consumption, <a href="#Page_183">183</a>;</li> + <li>predisposes to heat-prostration, <a href="#Page_244">244</a>.</li> +</ul></li> +<li><i>Amanita muscarius</i>, <a href="#Page_258">258</a>.</li> +<li><i>Amanita phalloides</i>, <a href="#Page_257">257</a>.</li> +<li>Ammonia, aromatic spirits of, <a href="#Page_259">259</a>.</li> +<li>Anaphylaxis, <a href="#Page_204">204</a>.</li> +<li><i>Ancistrodon contortrix</i>, <a href="#Page_263">263</a>.</li> +<li><i>Ancistrodon piscivorus</i>, <a href="#Page_262">262</a>.</li> +<li>Animals, bites of, <a href="#Page_249">249</a>; +<ul class="ix"> + <li>location of quarters, <a href="#Page_61">61</a>.</li> +</ul></li> +<li><i>Anopheles</i>, <a href="#Page_41">41</a>, <a href="#Page_171">171</a>, <a href="#Page_174">174</a>.</li> +<li>Antidotes for poisons, see under names of <a href="#Poisons">poisons</a>.</li> +<li>Antiseptics, <a href="#Page_231">231</a>, <a href="#Page_247">247</a>.</li> +<li>Antitoxin, for diphtheria, <a href="#Page_198">198</a>, <a href="#Page_203">203</a>; +<ul class="ix"> + <li>for lockjaw, <a href="#Page_233">233</a>.</li> +</ul></li> +<li>Apples, <a href="#Page_147">147</a>.</li> +<li>Arrowroot, <a href="#Page_112">112</a>.</li> +<li>Arsenic, <a href="#Page_252">252</a>.</li> +<li>Arteries, <a href="#Page_229">229</a>.</li> +<li>Artichokes, <a href="#Page_136">136</a>.</li> +<li>Asparagus, <a href="#Page_142">142</a>.</li> +<li>Atropine, <a href="#Page_259">259</a>.</li> +</ul> +<a name="B" id="B"></a><h4>B</h4> +<ul> +<li><i>Bacillus tuberculosis</i>, <a href="#Page_179">179</a>.</li> +<li><i>Bacillus typhosus</i>, <a href="#Page_186">186</a>.</li> +<li>Bacon, broiled, <a href="#Page_282">282</a>; +<ul class="ix"> + <li>curing of, <a href="#Page_280">280</a>;</li> + <li>fried, <a href="#Page_282">282</a>;</li> + <li>importance of, <a href="#Page_121">121</a>, <a href="#Page_122">122</a>;</li> + <li>unsmoked, <a href="#Page_282">282</a>.</li> +</ul></li> +<li>Baking, process of, <a href="#Page_166">166</a>.</li> +<li>Baths, for sick people, <a href="#Page_221">221</a>; +<ul class="ix"> + <li>hot and cold, <a href="#Page_13">13</a>;</li> + <li>importance of, <a href="#Page_12">12</a>;</li> + <li>sea, <a href="#Page_5">5</a>.</li> +</ul></li> +<li>Beans, bad, give lathyrismus, <a href="#Page_9">9</a>; +<ul class="ix"> + <li>how to cook, <a href="#Page_294">294</a>;</li> + <li>value of, <a href="#Page_133">133</a>, <a href="#Page_134">134</a>.</li> +</ul></li> +<li>Bed-bug, <a href="#Page_9">9</a>.</li> +<li>Bedmaking, <a href="#Page_219">219</a>.</li> +<li>Beef, broiled, <a href="#Page_275">275</a>; +<ul class="ix"> + <li>fried, <a href="#Page_275">275</a>;</li> + <li>Hamburg steak, <a href="#Page_274">274</a>;</li> + <li>hashed, <a href="#Page_276">276</a>;</li> + <li>pot-roast, <a href="#Page_274">274</a>;</li> + <li>roast, <a href="#Page_273">273</a>;</li> + <li>value of, <a href="#Page_20">20</a>.</li> +</ul></li> +<li>Beer, <a href="#Page_162">162</a>.</li> +<li>Beets, <a href="#Page_136">136</a>, <a href="#Page_138">138</a>.</li> +<li>Beri-beri, <a href="#Page_113">113</a>.</li> +<li><a name="Beverages" id="Beverages"></a>Beverages, <a href="#Page_30">30</a>; +<ul class="ix"> + <li>alcoholic, <a href="#Page_32">32</a>;</li> + <li>medicinal, <a href="#Page_33">33</a>;</li> + <li>“soft drinks,” <a href="#Page_32">32</a>.</li> +</ul></li> +<li>Biliousness, <a href="#Page_93">93</a>.</li> +<li>Biscuits, <a href="#Page_285">285</a>.</li> +<li>Bites of animals, flies, mosquitoes and snakes, see under several subjects.</li> +<li>Bleeding, how to stop, <a href="#Page_228">228</a>; +<ul class="ix"> + <li>in consumption, <a href="#Page_180">180</a>;</li> + <li>in typhoid fever, <a href="#Page_187">187</a>.</li> +</ul></li> +<li>Blisters, <a href="#Page_247">247</a>.</li> +<li>Blood-vessels, <a href="#Page_95">95</a>.</li> +<li>Bottle, for infants, <a href="#Page_73">73</a>.</li> +<li>Brandy, <a href="#Page_160">160</a>.</li> +<li>Bread, and its relations, <a href="#Page_104">104</a>; +<ul class="ix"> + <li>baking of, <a href="#Page_166">166</a>;</li> + <li>corn-bread, <a href="#Page_108">108</a>, <a href="#Page_111">111</a>, <a href="#Page_285">285</a>;</li> + <li>diseases derived from decomposed, <a href="#Page_9">9</a>;</li> + <li>graham-bread, <a href="#Page_107">107</a>;</li> + <li>rye-bread, <a href="#Page_108">108</a>;</li> + <li>why wheat-bread is the best, <a href="#Page_106">106</a>.</li> +</ul></li> +<li>Bricks, <a href="#Page_40">40</a>.</li> +<li>Bright's disease, <a href="#Page_95">95</a>, <a href="#Page_145">145</a>, <a href="#Page_156">156</a>, <a href="#Page_157">157</a>, <a href="#Page_158">158</a>, <a href="#Page_163">163</a>, <a href="#Page_173">173</a>, <a href="#Page_201">201</a>.</li> +<li>Broncho-pneumonia, <a href="#Page_201">201</a>.</li> +<li>Bruises, <a href="#Page_238">238</a>.</li> +<li>Brussels-sprouts, <a href="#Page_139">139</a>.</li> +<li>Burns, <a href="#Page_240">240</a>.</li> +<li>Buttermilk, <a href="#Page_150">150</a>.</li> +</ul> +<a name="C" id="C"></a><h4>C</h4> +<ul> +<li>Cabbage, <a href="#Page_138">138</a>.</li> +<li>Cake, <a href="#Page_115">115</a>.</li> +<li>Calomel, <a href="#Page_94">94</a>.</li> +<li><a name="Calories" id="Calories"></a>Calories, <a href="#Page_102">102</a>.</li> +<li>Carbohydrates, <a href="#Page_98">98</a>.</li> +<li>Carron-oil, <a href="#Page_241">241</a>.</li> +<li>Carrots, <a href="#Page_136">136</a>.</li> +<li>Cat, conveys diphtheria, <a href="#Page_10">10</a>; +<ul class="ix"> + <li>harbors tapeworms, <a href="#Page_10">10</a>.</li> +</ul></li> +<li>Cauliflower, <a href="#Page_139">139</a>.</li> +<li>Caustic, <a href="#Page_213">213</a>.</li> +<li>Celery, <a href="#Page_141">141</a>.</li> +<li>Cellulose, <a href="#Page_131">131</a>.</li> +<li>Cereals, <a href="#Page_284">284</a>.</li> +<li>Charlatans, <a href="#Page_7">7</a>.</li> +<li>Chewing, <a href="#Page_29">29</a>.</li> +<li>Chicken, baked, <a href="#Page_288">288</a>; +<ul class="ix"> + <li>boiled, <a href="#Page_288">288</a>;</li> + <li>broiled, <a href="#Page_290">290</a>;</li> + <li>fried, <a href="#Page_287">287</a>;</li> + <li>smothered, <a href="#Page_289">289</a>.</li> +</ul></li> +<li>Chickory (salad), <a href="#Page_142">142</a>.</li> +<li>Chilblains, <a href="#Page_246">246</a>.</li> +<li>Child, diseases of, <a href="#Page_82">82</a>, <a href="#Page_89">89</a>; +<ul class="ix"> + <li>exercise of, <a href="#Page_79">79</a>;</li> + <li>hygiene treatment of, <a href="#Page_88">88</a>;</li> + <li>ill-treatment of, <a href="#Page_64">64</a>;</li> + <li>instruction in cases of accident, <a href="#Page_223">223</a>;</li> + <li>sleep necessary to, <a href="#Page_79">79</a>;</li> + <li>syringe for, <a href="#Page_84">84</a>.</li> +</ul></li> +<li>Chills-and-fever, see <a href="#Malaria">Malaria</a>.</li> +<li>Chocolate, <a href="#Page_31">31</a>.</li> +<li>Cholera, <a href="#Page_8">8</a>, <a href="#Page_9">9</a>, <a href="#Page_140">140</a>.</li> +<li>Chromic acid, <a href="#Page_209">209</a>.</li> +<li>Cisterns, <a href="#Page_59">59</a>.</li> +<li>Clams, <a href="#Page_122">122</a>.</li> +<li>Cleanliness, <a href="#Page_220">220</a>.</li> +<li>Clothing, <a href="#Page_18">18</a>.</li> +<li>Cocoa, <a href="#Page_31">31</a>.</li> +<li>Cod-liver oil, <a href="#Page_125">125</a>.</li> +<li>Coffee, <a href="#Page_31">31</a>, <a href="#Page_151">151</a>.</li> +<li>Cold, accidents arising from, <a href="#Page_41">41</a>.</li> +<li>Cole, <a href="#Page_139">139</a>.</li> +<li>Colic, cause of, <a href="#Page_67">67</a>; +<ul class="ix"> + <li>treatment of, <a href="#Page_84">84</a>.</li> +</ul></li> +<li>Collodion, <a href="#Page_232">232</a>.</li> +<li>Color, in clothing, <a href="#Page_21">21</a>.</li> +<li>Constipation, <a href="#Page_85">85</a>.</li> +<li>Cooking, <a href="#Page_164">164</a>, <a href="#Page_170">170</a>.</li> +<li>Copper-head, <a href="#Page_263">263</a>, <a href="#Page_266">266</a>.</li> +<li>Coral-snakes, <a href="#Page_262">262</a>, <a href="#Page_263">263</a>, <a href="#Page_267">267</a>.</li> +<li>Corn, <a href="#Page_110">110</a>.</li> +<li>Corn-starch, <a href="#Page_112">112</a>.</li> +<li>Corrosive sublimate, <a href="#Page_231">231</a>.</li> +<li>Cotton-mouth, <a href="#Page_262">262</a>, <a href="#Page_266">266</a>.</li> +<li>Cows, carry tapeworm, <a href="#Page_51">51</a>; +<ul class="ix"> + <li>infected with tuberculosis, <a href="#Page_182">182</a>.</li> +</ul></li> +<li><i>Crotalus</i>, <a href="#Page_262">262</a>.</li> +<li>Croup, membranous, <a href="#Page_198">198</a>; +<ul class="ix"> + <li>treatment of, <a href="#Page_86">86</a>.</li> +</ul></li> +<li>Cucumber, <a href="#Page_141">141</a>.</li> +</ul> +<a name="D" id="D"></a><h4>D</h4> +<ul> +<li>Dandelion, <a href="#Page_138">138</a>.</li> +<li>“Death-cup,” <a href="#Page_257">257</a>.</li> +<li>Dextrose, <a href="#Page_126">126</a>.</li> +<li>Diarrhœa, reason for, <a href="#Page_144">144</a>; +<ul class="ix"> + <li>treatment of, <a href="#Page_82">82</a>.</li> +</ul></li> +<li>Diet, for the sick, <a href="#Page_221">221</a>; +<ul class="ix"> + <li>vegetarian, <a href="#Page_130">130</a>.</li> +</ul></li> +<li>Diphtheria, conveyance of, <a href="#Page_9">9</a>; +<ul class="ix"> + <li>description and treatment, <a href="#Page_198">198</a>.</li> +</ul></li> +<li>Dipsomaniac, <a href="#Page_157">157</a>.</li> +<li>Dirt-eaters, <a href="#Page_196">196</a>.</li> +<li>Diseases, avoidable, <a href="#Page_171">171</a>; +<ul class="ix"> + <li>contagious, <a href="#Page_89">89</a>;</li> + <li>contraction of, <a href="#Page_8">8</a>;</li> + <li>digestive, <a href="#Page_82">82</a>.</li> + <li>See also names of diseases.</li> +</ul></li> +<li>Disinfectants, <a href="#Page_192">192</a>.</li> +<li>Dog, conveys diphtheria, <a href="#Page_9">9</a>; +<ul class="ix"> + <li>dangers of, <a href="#Page_62">62</a>;</li> + <li>description of rabies in, <a href="#Page_211">211</a>;</li> + <li>harbors tapeworm, <a href="#Page_9">9</a>, <a href="#Page_10">10</a>.</li> +</ul></li> +<li>Drinks, see <a href="#Beverages">Beverages</a>.</li> +<li>Drowning, <a href="#Page_224">224</a>.</li> +<li>Dry-closet system, <a href="#Page_53">53</a>.</li> +<li>Dysentery, <a href="#Page_8">8</a>, <a href="#Page_9">9</a>, <a href="#Page_43">43</a>, <a href="#Page_140">140</a>.</li> +<li>Dyspepsia, <a href="#Page_145">145</a>, <a href="#Page_158">158</a>.</li> +</ul> +<a name="E" id="E"></a><h4>E</h4> +<ul> +<li>Earth, diseases contracted from, <a href="#Page_8">8</a>.</li> +<li>Eating, <a href="#Page_28">28</a>; +<ul class="ix"> + <li>importance of, <a href="#Page_92">92</a>;</li> + <li>over-eating too prevalent, <a href="#Page_95">95</a>.</li> +</ul></li> +<li>Eggs, coddled, <a href="#Page_292">292</a>; +<ul class="ix"> + <li>in vegetarian diet, <a href="#Page_130">130</a>;</li> + <li>nitrogenous food, <a href="#Page_118">118</a>;</li> + <li>scrambled, <a href="#Page_293">293</a>;</li> + <li>shirred, <a href="#Page_293">293</a>;</li> + <li>value of, <a href="#Page_123">123</a>.</li> +</ul></li> +<li><i>Elaps euryxanthus</i>, <a href="#Page_263">263</a>.</li> +<li><i>Elaps fulvius</i>, <a href="#Page_263">263</a>.</li> +<li>Emergencies, <a href="#Page_223">223</a>.</li> +<li>Emetics, <a href="#Page_251">251-259</a>.</li> +<li>Endive, <a href="#Page_142">142</a>.</li> +<li>Ergot, <a href="#Page_108">108</a>.</li> +<li>Ergotism, <a href="#Page_9">9</a>.</li> +<li>Ethers, compound, <a href="#Page_98">98</a>.</li> +<li>Exercise, <a href="#Page_79">79</a>.</li> +</ul> +<a name="F" id="F"></a><h4>F</h4> +<ul> +<li>Fabrics, <a href="#Page_20">20</a>.</li> +<li>Fats, <a href="#Page_98">98</a>, <a href="#Page_103">103</a>; +<ul class="ix"> + <li>in vegetables, <a href="#Page_131">131</a>;</li> + <li>unwholesomeness of, <a href="#Page_115">115</a>;</li> + <li>value of, <a href="#Page_123">123</a>.</li> +</ul></li> +<li>Fever, malaria, see <a href="#Malaria">Malaria</a>; +<ul class="ix"> + <li>scarlet, <a href="#Page_90">90</a>;</li> + <li>typhoid, contraction of, <a href="#Page_8">8</a>, <a href="#Page_9">9</a>, <a href="#Page_43">43</a>, <a href="#Page_140">140</a>, <a href="#Page_221">221</a>;</li> + <li>description and treatment, <a href="#Page_185">185</a>;</li> + <li>yellow, <a href="#Page_9">9</a>, <a href="#Page_41">41</a>, <a href="#Page_43">43</a>.</li> +</ul></li> +<li>Figs, <a href="#Page_146">146</a>.</li> +<li>Filaria, <a href="#Page_9">9</a>.</li> +<li>Fireplace, <a href="#Page_47">47</a>.</li> +<li>Fish, decomposed, source of ptomaine poisoning, <a href="#Page_9">9</a>; +<ul class="ix"> + <li>nitrogenous food, <a href="#Page_118">118</a>;</li> + <li>value of, <a href="#Page_122">122</a>.</li> +</ul></li> +<li>Fly, conveyor of disease, <a href="#Page_9">9</a>, <a href="#Page_10">10</a>, <a href="#Page_43">43</a>; +<ul class="ix"> + <li>sick-room, <a href="#Page_219">219</a>.</li> +</ul></li> +<li>Fly-agaric, <a href="#Page_258">258</a>.</li> +<li>Flukes, <a href="#Page_140">140</a>.</li> +<li>Foods, <a href="#Page_28">28</a>, <a href="#Page_99">99</a>; +<ul class="ix"> + <li>albuminous, <a href="#Page_119">119</a>;</li> + <li>amount necessary, <a href="#Page_96">96</a>;</li> + <li>breakfast-foods, <a href="#Page_113">113</a>;</li> + <li>diseases contracted from, <a href="#Page_8">8</a>;</li> + <li>in sick-room, <a href="#Page_221">221</a>;</li> + <li>Mellin's food, <a href="#Page_86">86</a>;</li> + <li>nitrogenous, <a href="#Page_98">98</a>, <a href="#Page_117">117</a>;</li> + <li>nutritive substances in, <a href="#Page_98">98</a>;</li> + <li>raw, <a href="#Page_105">105</a>, <a href="#Page_164">164</a>;</li> + <li>starchy, <a href="#Page_104">104</a>, <a href="#Page_165">165</a>, <a href="#Page_168">168</a>;</li> + <li>tables, <a href="#Page_100">100</a>.</li> +</ul></li> +<li>Formaldehyde gas, <a href="#Page_192">192</a>.</li> +<li>Frost-bite, <a href="#Page_245">245</a>.</li> +<li>Fruits, as food, <a href="#Page_30">30</a>; +<ul class="ix"> + <li>dangers in, <a href="#Page_144">144</a>;</li> + <li>diseases contracted from, <a href="#Page_9">9</a>;</li> + <li>not nutritious, <a href="#Page_146">146</a>.</li> +</ul></li> +<li>Furnace, <a href="#Page_46">46</a>.</li> +</ul> +<a name="G" id="G"></a><h4>G</h4> +<ul> +<li>Game, <a href="#Page_122">122</a>.</li> +<li>Garlic, <a href="#Page_140">140</a>.</li> +<li>Gin, <a href="#Page_160">160</a>.</li> +<li>Glanders, <a href="#Page_10">10</a>.</li> +<li>Glucose, <a href="#Page_126">126</a>.</li> +<li>Gout, <a href="#Page_156">156</a>, <a href="#Page_163">163</a>.</li> +<li>Grape-fruit, <a href="#Page_147">147</a>.</li> +<li>Greens, <a href="#Page_138">138</a>.</li> +<li>Ground-itch, <a href="#Page_195">195</a>.</li> +</ul> +<a name="H" id="H"></a><h4>H</h4> +<ul> +<li>Haig, a physician, <a href="#Page_148">148</a>.</li> +<li>Ham, boiled, <a href="#Page_281">281</a>; +<ul class="ix"> + <li>broiled, <a href="#Page_281">281</a>;</li> + <li>curing of, <a href="#Page_280">280</a>;</li> + <li>fried, <a href="#Page_281">281</a>;</li> + <li>wholesomeness of, <a href="#Page_121">121</a>.</li> +</ul></li> +<li>Headache, <a href="#Page_33">33</a>.</li> +<li>Health, <a href="#Page_5">5</a>.</li> +<li>Heat, accidents arising from, <a href="#Page_241">241</a>; +<ul class="ix"> + <li>for house, <a href="#Page_45">45</a>;</li> + <li>in sick-room, <a href="#Page_218">218</a>.</li> + <li>See also <a href="#Calories">Calories</a>.</li> +</ul></li> +<li>Heat-prostration, <a href="#Page_244">244</a>.</li> +<li>Hiccough, <a href="#Page_250">250</a>.</li> +<li>Hog, <a href="#Page_51">51</a>.</li> +<li>Hog-meats, <a href="#Page_120">120</a>.</li> +<li>Hominy, <a href="#Page_284">284</a>.</li> +<li>Hookworm, <a href="#Page_8">8</a>; +<ul class="ix"> + <li>method of transmission, <a href="#Page_50">50</a>, <a href="#Page_52">52</a>;</li> + <li>description and treatment of disease, <a href="#Page_193">193</a>.</li> +</ul></li> +<li>Horses, convey glanders, <a href="#Page_10">10</a>; +<ul class="ix"><li>killed by bad corn, <a href="#Page_109">109</a>.</li></ul></li> +<li>House, materials for, <a href="#Page_39">39</a>; +<ul class="ix"><li>sanitation of, <a href="#Page_35">35</a>.</li></ul></li> +<li>Husks, <a href="#Page_107">107</a>.</li> +<li><a name="Hydrophobia" id="Hydrophobia"></a>Hydrophobia, from dog's bite, <a href="#Page_9">9</a>, <a href="#Page_249">249</a>; +<ul class="ix"><li>description and treatment, <a href="#Page_211">211</a>.</li></ul></li> +<li>Hygiene, <a href="#Page_1">1</a>, <a href="#Page_6">6</a>; +<ul class="ix"> + <li>of infancy and childhood, <a href="#Page_63">63</a>;</li> + <li>of the person, <a href="#Page_12">12</a>;</li> + <li>of the sick-room, <a href="#Page_217">217</a>.</li> +</ul></li> +<li>Hypersensitiveness, <a href="#Page_204">204</a>.</li> +</ul> +<a name="I" id="I"></a><h4>I</h4> +<ul> +<li>Indigestion, <a href="#Page_145">145</a>.</li> +<li>Infants, hygiene and feeding of, <a href="#Page_63">63</a>; +<ul class="ix"><li>weaning of, <a href="#Page_67">67</a>.</li></ul></li> +<li>Iodine, as antiseptic, <a href="#Page_231">231</a>; +<ul class="ix"><li>in blisters, <a href="#Page_247">247</a>.</li></ul></li> +</ul> +<a name="K" id="K"></a><h4>K</h4> +<ul> +<li>Kak-ke, <a href="#Page_9">9</a>, <a href="#Page_113">113</a>.</li> +<li>Kala-azar, <a href="#Page_9">9</a>.</li> +<li>Kissing, <a href="#Page_89">89</a>.</li> +</ul> +<a name="L" id="L"></a><h4>L</h4> +<ul> +<li>Lathyrismus, <a href="#Page_9">9</a>.</li> +<li>Lead-water, <a href="#Page_261">261</a>.</li> +<li>Leeks, <a href="#Page_140">140</a>.</li> +<li>Legumes, <a href="#Page_133">133</a>.</li> +<li>Legumins, <a href="#Page_98">98</a>, <a href="#Page_118">118</a>.</li> +<li>Lemons, <a href="#Page_146">146</a>.</li> +<li>Lentils, <a href="#Page_133">133</a>, <a href="#Page_134">134</a>.</li> +<li>Lettuce, <a href="#Page_139">139</a>.</li> +<li>Ligature, <a href="#Page_230">230</a>, <a href="#Page_270">270</a>.</li> +<li>Lime-water, <a href="#Page_71">71</a>, <a href="#Page_261">261</a>.</li> +<li>Liquids, <a href="#Page_148">148</a>.</li> +<li>Liquors, malt, <a href="#Page_162">162</a>.</li> +<li>Liver, <a href="#Page_93">93</a>; +<ul class="ix"><li>cirrhosis of the, <a href="#Page_158">158</a>.</li></ul></li> +<li>Lockjaw, <a href="#Page_227">227</a>; +<ul class="ix"><li>antitoxin for, <a href="#Page_232">232</a>.</li></ul></li> +<li>Loeffler, discovered diphtheria germ, <a href="#Page_198">198</a>.</li> +</ul> +<a name="M" id="M"></a><h4>M</h4> +<ul> +<li><a name="Malaria" id="Malaria"></a>Malaria, conveyed by mosquito, <a href="#Page_9">9</a>, <a href="#Page_41">41</a>, <a href="#Page_43">43</a>; +<ul class="ix"><li>description and treatment, <a href="#Page_171">171</a>.</li></ul></li> +<li>Maltose, <a href="#Page_86">86</a>.</li> +<li>Massasauga, <a href="#Page_266">266</a>.</li> +<li>Mastication, <a href="#Page_96">96</a>.</li> +<li>Meat, cooking of, <a href="#Page_168">168</a>; +<ul class="ix"> + <li>nitrogenous food, <a href="#Page_118">118</a>;</li> + <li>source of ptomaine poisoning, <a href="#Page_9">9</a>;</li> + <li>value of, <a href="#Page_119">119</a>.</li> +</ul></li> +<li>Medicine, <a href="#Page_221">221</a>; +<ul class="ix"><li>patent, <a href="#Page_91">91</a>, <a href="#Page_158">158</a>.</li></ul></li> +<li>Meninges, <a href="#Page_207">207</a>.</li> +<li>Meningitis, cerebrospinal, <a href="#Page_206">206</a>.</li> +<li><i>Micrococcus intracellulais</i>, <a href="#Page_207">207</a>.</li> +<li>Milk, an ideal food, <a href="#Page_128">128</a>; +<ul class="ix"> + <li>apt to promote indigestion, <a href="#Page_150">150</a>;</li> + <li>as a drink, <a href="#Page_31">31</a>-<a href="#Page_32">32</a>;</li> + <li>in vegetarian diet, <a href="#Page_130">130</a>;</li> + <li>infected with tuberculosis, <a href="#Page_182">182</a>;</li> + <li>malted, <a href="#Page_86">86</a>;</li> + <li>modified cow's, <a href="#Page_67">67</a>;</li> + <li>mother's, <a href="#Page_65">65</a>;</li> + <li>peptonized, <a href="#Page_75">75</a>;</li> + <li>sterilized (Pasteurized), <a href="#Page_74">74</a>;</li> + <li>table for calculating proportions of milk to be fed, <a href="#Page_70">70</a>.</li> +</ul></li> +<li>Mint, <a href="#Page_142">142</a>.</li> +<li>Moccasin (snake), <a href="#Page_261">261</a>, <a href="#Page_262">262</a>, <a href="#Page_263">263</a>, <a href="#Page_266">266</a>.</li> +<li>Mosquito, <a href="#Page_9">9</a>, <a href="#Page_41">41</a>, <a href="#Page_171">171</a>, <a href="#Page_173">173</a>.</li> +<li>Mouse, <a href="#Page_9">9</a>.</li> +<li><a name="Mushrooms" id="Mushrooms"></a>Mushrooms, <a href="#Page_256">256</a>.</li> +<li>Mutton, boiled, <a href="#Page_283">283</a>; +<ul class="ix"> + <li>chops, <a href="#Page_284">284</a>;</li> + <li>cutlets, <a href="#Page_283">283</a>;</li> + <li>roast <a href="#Page_283">283</a>;</li> + <li>value of, <a href="#Page_120">120</a>.</li> +</ul></li> +</ul> +<a name="N" id="N"></a><h4>N</h4> +<ul> +<li><i>Necator Americanus</i>, <a href="#Page_193">193</a>.</li> +<li>Nervousness, <a href="#Page_88">88</a>.</li> +<li>Nipple, <a href="#Page_73">73</a>.</li> +<li>Nose, <a href="#Page_184">184</a>.</li> +<li>Nursing, <a href="#Page_217">217</a>.</li> +</ul> +<a name="O" id="O"></a><h4>O</h4> +<ul> +<li>Oatmeal, <a href="#Page_114">114</a>, <a href="#Page_284">284</a>.</li> +<li>Okra, <a href="#Page_142">142</a>.</li> +<li>Opiates, <a href="#Page_85">85</a>.</li> +<li>Opium, <a href="#Page_254">254</a>.</li> +<li>Oysters, <a href="#Page_118">118</a>, <a href="#Page_122">122</a>.</li> +</ul> +<a name="P" id="P"></a><h4>P</h4> +<ul> +<li>Pains, rheumatic, <a href="#Page_145">145</a>.</li> +<li>Paris green, <a href="#Page_252">252</a>.</li> +<li>Parsley, <a href="#Page_142">142</a>.</li> +<li>Parsnips, <a href="#Page_136">136</a>.</li> +<li>Pasteur, <a href="#Page_214">214</a>.</li> +<li>Pastries, <a href="#Page_115">115</a>.</li> +<li>Peaches, <a href="#Page_146">146</a>.</li> +<li>Peanuts, <a href="#Page_133">133</a>, <a href="#Page_134">134</a>.</li> +<li>Peas, <a href="#Page_133">133</a>, <a href="#Page_134">134</a>.</li> +<li>Pellagra, <a href="#Page_9">9</a>, <a href="#Page_109">109</a>.</li> +<li>Peppers, green, <a href="#Page_142">142</a>.</li> +<li>Phosphorus, <a href="#Page_253">253</a>.</li> +<li>Pickles, <a href="#Page_144">144</a>.</li> +<li>Pieplant, <a href="#Page_142">142</a>.</li> +<li>Pilot-snake, <a href="#Page_262">262</a>.</li> +<li><a name="Pit-vipers" id="Pit-vipers"></a>Pit-vipers, <a href="#Page_261">261</a>, <a href="#Page_265">265</a>.</li> +<li>Plague, bubonic, <a href="#Page_9">9</a>.</li> +<li><i>Plasmodium malaria</i>, <a href="#Page_171">171</a>.</li> +<li>Plaster, for blisters, <a href="#Page_247">247</a>; +<ul class="ix"><li>for sprains, <a href="#Page_235">235</a>.</li></ul></li> +<li>Poison-dogwood, <a href="#Page_260">260</a>.</li> +<li>Poison-elder, <a href="#Page_260">260</a>.</li> +<li>Poison-ivy, <a href="#Page_259">259</a>.</li> +<li>Poison-oak, <a href="#Page_259">259</a>.</li> +<li><a name="Poisons" id="Poisons"></a>Poisons, acid and alkaline, <a href="#Page_252">252</a>; +<ul class="ix"> + <li>ptomaine, <a href="#Page_9">9</a>;</li> + <li>treatment of poison cases, with antidotes, <a href="#Page_251">251</a>.</li> +</ul></li> +<li>Poison-sumac, <a href="#Page_260">260</a>.</li> +<li>Pork, boiled, <a href="#Page_280">280</a>; +<ul class="ix"> + <li>broiled, <a href="#Page_279">279</a>;</li> + <li>fried, <a href="#Page_279">279</a>;</li> + <li>roast, <a href="#Page_279">279</a>.</li> +</ul></li> +<li>Potassium permanganate, <a href="#Page_254">254</a>, <a href="#Page_255">255</a>, <a href="#Page_269">269</a>.</li> +<li>Potatoes, <a href="#Page_135">135</a>, <a href="#Page_136">136</a>; +<ul class="ix"> + <li>baked, <a href="#Page_294">294</a>;</li> + <li>boiled, <a href="#Page_294">294</a>;</li> + <li>cooking of, <a href="#Page_167">167</a>;</li> + <li>disadvantages of, <a href="#Page_112">112</a>.</li> +</ul></li> +<li>Poultry, <a href="#Page_122">122</a>.</li> +<li>Privies, <a href="#Page_49">49</a>, <a href="#Page_52">52</a>, <a href="#Page_198">198</a>.</li> +<li>Ptomaines, poisoning by, <a href="#Page_9">9</a>.</li> +<li>Puddings, apple, <a href="#Page_295">295</a>; +<ul class="ix"> + <li>batter, <a href="#Page_295">295</a>;</li> + <li>brown betty, <a href="#Page_296">296</a>;</li> + <li>caramel custard, <a href="#Page_296">296</a>;</li> + <li>cottage, <a href="#Page_295">295</a>;</li> + <li>cream of corn-starch, <a href="#Page_296">296</a>;</li> + <li>rice, <a href="#Page_297">297</a>.</li> +</ul></li> +<li>Pumpkin, <a href="#Page_143">143</a>.</li> +<li>Pus, <a href="#Page_232">232</a>.</li> +</ul> +<a name="Q" id="Q"></a><h4>Q</h4> +<ul> +<li>Quacks, medical, <a href="#Page_4">4</a>, <a href="#Page_7">7</a>.</li> +<li>Quinine, <a href="#Page_173">173</a>.</li> +</ul> +<a name="R" id="R"></a><h4>R</h4> +<ul> +<li>Rabies, see <a href="#Hydrophobia">Hydrophobia</a>.</li> +<li>Radishes, <a href="#Page_136">136</a>.</li> +<li>Rat, <a href="#Page_9">9</a>.</li> +<li>Rat-poison, <a href="#Page_25">25</a>.</li> +<li>Rattlesnake, <a href="#Page_261">261</a>, <a href="#Page_262">262</a>, <a href="#Page_264">264</a>; +<ul class="ix"><li>ground-rattlers, <a href="#Page_262">262</a>, <a href="#Page_265">265</a>.</li></ul></li> +<li>Recipes, <a href="#Page_273">273</a>.</li> +<li>Resins, <a href="#Page_231">231</a>.</li> +<li>Respiration, artificial, <a href="#Page_225">225</a>.</li> +<li>Rest, need of, <a href="#Page_22">22</a>.</li> +<li>Rhubarb, <a href="#Page_142">142</a>.</li> +<li><i>Rhus</i>, poisoning by, <a href="#Page_259">259</a>.</li> +<li><i>Rhus toxicodendron</i>, <a href="#Page_259">259</a>.</li> +<li><i>Rhus venenata</i>, <a href="#Page_259">259</a>.</li> +<li>Rice, boiled, <a href="#Page_285">285</a>; +<ul class="ix"> + <li>cooking of, <a href="#Page_167">167</a>;</li> + <li>value of, <a href="#Page_113">113</a>.</li> +</ul></li> +<li>Rochdale, system of, <a href="#Page_53">53</a>.</li> +<li>Rolls, <a href="#Page_286">286</a>.</li> +<li>Rum, <a href="#Page_160">160</a>.</li> +</ul> +<a name="S" id="S"></a><h4>S</h4> +<ul> +<li>Salad plants, <a href="#Page_139">139</a>.</li> +<li>Saliva, <a href="#Page_29">29</a>.</li> +<li>Sanitation, <a href="#Page_35">35</a>.</li> +<li>Sauerkraut, <a href="#Page_139">139</a>.</li> +<li>Scab, <a href="#Page_233">233</a>.</li> +<li>Schafer, Prof., system of artificial respiration, <a href="#Page_225">225</a>.</li> +<li>Screens, <a href="#Page_41">41</a>, <a href="#Page_176">176</a>, <a href="#Page_219">219</a>.</li> +<li>Sewage, disposal of, <a href="#Page_49">49</a>.</li> +<li>Shallots, <a href="#Page_140">140</a>.</li> +<li>Sheet, rubber, <a href="#Page_219">219</a>.</li> +<li>Sick-room, <a href="#Page_217">217</a>.</li> +<li><i>Sistrurus</i>, <a href="#Page_262">262</a>.</li> +<li>Sleep, <a href="#Page_26">26</a>, <a href="#Page_78">78</a>.</li> +<li>Sleeping-sickness, <a href="#Page_1">1</a>.</li> +<li>Snake, harlequin, <a href="#Page_262">262</a>.</li> +<li>Snake-bites, <a href="#Page_268">268</a>.</li> +<li>Snakes, columbine, <a href="#Page_262">262</a>, <a href="#Page_263">263</a>; +<ul class="ix"> + <li>elapine, <a href="#Page_263">263</a>;</li> + <li>non-venomous, <a href="#Page_264">264</a>;</li> + <li>venomous, <a href="#Page_261">261</a>;</li> + <li>viperine, <a href="#Page_261">261</a>.</li> +</ul></li> +<li>Soups, meat, <a href="#Page_292">292</a>; +<ul class="ix"><li>vegetable, <a href="#Page_290">290</a>.</li></ul></li> +<li>Sours, <a href="#Page_147">147</a>.</li> +<li>Spinach, <a href="#Page_138">138</a>.</li> +<li>Splints, <a href="#Page_235">235</a>.</li> +<li>Sprains, <a href="#Page_234">234</a>.</li> +<li>Sputum, <a href="#Page_184">184</a>.</li> +<li>Squash, <a href="#Page_143">143</a>.</li> +<li>Starches, <a href="#Page_98">98</a>, <a href="#Page_104">104</a>; +<ul class="ix"> + <li>changes in, <a href="#Page_165">165</a>;</li> + <li>in cooking, <a href="#Page_97">97</a>;</li> + <li>in vegetables, <a href="#Page_131">131</a>;</li> + <li>raw, <a href="#Page_105">105</a>.</li> +</ul></li> +<li>Steam, <a href="#Page_46">46</a>.</li> +<li>Stove, <a href="#Page_47">47</a>.</li> +<li>Streams, <a href="#Page_60">60</a>.</li> +<li>Strychnine, as antidote, <a href="#Page_269">269</a>; +<ul class="ix"><li>poisoning by, <a href="#Page_254">254</a>.</li></ul></li> +<li>Sugar, consumption of, <a href="#Page_126">126</a>; +<ul class="ix"> + <li>from beets, <a href="#Page_136">136</a>;</li> + <li>in vegetables, <a href="#Page_131">131</a>;</li> + <li>kinds of, <a href="#Page_125">125</a>;</li> + <li>raw, <a href="#Page_105">105</a>.</li> +</ul></li> +<li>Sunstroke, <a href="#Page_242">242</a>.</li> +<li>Swamp-dogwood, <a href="#Page_260">260</a>.</li> +<li>Syringe, <a href="#Page_84">84</a>.</li> +<li>Syrups, <a href="#Page_33">33</a>; +<ul class="ix"><li>soothing, <a href="#Page_255">255</a>.</li></ul></li> +</ul> +<a name="T" id="T"></a><h4>T</h4> +<ul> +<li>Tapeworm, <a href="#Page_8">8</a>, <a href="#Page_9">9</a>, <a href="#Page_51">51</a>.</li> +<li>Tea, <a href="#Page_31">31</a>, <a href="#Page_152">152</a>.</li> +<li>Teeth, care of, <a href="#Page_80">80</a>, <a href="#Page_248">248</a>; +<ul class="ix"> + <li>teething of infants, <a href="#Page_80">80</a>;</li> + <li>tooth-ache, <a href="#Page_248">248</a>.</li> +</ul></li> +<li>Toadstool, see <a href="#Mushrooms">Mushroom</a>.</li> +<li>Tobacco, <a href="#Page_34">34</a>.</li> +<li>Tomato, <a href="#Page_141">141</a>.</li> +<li>Tonsillitis, follicular, <a href="#Page_200">200</a>.</li> +<li>Tooth-ache, <a href="#Page_248">248</a>.</li> +<li>Treatment, immunizing, <a href="#Page_205">205</a>; +<ul class="ix"><li>pasteur, <a href="#Page_214">214</a>.</li></ul></li> +<li>Tricina, <a href="#Page_18">18</a>.</li> +<li>Tuberculosis, <a href="#Page_94">94</a>, <a href="#Page_95">95</a>, <a href="#Page_156">156</a>; +<ul class="ix"><li>description and treatment, <a href="#Page_178">178</a>.</li></ul></li> +<li>Tubers, <a href="#Page_135">135</a>.</li> +<li>Turnips, <a href="#Page_136">136</a>, <a href="#Page_137">137</a>, <a href="#Page_138">138</a>.</li> +</ul> +<a name="V" id="V"></a><h4>V</h4> +<ul> +<li>Vaccination, <a href="#Page_88">88</a>.</li> +<li>Veal, boiled, <a href="#Page_277">277</a>; +<ul class="ix"> + <li>fried, <a href="#Page_277">277</a>;</li> + <li>jellied, <a href="#Page_278">278</a>;</li> + <li>roast, <a href="#Page_276">276</a>;</li> + <li>stew or pot-pie, <a href="#Page_277">277</a>.</li> +</ul></li> +<li>Vegetables, cooking of, <a href="#Page_293">293</a>; +<ul class="ix"> + <li>digestibility of, <a href="#Page_132">132</a>, <a href="#Page_133">133</a>;</li> + <li>diseases contracted from, <a href="#Page_9">9</a>.</li> +</ul></li> +<li>Ventilation, <a href="#Page_48">48</a>, <a href="#Page_218">218</a>.</li> +<li>Vinegar, <a href="#Page_133">133</a>, <a href="#Page_136">136</a>, <a href="#Page_147">147</a>.</li> +<li>Vipers, <a href="#Page_262">262</a>. See also <a href="#Pit-vipers">pit-vipers</a>.</li> +<li>Vomiting, <a href="#Page_67">67</a>, <a href="#Page_87">87</a>.</li> +</ul> +<a name="W" id="W"></a><h4>W</h4> +<ul> +<li>Waffles, <a href="#Page_107">107</a>.</li> +<li>Wall-paper, <a href="#Page_41">41</a>.</li> +<li>Water, as a drink, <a href="#Page_30">30</a>, <a href="#Page_148">148</a>; +<ul class="ix"> + <li>dangers of, <a href="#Page_140">140</a>;</li> + <li>diseases contracted from, <a href="#Page_8">8</a>;</li> + <li>for heating, <a href="#Page_46">46</a>;</li> + <li>for poisons, <a href="#Page_251">251</a>;</li> + <li>for wounds, <a href="#Page_230">230</a>.</li> +</ul></li> +<li>Water-supply, <a href="#Page_57">57</a>.</li> +<li>Wells, <a href="#Page_58">58</a>.</li> +<li>Whisky, <a href="#Page_160">160</a>.</li> +<li>Wines, <a href="#Page_161">161</a>.</li> +<li>Work, <a href="#Page_22">22</a>.</li> +<li>Worms, <a href="#Page_140">140</a>.</li> +<li>Wounds, <a href="#Page_227">227</a>.</li> +</ul> +<a name="Y" id="Y"></a><h4>Y</h4> +<ul> +<li>Yams, <a href="#Page_135">135</a>.</li> +<li>Yeast, <a href="#Page_286">286</a>.</li> +</ul> + + + + + + + + + +<pre> + + + + + +End of the Project Gutenberg EBook of Health on the Farm, by H. 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