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diff --git a/old/53974.txt b/old/53974.txt deleted file mode 100644 index 3a0a6ea..0000000 --- a/old/53974.txt +++ /dev/null @@ -1,6587 +0,0 @@ -Project Gutenberg's Principles of Public Health, by Thos. D. Tuttle - -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/license - - -Title: Principles of Public Health - A Simple Text Book on Hygene Presenting the Principles - Fundamental to the Conservation of Individual and Community - Health - -Author: Thos. D. Tuttle - -Release Date: January 16, 2017 [EBook #53974] - -Language: English - -Character set encoding: ASCII - -*** START OF THIS PROJECT GUTENBERG EBOOK PRINCIPLES OF PUBLIC HEALTH *** - - - - -Produced by Charlene Taylor, John Campbell and the Online -Distributed Proofreading Team at http://www.pgdp.net (This -file was produced from images generously made available -by The Internet Archive) - - - - - - - - - - TRANSCRIBER'S NOTE - - Italic text is denoted by _underscores_. - - Bold text is denoted by =equal signs=. - - Obvious typographical errors and punctuation errors have been - corrected after careful comparison with other occurrences within - the text and consultation of external sources. Misspellings in - the text, and inconsistent or archaic usage, have been retained. - - - - - PRINCIPLES OF - PUBLIC HEALTH - - A SIMPLE TEXT BOOK ON HYGIENE - PRESENTING THE PRINCIPLES FUNDAMENTAL - TO THE CONSERVATION OF - INDIVIDUAL AND COMMUNITY HEALTH - - BY THOS. D. TUTTLE, B.S., M.D. - - SECRETARY AND EXECUTIVE OFFICER OF - THE STATE BOARD OF HEALTH OF MONTANA - - [Illustration: (publisher's colophon)] - - YONKERS-ON-HUDSON, NEW YORK - WORLD BOOK COMPANY - 1910 - - - - -CONSERVATION OF HEALTH - - "Our national health is physically our greatest asset. To prevent - any possible deterioration of the American stock should be a - national ambition."--THEODORE ROOSEVELT. - - -_The conservation of individual and national health is the keynote -of these books_ - -PRINCIPLES OF PUBLIC HEALTH - - By THOS. D. TUTTLE, M.D., Secretary and Executive Officer of the - State Board of Health of Montana. Illustrated. Cloth. vii + 186 - pages. List price 50 cents, mailing price 60 cents. - -PRIMER OF HYGIENE - - By JOHN W. RITCHIE, of the College of William and Mary in - Virginia, and JOSEPH S. CALDWELL, of the George Peabody College - for Teachers, Nashville, Tennessee. Illustrated. Cloth. vi + 184 - pages. List price 40 cents, mailing price 48 cents. - -PRIMER OF SANITATION - - By JOHN W. RITCHIE. Illustrated. Cloth. vi + 200 pages. List - price 50 cents, mailing price 60 cents. - -HUMAN PHYSIOLOGY - - By JOHN W. RITCHIE. Illustrated in black and colors. Cloth. vi + - 362 pages. List price 80 cents, mailing price 96 cents. - - - WORLD BOOK COMPANY - CASPAR W. HODGSON, _Manager_ - YONKERS-ON-HUDSON, NEW YORK - - - _Copyright, 1910, by World Book Company. All rights reserved_ - - - - -INTRODUCTION - - -The earliest history of remote ages describes methods employed in -combating disease, and down through all the centuries the struggle -against infection has been going on. The science of health as -applied in recent years reveals wonderful progress in the avoidance -of disease, and in the control of the violent epidemics by which -in the past nations were almost exterminated. Modern methods of -hygiene and sanitation as applied to public health have robbed -smallpox and diphtheria of their death-dealing power; cholera and -yellow fever have been forced to retreat before the victorious -hosts of applied medical science; tuberculosis, the greatest foe -of human life, is slowly but surely receding before the determined -efforts of modern preventive medicine. - -By nature man is endowed with resistive power sufficient to ward -off most forms of disease, provided he keeps his health at a normal -standard by right living. If, however, he allows his health to -become impaired by reason of overwork, bad habits, wilful exposure -to contagion or unhealthful surroundings, he readily falls a prey -to disease. - -The author of _Principles of Public Health_ has here set forth the -general rules of life by the observance of which every adult and -every child not only can do much to preserve his own health but -also can prove himself a prominent factor in raising the standard -of public health. A campaign of education is demanded to arrest the -enormous loss of life which is carrying so many to untimely graves, -and the instruction given in this volume will be of inestimable -value in teaching people how to avoid avoidable disease. - -The author has not attempted to deal with all the diseases that -may be classed as preventable; as the work is intended for use in -the public schools, only such diseases are mentioned as it seems -fitting to present to school children. To teach our children a -proper respect for their own health and for the community welfare -is to fit them for the best citizenship. - - E. A. PIERCE, M. D. - - PORTLAND, OREGON - - - - -ACKNOWLEDGMENTS - - -The author wishes to express his sincere appreciation of the -valuable assistance rendered in the preparation of this work -by Dr. S. T. Armstrong, of New York City; Dr. H. Wheeler Bond, -Commissioner of Health, St. Louis, Missouri; Dr. H. M. Bracken, -Secretary and Executive Officer of the State Board of Health of -Minnesota; J. S. Caldwell, Professor of Biology, George Peabody -College for Teachers, Nashville, Tennessee; R. J. Condon, -Superintendent of Schools, Providence, Rhode Island; Mrs. Nona B. -Eddy, of the Public Schools of Helena, Montana; Dr. F. M. McMurray, -of Teachers College, Columbia University, New York City; Miss -Jessie B. Montgomery, Supervising Critic in Training School, State -Normal School, Terre Haute, Indiana; Dr. E. A. Pierce, Secretary -and Executive Officer of the State Board of Health of Oregon. - - - - -CONTENTS - - - PART I--THE FIGHT FOR HEALTH - - CHAPTER PAGE - - I. CONSTANT DANGER OF ILLNESS 1 - - II. THE NECESSITY OF CARING FOR THE BODY 4 - - III. HOW CLOTHING AFFECTS HEALTH 9 - - IV. THE USES OF FOOD 14 - - V. CARE OF FOOD--MEATS 18 - - VI. CARE OF FOOD--MILK 22 - - VII. DECOMPOSITION OF FOOD 30 - - VIII. HARM DONE BY IMPROPER COOKING 34 - - IX. HOW NEATNESS, CHEERFULNESS, AND GOOD MANNERS - PROMOTE HEALTH 37 - - X. DANGERS FROM POOR TEETH 41 - - XI. NECESSITY FOR PURE AIR AND HOW TO SECURE IT 45 - - XII. REST ESSENTIAL TO HEALTH 51 - - XIII. CARE OF THE EYE AND EAR 56 - - XIV. CARE OF THE SKIN 60 - - XV. COMMON POISONS TO BE AVOIDED 64 - - - PART II--THE ENEMIES OF HEALTH - - XVI. DISEASE GERMS 73 - - XVII. ENCOURAGEMENT OF DISEASE BY UNCLEANLY - HABITS 75 - - XVIII. FLIES AS CARRIERS OF DISEASE 79 - - XIX. HOW DISEASE GERMS GET INTO WATER 85 - - XX. TRANSMISSION OF DISEASE THROUGH THE AIR 89 - - XXI. INSECTS AS CARRIERS OF DISEASE 92 - - XXII. HOW TO KEEP GERMS OUT OF WOUNDS 95 - - XXIII. TRANSMISSION OF DIPHTHERIA 100 - - XXIV. THE CURE OF DIPHTHERIA 108 - - XXV. HOW TYPHOID FEVER GERMS ARE CARRIED 113 - - XXVI. HOOKWORM DISEASE AND AMOEBIC DYSENTERY 120 - - XXVII. HOW SCARLET FEVER IS CARRIED 123 - - XXVIII. MEASLES AND WHOOPING COUGH DANGEROUS - DISEASES 128 - - XXIX. HOW SMALLPOX IS PREVENTED 131 - - XXX. WHY VACCINATION SOMETIMES SEEMS A FAILURE 138 - - XXXI. CONSUMPTION, THE GREAT WHITE PLAGUE 142 - - XXXII. HOW CONSUMPTION IS SPREAD AND HOW PREVENTED 150 - - XXXIII. HOW CONSUMPTION IS CURED 157 - - - APPENDIX--SUMMARY OF ANATOMY 163 - - SUGGESTIONS TO THE TEACHER 182 - - INDEX 183 - - - - -PART I - -THE FIGHT FOR HEALTH - - - - -CHAPTER I - -CONSTANT DANGER OF ILLNESS - - -Every boy and girl confidently expects to grow into a strong and -healthy man or woman. How often we hear a child say, "When I am a -man," or "When I am a woman;" but I have never heard a boy or a -girl say, "If I live to be a man or woman." When you think of what -you will do when you are grown into men or women, it never occurs -to you that you may be weak and sickly and therefore not able to -do the very things that you would most like to do. This suggests -that sickness is not natural, else the thought that you may perhaps -become sick would enter your mind. As a matter of fact, most -sickness is not natural. - -[Sidenote: The fight for life] - -There is a constant struggle going on in the world. You see a fight -about you every day among the animals. You see the spider catch the -fly, the snake catch the frog, the bird catch the insect, and the -big fish catch the minnow; and you have heard of wars where men -kill one another. - -The greatest enemies that men have to fight, however, are not -other men, or wild animals, but foes that kill more men, women and -children every year than were ever killed in the same length of -time by war. These foes are small, very small, but you must not -think that because things are small they are not dangerous. We -call these foes _disease germs_. - -[Illustration: FIG. 1. Looking at cells through a microscope.] - -[Illustration: FIG. 2. Some skin cells as seen through a -microscope.] - -[Sidenote: The nature of a germ] - -The germ is a very, very small body; it is the smallest living -body that we know. Later we shall learn that our bodies are made -up of cells, and that these cells are extremely small--so small -that it takes a very powerful microscope to see one of them. The -germ is still smaller than the cells in our bodies, and it is -made of a single cell. There are a great many kinds of germs in -the world. Fortunately, most of them are not harmful. Some germs -cause disease, but there are other germs that not only are not -harmful, but are actually helpful to men. Among the helpful germs -are those that enrich the ground, and these should be protected; -but all germs that cause disease should be destroyed as rapidly -as possible. These germs are fighting all the time against our -health. They are not armed with guns and cannon, neither do they -build forts from which to fight; but they get inside our bodies and -attack us there. - -[Sidenote: How to fight germs] - -There are three principal ways by which we fight disease germs: -_first_, by keeping our bodies so well and strong that germs -cannot live in them; _second_, by keeping germs out of our bodies; -_third_, by preventing germs from accumulating in the world--that -is, by killing as many of them as possible. - -If it is possible to keep so well and strong that disease germs -cannot live in our bodies, you will naturally infer that there are -other causes of sickness besides disease germs. That is true, for -there are a great many things beside germs that cause our bodies to -get into such a condition that disease germs can enter and grow and -make us ill. We sometimes call this a "run-down" condition. Before -we begin, then, to study the germs that cause disease, we must -learn how to keep our bodies strong and ready to fight these germs. - - =Questions.= 1. What evidence have we that sickness is not - natural? 2. Name some of the fights going on in the animal world. - 3. What can you say of the amount of illness caused by germs? 4. - Tell what you have learned about germs. 5. Name three ways of - fighting germs. - - =Remember.= 1. Most sickness comes from failure to observe - Nature's laws. 2. We must keep up a constant fight against germs - that cause sickness. 3. We fight germs by killing as many of them - as we can, and by keeping our bodies so strong that if a disease - germ enters it cannot grow. - - - - -CHAPTER II - -THE NECESSITY OF CARING FOR THE BODY - - -[Illustration: FIG. 3. The organs of the body.] - -[Sidenote: How the body is like an automobile] - -These bodies of ours are built somewhat like automobiles. An -automobile is made up of a framework, wheels, body, gasoline tank, -engine, and steering-gear. The human body has much the same form of -construction. We have a frame, which is made of the bones of the -body. We have arms and legs, which correspond to the wheels of the -automobile. We have many little pockets in our bodies in which fat -is stored, and these little pockets answer to the gasoline tank -of the automobile. We have an engine which, like the automobile -engine, is made up of many parts; and we have a head or brain, that -plays the same part as the steering-gear of the automobile. - -The automobile has a tank in which is carried the gasoline -necessary to develop power for the machine. If the gasoline gives -out, the engine will not run, and before the owner starts on a -trip, he is always careful to see that the tank is well filled. -In the same way, if we do not provide new fat for the pockets in -our bodies in which the fat is stored, our supply will soon give -out and our bodies will refuse to work, just as the engine of the -automobile will refuse to work when the gasoline is used up. - -[Sidenote: What cells are like] - -The automobile is made of iron and wood and rubber, and each bit -of iron and wood and rubber is made up of tiny particles. The body -is made of bones and muscles, covered with skin, and all these are -made up of very fine particles that we call cells. Every part of -the body is made of these fine cells. The cells are so small that -they can be seen only with a powerful microscope. If you look at -your hand you cannot see a cell, because it takes a great many -cells to make a spot large enough for you to see. In Figure 1 you -see a boy looking through a microscope, and beside him you see a -picture of what he sees. This picture does not look like the skin -on your hand, neither does it look like the skin on the boy's hand; -but it is nothing more nor less than a piece of skin taken from -that boy's hand, and it looks just as a piece of skin from your -own hand would look if you were to see it through a very strong -microscope. - -[Sidenote: Why cells must not be killed] - -The whole body is made up of just such little cells as you see in -Figure 4, and each cell is alive and has a certain work to perform. -It is very important that we keep these cells from dying and that -they perform the work for which they are intended, for if these -cells die or fail to act, the body becomes sick or dies. - -[Illustration: FIG. 4. A cell. (a) Cell body; (b) nucleus; (c) -nucleolus.] - -You can scratch some of the paint from your automobile and the -machine will work just as well as ever. Apparently no harm has been -done, but an opening has been made through which moisture and germs -can enter and cause the wood to rot and the iron to rust. You can -remove certain parts of the automobile and still the machine will -do its work; but you cannot take away too much of any one part -without weakening the automobile, and if certain parts are missing -(such as the sparker, the battery, or the steering-gear), the -usefulness of the machine is destroyed. So it is with the body. You -can scratch off some of the skin and not do any apparent harm, but -you have made an opening through which germs may get into the body. -You can remove certain parts of the body, such as the arm or leg, -and still the body will do efficient service. But there are certain -parts of the body that are necessary to life, just as certain parts -of the automobile are necessary to the usefulness of the machine. -You cannot remove the heart and live; you cannot remove the brain -and live. - -[Sidenote: How cells are killed] - -You are probably thinking that it must be easy to kill such a -little thing as a cell; and so it is. Cells can be killed by too -much heat or too much cold. When you skin your hand, you kill many -cells, and at the same time make an opening for germs to get in and -cause sickness. You can kill cells also by starving them, for they -must have not only enough food, but the right kind of food. If you -feed your bodies on nothing but candy, pie, and cake, most of the -cells will refuse to perform their work and many of them will die. -These cells must have also an abundance of air, and the air must be -pure and fresh. If you breathe the air that others have breathed or -that contains poison of any kind, you will soon find that you are -not feeling well. This simply means that so many of the cells are -being starved for fresh air, that not enough strong ones are left -to do the necessary work. You can kill these cells by overwork, for -they must have a proper amount of rest. If you go to school all -day long and then sit up until midnight every night, you must not -expect the cells of your body to keep strong and well. You can kill -these cells by the use of certain things that act as poisons to -them, such as tobacco, beer, wine, or whisky. - - =Questions.= 1. In what way is the body like an automobile? 2. - What are cells like? 3. Why must cells not be killed? 4. Name - five ways by which we kill cells. - - =Remember.= 1. Each part of the body is important to the welfare - of the whole body. 2. Each part of the body is made up of very - small particles that we call cells; each cell in the body is - alive and has a certain work to perform. 3. Cells are very easily - weakened and killed. 4. There are five principal ways by which - we kill the cells in our bodies: by too much heat or cold; by not - giving them the proper kinds of foods; by not giving them enough - fresh air; by giving them too much work to do; and by poisoning - them. - - - - -CHAPTER III - -HOW CLOTHING AFFECTS HEALTH - - -[Illustration: FIG. 5. Warm, dry clothing necessary for health.] - -[Sidenote: Why the body should be equally covered] - -The body should always be kept at as nearly uniform a temperature -as possible. In order to do this we wear clothing. Clothing keeps -out the heat on a hot day, just as it keeps the heat in and the -cold out on a cold day. The clothing should be equally heavy on -all parts of the body. It is not right to wear a thick dress over -your chest and leave your shoulders and arms bare, or nearly so. -People who do this are killing a great many cells by letting part -of their bodies become chilled while the rest is warm, probably too -warm. - -[Sidenote: Why clothing should not be too heavy] - -The clothing should be just heavy enough to keep the body warm. -If you wear such heavy clothing indoors that you are constantly -perspiring, your underclothes become damp, and when you go out, -even though you put on your overcoat, your body becomes chilled. If -you begin to sneeze, that is Nature's way of telling you that you -are killing many of your cells by too much cold. - -People sometimes get warm from exercising, and then take off their -coats. They should have removed their coats before they began to -exercise. If you take off your coat after you are too warm, your -body becomes chilled. Baseball pitchers know this, and if you watch -a good pitcher, you will see that he always puts on his sweater as -soon as he stops pitching, even though he is very warm. He knows -that if he cools off too quickly, he will become stiff and sore and -cannot pitch good ball. - -[Sidenote: When a draft is dangerous] - -Sometimes a person sits in a warm room until he begins to perspire -freely. Then he opens a window and sits in the draft. Under -ordinary conditions, the cool wind alone would chill the body, but -now the rapid drying of the perspiration makes the body cool still -more quickly. The sudden chill causes the person to take cold, -which is simply another way of saying that he has killed many cells -and caused others to fall sick, so that they cannot perform their -work. We cannot get too much fresh air. Drafts do not hurt us if -we are thoroughly wrapped up; but it is very dangerous to allow -the wind to strike the body when it is not well protected, and -especially when it is damp with perspiration. - -[Illustration: FIG. 6. Properly prepared for wet weather.] - -[Sidenote: Why damp clothing is dangerous] - -Damp clothing chills the body very rapidly and kills many cells. -Indeed, if a single one of the germs that cause pneumonia were to -enter your lungs while you were wearing damp clothing, it would -grow so rapidly that you might have pneumonia in a very little -while. That is why it is important to change your shoes and -stockings as soon as you get them wet, and to take off immediately -any clothing that becomes damp. It is hard for boys and girls to -keep their feet dry in the winter and spring months, and rubbers -are a nuisance; but if you expect to grow into the strong man or -woman you picture yourself becoming, you must take care to wear -your rubbers. Otherwise you may become weak and sickly, and never -be able to do the things you hope to do. - -The feet are not the only part of the body that needs to be kept -dry. A wet coat is just as harmful as wet shoes and stockings; -hence, you should always carry an umbrella or wear a raincoat when -you go out into the rain. Umbrellas are unhandy for boys and girls -to carry, but if you will remember that thousands of little cells -in your body are being injured when you get wet and chilled, you -will be willing to take your umbrella. - -[Sidenote: When to wear an overcoat] - -In cold weather the same amount of clothing should not be worn in -the house and outdoors; for this reason, we have overcoats. If you -wear your overcoat in the house, you will become overwarm and your -underclothing will then become damp with perspiration; when you go -outdoors into the cold air, this dampness will have just the same -effect as would dampness that comes from outside. - -[Illustration: FIGS. 7 and 8. If you keep your overcoat on in the -house, your underclothes become damp from perspiration, and when -you go outdoors your body becomes chilled.] - -As soon as the weather gets cold, put on your overcoat every time -you go outdoors, and take it off as soon as you come into the -house. This is troublesome for boys and girls to do, because they -want to run in and out of the house so often; but on the other -hand, think of all the cells you will kill if you do not do this, -and you will certainly consider it worth while to take off your -coat and put it on again. - - =Questions.= 1. How does keeping the body equally covered protect - the cells? 2. Give reasons for not wearing too heavy clothing. 3. - When is it safe to sit in a draft, and when dangerous? 4. What - is the danger of keeping on wet shoes or other damp clothing? 5. - When and why should overcoats be worn? - - =Remember.= 1. Clothing should be just heavy enough to keep the - body warm all the time. 2. Never take off your coat or sit in - a draft when you are too warm. 3. Since wearing damp clothing - causes a great deal of sickness, change your clothes as soon as - they become wet or damp. 4. Do not forget to take your umbrella - when it is raining and to wear your rubbers when the ground is - wet. 5. In cold weather wear your overcoat when you are outdoors, - but take it off when you come into the house. - - - - -CHAPTER IV - -THE USES OF FOOD - - -We kill a great many of the cells in our bodies by starving them; -either we do not give them enough food or we do not supply the -right kind of food. - -[Sidenote: Why the body needs new cells] - -Not only must we feed the cells in our bodies, but we must be -constantly making new ones, for in all our work or play, awake or -asleep, we are constantly using up certain cells. These cells are -used to make the body go, just as the engine uses coal to form the -steam that gives it power to run. Boys and girls grow fast and, of -course, if they expect to become well men and women, they must make -a great many new cells all the time, in addition to those used in -doing the work of the body. If we are to make new cells we must -have the right kind of food with which to make them. - -[Sidenote: How the body keeps itself warm] - -We want to do something besides make new cells; we want to keep -warm and well the cells we already have. No amount of clothing -would keep you warm if you were not making heat inside your body -all the time, any more than you could make a telephone post warm -by putting your coat on it. Therefore it is necessary to have food -that makes heat in the body, in addition to food that builds cells. - -We eat a great many kinds of foods, and all that we eat is used -either for building new cells or for producing heat in the body. -Thus we can divide all our foods into two classes--building -material and heat-producing material. The type of building material -is lean meat, and the type of heat-producing material is fat meat -and starches, such as potatoes and bread. Milk contains much -building material as well as heat-producing material. That is why -a baby grows and keeps warm while he takes nothing but milk. - -[Sidenote: The building foods] - -Lean meat is the best of all building foods. Eggs are largely a -form of lean meat, and hence constitute a good article of food for -building purposes. Certain vegetables contain a large per cent of -building material; this is especially true of dried beans and peas. -Wheat flour and corn meal (particularly when made of whole wheat -and unbolted meal) contain much building material. - -It is possible for one to live and grow when eating only vegetable -matter. But the boy or girl who tries to become a strong man or -woman by eating only vegetables will be disappointed; these are -mostly heat-producing foods and will not make strong bodies. -Experience has proved that the best results are obtained by eating -what is called "a mixed diet," that is, a diet composed partly of -lean meats and partly of fats and vegetables. - -[Sidenote: The heat-producing foods] - -Of the heat-producing foods, fat is the most powerful. Most of the -fat that we eat is used immediately for producing in the body heat, -and therefore power, but a part of it is stored up for future use. -We see it in all healthy young persons. It is this stored-up fat -that gives the body its rounded form. When any one has been sick he -is thin, because, to produce heat and power while he was sick, he -has had to use the fat stored up in his body. To have such a supply -of fat is like having a bank account to draw on when out of work. -We might call the deposits of fat in our bodies our health banks. - -Fat meat is not the only form in which we eat fats; we eat them -in a great many other ways. Certain vegetables, such as beans, -contain an oil that forms fat. Ripe olives contain a great deal -of fatty oil. Butter is a very important form of fat, and cream -contains a large amount of it. - -[Sidenote: Cost of suitable foods] - -In selecting our foods we should think of two things: _first_, the -value of the food as a heat-producer or as a building material; -and _second_, the cost of the food. We may like butter much better -than bacon, but we should remember that, pound for pound, bacon has -a greater nourishing power than butter, and a pound of bacon will -cost far less than a pound of butter.[1] - -Vegetable foods produce heat by means of the starch which they -contain. All vegetables contain starch. This starch is changed -into a kind of sugar in the body, and when thus changed it is used -to produce heat and power. All vegetable foods do not have the -same heat-producing power. There is more heat-producing power in -a pound of oatmeal than there is in ten pounds of cabbage. Ten -cents' worth of dried beans will produce more heat in the body -than will a dollar's worth of lettuce. Thirty cents' worth of corn -meal will do more building in the body than will a piece of mutton -worth a dollar and a half; but you would have to eat a large amount -of corn meal in order to secure the building effect that would -result from eating a small quantity of mutton. In most fruits the -only nourishing quality is in the sugar they contain. This sugar -produces heat in the body just as starch does. - -[Sidenote: The real value of advertised foods] - -You will see some foods advertised as possessing a wonderful -nourishing power. Do not let such statements deceive you, for no -food can have a greater nourishing power than the things from which -it is made. If the particular food advertised is made from wheat -flour, its nourishing power is just the same as that of an equal -quantity of wheat flour. If it is made from corn meal, it can have -no greater nourishing power than has the meal itself. - -We have learned something about the materials necessary in food and -why they are needed. We must now learn why foods that contain these -materials sometimes do not give us as good results as we might hope -for. - - =Questions.= 1. What use does the body make of new cells? 2. How - does the body keep itself warm? 3. Name two uses that the body - makes of food. 4. What foods are especially useful for making - cells? 5. What foods are chiefly used for making heat? 6. Select - articles of food for two meals of equal nourishing value, one - meal to be expensive and the other inexpensive. 7. How would you - determine the real value of any food? - - =Remember.= 1. Foods are used to make heat and power in the body - and to make the body grow. 2. The foods that make the body grow - are called building materials, and lean meat is the best kind - of building material. 3. The foods that produce heat and power - in the body are called heat-producing materials, and fats and - starches are the best heat-producers. 4. All vegetables contain - starch, some of them contain a fatty oil, and most of them - contain some building material. 5. You can get as much building - and heat-producing material from cheap foods as you can from - expensive foods. - - - - -CHAPTER V - -CARE OF FOOD--MEATS - - -[Sidenote: Value of meat as a food] - -Meat is one of the most important articles of our diet. It -furnishes essential materials for building cells, and it furnishes -fat for making heat and power in the body. - -[Illustration: FIG. 9. A double menace to health; the -slaughterhouse is dirty, and the filth is drained into a stream.] - -[Sidenote: Characteristics of good meat] - -Since meat is so important an article of food, we should be very -careful to see that it is handled in a way to keep it always -perfectly clean. We should make sure that it comes from animals -absolutely free from any kind of disease, and that no germs have -been allowed to develop poisons in it. - -[Sidenote: How meat may be kept clean] - -While people know that they ought to pay attention to these things, -as a matter of fact they do not do it. They take very little -interest in the way the meat that they are to eat is handled, and -very few ever go to the slaughterhouse or into the back room of the -butcher shop to see whether things are kept clean or not. Some -people say, "Oh, we do not like to go there because it is such a -horrid place." If these places were kept clean, as they should be, -they would not be "horrid." And if the people who buy the meat -would occasionally visit them, these places would be kept clean. - -[Illustration: FIG. 10. Properly displayed foods, protected from -handling and from dirt and flies.] - -If the slaughterhouse and the butcher shop where your meats are -handled are not kept clean, the meat is sure to have germs growing -in it, and these germs will cause poisons called _ptomaines_ to -form in the meat. There may not be enough of them to make you -sick, but there will be enough to injure some of the cells of your -body, and to deprive you of much of the nourishment that you would -otherwise get from the meat. - -All boys and girls should belong to a "Clean Meat League" and -should try to persuade their parents not to buy meat from any -butcher who does not keep his slaughterhouse and butcher shop clean. - -[Sidenote: Dangers from diseased meat] - -Sometimes butchers are anxious to make money fast and take little -thought for the number of people they may make ill. They can buy -sick cows very much cheaper than well ones. The meat from a sick -cow looks just like the meat from a healthy cow, and the dishonest -butcher sells both at the same price. The meat from the diseased -cow is not suitable for food. It may cause you to have the same -disease that the cow had, or it may only be changed to such an -extent that it will not give you the nourishment that you should -get from good meat. The butcher who sells you meat from a sick cow -is of course dishonest. - -[Illustration: FIG. 11. Improperly displayed foods, exposed to -handling and to dirt and flies.] - -[Sidenote: How to prevent the sale of diseased meats] - -Ask your father to visit the slaughterhouse where your meat is -killed. The only thing you need to do is to persuade him to go and -see whether the cattle are sick or not. If the cattle look sick, -you will not have to ask him not to buy the meat. No person should -ever eat meat that comes from a diseased animal, no matter what the -nature of the sickness may be. People who will take the trouble to -visit the slaughterhouses occasionally, to investigate these things -for themselves, will not have such meat offered them. - -[Sidenote: Importance of giving animals clean food] - -Animals that are fed on filthy food are not fit for human -consumption. Butchers often feed the offal (the insides) of animals -to the hogs. This makes the hogs fatten quickly, but it also makes -them diseased. When you go to the slaughterhouse with your father, -ask him to go around to the back door, and if you see hogs eating -this filth, do not buy any more meat from that butcher. - - =Questions.= 1. What use does the body make of meat? 2. What - conditions are essential for good meat? 3. How can meat be kept - clean? 4. Why is meat from a diseased animal unfit for food? 5. - How can you help in preventing the sale of meat from diseased - animals? 6. Why should animals not be fed with offal? - - =Remember.= 1. Meat that is not handled in a clean manner - is sure to contain germs that cause a poison to form in the - meat. 2. Never buy meat from a butcher who does not keep his - slaughterhouse and butcher shop clean. 3. Meat from a diseased - animal is not fit for food. 4. Meat from animals fed on filthy - food should not be eaten. 5. Form a "Clean Meat League" and visit - the slaughterhouse where your meat is killed. - - - - -CHAPTER VI - -CARE OF FOOD--MILK - - -[Sidenote: Value of milk as a food] - -Milk is another important article of food. The Department of -Agriculture at Washington says that milk furnishes sixteen per -cent of the nourishment of the people of the country. Milk is an -excellent food when it is pure, but when it is not pure it is very -dangerous. - -[Illustration: FIG. 12. A clean dairy.] - -[Sidenote: Milk as a carrier of germs] - -Milk has carried the germs of every disease of which the germ is -known; it has also carried many diseases of which we do not know -the germ. Disease germs grow rapidly in milk, and they do not -make the milk look different or taste different from milk that is -perfectly pure. If you could take two bottles of milk entirely free -from disease germs and put typhoid fever germs in one, and should -set both bottles in an ice box for twenty-four hours, you would -not then be able to tell into which one you had put the germs. The -milk in both bottles would look and taste just the same. The only -difference between the milk in the two bottles would be that if you -drank from one it would make you stronger and would furnish you -with both building material and power-producing material, while -if you drank from the other you would become very ill and would -probably die. - -[Sidenote: How disease germs get into milk:] - -Since we cannot tell from the taste or the appearance of milk -whether or not there are disease germs in it, we must take every -precaution possible to keep them out. The first step is to learn -where the disease germs come from and how they get into the milk. - -[Illustration: FIG. 13. Polluted milk is sure to come from a dairy -where cleanliness is not observed.] - -[Sidenote: (_1_) By dirt on the cow] - -Every cow has more or less dirt on her sides and udder; some have -a great deal. When the cow is milked, much of the dirt falls into -the milk bucket. This dirt always contains a great many germs of -different kinds, and many of them are germs that cause disease. -Straining the milk will take out much of the dirt, but disease -germs will go through the finest strainer that was ever made. - -In Figure 13 we see a man milking a dirty cow. The owner has -allowed his lot to become so dirty that the cow cannot find a clean -place in which to lie down. If the man kept his lot clean, and if -before milking the light dirt on the cow's sides and udder were -wiped off with a damp cloth, no germs would fall into the milk. - -[Sidenote: (_2_) By dirt in the cow barn] - -Another source of dirt and disease germs in milk is the barn. The -walls of a barn where cows are milked should always be kept clean -and should be whitewashed frequently. If this is done, there will -be comparatively little dirt on the walls to fall into the milk. - -[Illustration: FIG. 14. Only clean milk will come from a dairy -where proper precautions are taken.] - -Of course the walls and floors of a barn cannot be kept absolutely -clean. There will always be some dirt, and the movements of the -cows shifting their position and switching their tails, will stir -up the dust; so it is important to remove the milk from the barn as -soon as possible. Milk cans should never be kept in the barn. The -milk should be taken directly from the barn to a cooling house and -there strained. - -All barns where cows are kept should have plenty of windows, that -there may be an abundance of light and fresh air. Cows need fresh -air just as much as people do, while a barn that is not supplied -with plenty of light is very likely to be a dirty barn. - -Keep dirt and disease germs out of the milk by keeping the barn -clean and by taking the milk away from the barn as soon as possible. - -[Illustration: FIG. 15. A dirty, insanitary milk-house.] - -[Illustration: FIG. 16. A clean, inexpensive milk-house.] - -[Sidenote: (3) By dirt on the milkman] - -Another source of dirt and disease germs in milk is the milkman or -milkmaid. No matter how careful we may be, our clothes hold more or -less dust, and all dust contains germs, very often disease germs. -When a person is milking a cow, the dust from his clothes is shaken -off into the milk. The only way to avoid this is to wear, while -milking, a special suit of clothes made of white cloth, which may -be washed as soon as it shows the least particle of dirt. - -The milker's hands, too, are often dirty. Perhaps he carefully -washes his hands after milking, but not before. It is a common -custom for milkers to moisten their hands with milk while milking, -and to do this frequently. The result is that dirty milk from their -hands is constantly dropping into the milk pail. This is a very -bad habit, and doubly bad if the milkman has not washed his hands -before milking. - -Sometimes there are sick people at the dairy farm. Often some one -nurses a sick person until milking time and then goes out and milks -the cows. When this is done, the milker is almost sure to plant the -germs of the disease in the milk. No milk should ever be used from -any dairy where there is an infectious disease; and no one who has -charge of a sick person, no matter what the nature of the sickness, -should ever handle milk that is to be used by others. - -[Illustration: FIG. 17. A model bottling establishment.] - -[Sidenote: (4) By dirt in cans and bottles] - -The cans and bottles in which the milk is placed are frequently -sources of dirt and germs. Milk cans and bottles are supposed to be -thoroughly washed before milk is put into them, and they should be -thoroughly scalded after they are washed. This is not always done, -and sometimes the bottles are not washed at all. - -Some dairymen will tell you that the bottles and cans are always -washed and scalded just before the milk is put into them, and that -this is never neglected by any dairyman. That is what a dairyman -once told me. Then I asked him how he accounted for the fact that -I had found a milk ticket in the bottle with the fresh milk. Of -course he could not explain this, though I thought I could explain -it for him. The old milk bottle was returned to the milkman with -the ticket for the new milk inside it. The deliveryman left the -fresh milk, but forgot to take the ticket out of the bottle; and -the man who "washed" the bottles must have forgotten to take out -the ticket too. Of course, the bottle was not washed at all, and if -one bottle goes unwashed, it is reasonable to assume that others -are neglected in the same way. - -Milk bottles and cans should always be thoroughly washed before -fresh milk is put into them. This washing cannot be done by little -children; it is work for a man or woman, and careful work at that. - -[Sidenote: (5) By polluted water] - -I have just told you that milk vessels should be thoroughly washed. -It is true, however, that disease germs may get into the milk -through this very process of washing the vessels. Water sometimes -contains disease germs, especially the germs that cause typhoid -fever, cholera, and other diseases of the intestines. Such water -is said to be polluted. When milk vessels are washed with polluted -water, the germs are left in them and thus get into the milk. If -the water used to wash the cans is thoroughly boiled, the germs -will be killed; hence it is important to scald all milk vessels. - -All water used about a dairy should be perfectly pure. If there is -the least suspicion about the quality of the water, it should be -examined by a chemist; and if it is not pure, the milk from such -a dairy should not be used. In order to prevent the possibility -of any infection, all water used to wash milk vessels should be -thoroughly boiled even when the water is known to be pure, and the -vessels should afterward be scalded, to kill any germs that may be -left after washing. - -[Sidenote: (6) By flies falling into the milk] - -Flies very frequently get into the milk. Later we shall learn more -about how flies carry germs, but at present it is enough to know -that on every fly there are a great many germs, and whenever a fly -gets into milk it plants those germs and they grow very rapidly. -As soon as a cow is milked, the milk should be taken to a clean -cooling house, with screens at all the windows and doors, and there -strained into a vessel and cooled. - -[Sidenote: (7) By disease in the cow] - -The last way that we will mention by which germs get into milk is -by disease in the cow herself. Cows suffer from many diseases, -just as men do; and when a cow is sick, her milk is very likely -to contain the germs of the disease that is making her sick. -Especially is this true of tuberculosis, or consumption, as it is -called. A great many children get consumption by drinking milk -from consumptive cows. No milk should ever be used from a cow that -is not healthy. All dairy cows should be examined at frequent -intervals by a competent veterinarian to make sure that they are -free from any disease. - - =Questions.= 1. Milk forms what per cent of the food of the - people of the United States? 2. Why is it important that milk - should be kept clean? 3. Name some ways by which germs get into - milk. 4. What is the danger from a dirty cow and barn? 5. How can - this danger be prevented? 6. How does the milkman allow germs to - get into the milk, and how can he avoid doing so? 7. How should - milk cans and bottles be washed? 8. Why is it important that only - pure water be used about the dairy? 9. How can flies be kept out - of milk? 10. How should milch cows be tested to make sure that - they are free from tuberculosis? - - =Remember.= 1. Milk is a very important article of food; it is - both a building and a heat-producing material. 2. When milk is - not properly handled, it contains many disease germs. 3. Disease - germs often get into milk from unwashed bottles and cans; from - dirty barns; from dirty milkmen; from dirty water used to wash - the cans and bottles; from flies falling into the milk; from - diseased cows. - - - - -CHAPTER VII - -DECOMPOSITION OF FOOD - - -[Illustration: FIG. 18. Partially decayed fruit is not fit for -food.] - -[Sidenote: Why partially decomposed foods should not be eaten] - -Vegetables and fruits that are partially decayed should not be -eaten. Even if an orange is decayed only on one side, the products -of decomposition--that is, the poisons produced by decay--have -extended all through the orange. You cannot see them, but they are -there. It is the same with a decaying apple, potato, or melon. It -never pays to buy partially decayed or stale fruits or vegetables, -for not only are they dangerous to health, but they are so reduced -in nourishing qualities by decomposition that you get little value -for the money you spend. It is always better economy to buy fresh -fruits and vegetables, or even canned vegetables, when the latter -are properly put up. - -[Sidenote: What causes decomposition] - -All decomposition (rotting) in fruits and vegetables is due to the -action of germs. If you will look at a bunch of old grapes, you -will notice that some of the grapes are rotten, while others have -dried up. Now, if you examine them very carefully, you will find -that all the decomposed grapes have breaks in the skin. The break -may be very small, but it is there, and through this break the -germs that cause decomposition have entered. You will find also -that there is not the slightest break in the skin of any grape that -has dried up. The germs could not enter, hence there has been no -decomposition. It is the same with other fruits and vegetables: if -the germs that cause decomposition cannot get inside, the fruit or -vegetable will dry up, but will not rot. - -[Illustration: FIG. 19. Fruits displayed for sale, but properly -protected from flies, dust, and dirty hands.] - -Germs can go through a very small opening--so small that you may -not be able to find it; but if there is decomposition, the hole is -there. - -The skin of the body acts in the same way as the skin of the grape -and keeps out a great many germs that would make us sick were they -able to get through the skin. They often get through the skin when -we cut ourselves. - -Meats decompose as well as fruits and vegetables, and the -decomposition is due to the presence of germs in the meat. We -cannot keep all germs out of meat, but we can keep out a great many -of them by having everything clean about the meat, by keeping it -covered as much of the time as possible, and by handling it only -with clean hands. - -[Illustration: FIG. 20. Fruits for sale, not properly protected -from flies, dirt, and other sources of filth.] - -[Sidenote: Why foods do not decompose in very cold places] - -When meat is kept so cold that it is almost frozen, the germs -cannot grow, and decomposition is prevented. In this way meat can -be kept perfectly free from decomposition for several weeks. After -the meat is taken from the cold storage room, it should be cut as -soon as possible into steaks, roasts, and other pieces for cooking; -and when taken to your home, it should be kept in an ice box until -the time to cook it. You cannot keep meat very long at home without -decomposition starting, because small ice boxes are not cold enough -to check entirely the growth of germs. - -Unless the meat is to be eaten hot, it should be cooled after -cooking and placed again in the ice box as soon as possible. -Cooking kills the germs that are in the meat before it is cooked; -but unless it is kept in a very cold place and protected from flies -after it is cooked, germs will get into it again as soon as it is -cold. Cooked meat will decompose just the same as uncooked meat. - -[Sidenote: What is formed in food by decomposition] - -When germs are allowed to grow in meat, as always happens when it -is not kept in a very cold place, these germs cause the poisons -that we call ptomaines. The people who eat such meat become sick, -and in many cases do not recover. Cooking meat that contains -ptomaines will kill the germs that caused the poison, but it will -not destroy the poison that has already been formed. - -[Sidenote: Why some canned meats are poisonous] - -People not infrequently are poisoned by eating canned meat. -Sometimes you will hear it said that the poison formed because the -meat was in cans. This is not true; the cans had nothing to do -with the forming of the poison. This was caused by germs that were -allowed to grow in the meat before it was cooked. When the meat was -cooked the germs were killed, but the poison was not destroyed. In -other words, the poison developed before the meat was canned, and -not after it was put into the cans. - - =Questions.= 1. What is the objection to eating fruits when they - are partially decayed? 2. Why do some foods shrivel while others - decay? 3. Why does decomposition not go on in cold places? 4. - What are ptomaines? 5. When are ptomaines formed in canned meats? - - =Remember.= 1. Partially decomposed fruits or vegetables are not - suitable for foods. 2. Meats in which germs have been allowed to - grow should not be eaten. 3. Cooking meat kills the germs in it, - but does not destroy the poisons that the germs have formed. 4. - When canned meats are poisonous, it is because the poison was - formed before the meat was canned; the poison is not caused by - the can. - - - - -CHAPTER VIII - -HARM DONE BY IMPROPER COOKING - - -[Sidenote: Effects of improper cooking] - -Nearly all food should be cooked before it is eaten; but if the -cooking is not properly done, much of the nourishing power of the -food is destroyed, and in some instances the food is rendered -actually injurious. - -[Sidenote: Why starchy foods should be thoroughly cooked] - -Starchy foods should be thoroughly cooked in order that the -coverings which surround the little granules may be broken or -made soft. If starchy foods are not thoroughly cooked, the little -grains go into the stomach as hard as grains of sand; then most of -them are not digested at all, but pass out of the system without -furnishing any nourishment to the body. If starchy foods are fried -in fats, as is the case with doughnuts, the granules of starch -become coated with fat. As the fat is not digested until it comes -to the intestines, the saliva never reaches the coverings of the -starch, and more work is thrown on the other juices of the body. -The result is that the little glands which make these other juices -are overworked, or else the starch is not digested at all and -therefore furnishes no nourishment to the body. When bread is -sticky (we sometimes call it soggy) in the middle of the loaf, it -is because the flour has not been thoroughly cooked and the little -grains or granules of starch are still hard. You cannot feel these -granules between your fingers, but they are hard just the same, and -very little of such food is made use of in the body. - -Remember that all starchy foods should be thoroughly cooked, and -remember, too, that all vegetables are chiefly starchy in character. - -[Sidenote: How fats should be cooked] - -When fats are cooked over a very hot fire, an acid is developed -that is injurious to the body. This does not mean that when the -fire is hot enough to broil a steak well, it causes this acid to -form; neither does it mean that heat sufficient to boil the grease -for cooking doughnuts will cause it to form. Every cook knows -that when she fries fat meat over a fire that is too hot, it has -a bitter taste. This bitter taste is caused by an acid which will -destroy a part of the usefulness of the food in the body and will -cause many of the cells to stop doing their work properly. - -[Sidenote: How meats should be cooked] - -There is a great difference of opinion in regard to cooking foods, -especially meats. Some people will tell you that meats should not -be cooked at all; that man originally ate his meat raw and that -this is the proper way. Others will tell you that all meat should -be cooked until it does not show a particle of red, even until it -is dry throughout. These are the two extremes; and it is never well -to go to extremes in anything, especially in matters that concern -the health. - -Meat should always be cooked, because by being cooked it is made -more easily digestible; but it should not be cooked, until all the -juices, which contain much of the nourishing matter, are dried up -and the meat made hard. Meat that is cooked until it is dry and -hard is more difficult to digest than meat that is not cooked at -all. - - =Questions.= 1. What effect has improper cooking on foods? 2. Why - should starches be thoroughly cooked? 3. What is the objection - to starchy foods fried in grease? 4. What changes take place in - fatty food when it is fried over a very hot fire? 5. Why should - all meats be cooked? 6. What is the objection to cooking meat - until the juices are dried out? - - =Remember.= 1. Starchy foods should be thoroughly cooked so that - the fine grains may be softened and the food thus made more easy - to digest. 2. Fats should not be fried over a very hot fire - because too much heat causes a poison to form in the fat. 3. - Meats should be cooked, but never until they become dry, as the - juices in the meat contain most of the nourishing material. - - - - -CHAPTER IX - -HOW NEATNESS, CHEERFULNESS, AND GOOD MANNERS PROMOTE HEALTH - - -[Sidenote: Why mealtime should be pleasant] - -The dining table should be the pleasantest and most inviting place -in the house. If you are complaining and quarreling during the -meal, you cannot enjoy the food; you cannot eat it properly; and -your ill temper will so affect your body that you cannot properly -digest what you eat. A dirty table, with flies swarming over the -food, is not very tempting, and when seated at such a table, one -does not eat the things that are best for him and sometimes does -not eat anything at all. - -[Illustration: FIG. 21. A clean, inviting dining-room.] - -[Sidenote: How uninviting luncheons affect the appetite] - -The luncheons that boys and girls take to school with them are -often prepared in so careless a way that they are extremely -uninviting. The substantial school lunch can be made just as -appetizing as the dainty refreshments at an afternoon tea or at -a party. If the same care is devoted to the preparation of the -one as of the other, boys and girls will eat their lunches with -enjoyment and good appetites. - -[Sidenote: Why an attractive table calls for pleasing guests] - -If the table is made to look clean and inviting, do you not think -that you, in your turn, should make yourself as neat and clean as -possible before you come to it? Dirt on your hands and face not -only does not look well, but contains a great many germs that may -get into your food and thus find their way into your body and try -to make you ill. - -[Illustration: FIG. 22. Two lunches. Which is the more tempting?] - -[Sidenote: How foods should be eaten] - -Besides being eaten in pleasant surroundings, all food should be -eaten slowly. Let us suppose that we are all seated at a clean, -inviting table and everyone is clean and happy. Before the children -is the very kind of food that is best for them. It looks good and -they know it is good, and they want to eat all they can of it. But -they think of a game of jacks or of ball that they want to play as -soon as dinner is over, so they simply "bolt" their food. - -What are teeth made for? Why, to chew with, of course. But why are -we given some teeth that are sharp like knives, and some that are -flat like millstones? It seems probable that these different kinds -of teeth are intended for special purposes, and so they are. If -our teeth were intended only for cutting our food into bits small -enough to swallow without causing pain, there would be no need -for any except the sharp, knife-like teeth. But we have the big -grinders, which were made to use, and it is very important that -they be used in the right way. - -[Sidenote: Why food should be thoroughly chewed] - -We do not chew our food simply to make it fine enough to swallow, -but for quite another reason as well. In our mouths there is a -fluid called _saliva_. Think of something that you are very fond -of eating, and the mere thought of it makes the saliva come into -your mouth. This saliva has a very important duty to perform in -connection with preparing the food for the little cells of the -body. Each little grain of starch--and you will remember that all -vegetable foods are composed largely of starch--has a capsule about -it. This simply means that it is done up in a little package. The -saliva helps to open this capsule by making it soft (just as water -will soften the paper on a package of candy), so that the other -digestive juices can reach the starch and turn it into the kind of -sugar that is used in the body. If you do not chew your food very -fine, the saliva will not reach the starch granules, the little -packages of starch will be hard to open when they go into the -stomach, and much of the starch will never be made use of in the -body. The saliva has much the same action on the coverings of the -little packages of meat, for all the meat that we eat is done up in -similar packages. - -A great Englishman, Mr. Gladstone, who lived to be eighty-three, -made a practice of chewing every bite of food twenty times, and he -thought this had a great deal to do with his being such a strong -and well man and living to such an old age. - -[Sidenote: When desserts are not harmful] - -After you have eaten meats, bread, and vegetables, it will do no -harm to eat a piece of pie or cake, or a dish of ice-cream or some -other dessert. It is not easy, as a rule, to digest these things -(that is, to get them into such shape that they can be used as food -by the little cells in the body), but a moderate amount of them is -very good for boys and girls, as well as for grown people. If you -refuse to eat the meat and bread, but wait until the dessert is -served and then fill your stomach with sweet things, you will be -starving some of the little cells, and you will be reminded of this -very soon. Sometimes you may be reminded of it by having a pain in -your stomach, but more often by getting low grades in your lessons -at school. Your teacher will know it, too, because you will be so -restless and inattentive in your classes that she will have to give -you a low grade in deportment as well. - - =Questions.= 1. What kind of topics should be discussed at - mealtime? 2. What is the objection to an untidy table? 3. What - kind of luncheon do you like best? 4. What does a clean table - call for? 5. What is the importance of eating slowly? 6. Why - should we chew our food thoroughly? 7. When are desserts not - harmful? - - =Remember.= 1. The dining table should be the most inviting - place in the house. 2. Unpleasant subjects should be avoided at - mealtime. 3. A clean table calls for clean people. 4. Eat slowly - and chew your food thoroughly, that the saliva may reach each - grain of starch. 5. Desserts are not harmful if eaten at the end - of a meal composed of good building and heat-producing materials. - - - - -CHAPTER X - -DANGERS FROM POOR TEETH - - -We have learned that chewing is not merely a process of cutting our -food into such lumps as we can swallow without hurting ourselves; -but that the food must be ground up fine and thoroughly mixed with -the saliva, that the saliva may reach every particle of starch. If -we do not have good teeth, we cannot grind our food as fine as it -ought to be ground, and, as a result, a great deal of the starch -will not be reached by the saliva. - -Nature starts every child with a full set of good, strong, clean -teeth. These teeth, which we call first, or milk, teeth, are not -very large, but they are perfect in every respect and last until -the second, or permanent, teeth come in. That is, they will last so -long _if they are taken care of_. If they are not taken care of, -they will decay just as the later teeth will decay, and they must -be cared for in the same way. - -[Sidenote: Why we have baby or milk teeth] - -Boys and girls sometimes wonder why they have a set of teeth that -come out before they can have the teeth that must last them the -rest of their lives. This is simply because there is not room -enough in a child's mouth for the big, permanent teeth. We must -have teeth while our jaws are growing, so we have first a set of -little teeth. Then just as soon as our jaws get large enough for -the big teeth, the little teeth come out and the big ones come in. - -Teeth are about the hardest substance in the body. If we take care -of our second teeth, they should last as long as we live. The only -reason they do not last is because we do not take care of them. If -a person would keep his teeth clean all the time, he would rarely -be obliged to have a single permanent tooth pulled. - -[Sidenote: Why teeth break easily] - -Teeth are so hard that they are brittle, that is, they break -easily. Glass is brittle, and you can chip off a piece of glass -with a pin by sticking the pin into a crack in the glass. In just -the same way you can chip off a piece of a tooth by sticking a pin -between two teeth. That is what often happens when people pick -their teeth with pins, or with any other hard substance. A metal -toothpick is just as bad as a pin. - -[Illustration: FIG. 23. Teeth were not intended for nutcrackers.] - -Another way by which little pieces are chipped off the teeth is by -biting hard things. Sometimes we see boys and girls cracking nuts -with their teeth; again we see them trying to bite wires in two. -They put their teeth to many uses for which teeth were never made. -They do not realize, while they are abusing their teeth in this -way, that they are probably chipping the enamel, which is the hard, -shiny covering of the tooth, and are destroying the one protection -that their teeth have against decay. - -[Sidenote: Why teeth decay] - -When a little piece is chipped off a tooth, an opening is made -through the enamel. Through this opening germs may lodge in the -inner part of the tooth, which is soft. When this happens, a little -black speck appears on the tooth, and after a while the tooth -begins to ache. If you have a toothache, you go to a dentist, and -he probably finds that germs have caused the tooth to decay until -there is a hole extending into the very center of it. - -Teeth grow very close together, but there is always a little space -between them. Whenever you eat anything, particles of the food get -into these spaces and if allowed to remain there, soon decompose. -These decomposing particles of food between the teeth will -gradually soften even the enamel, and in this way little openings -are made for germs to get into the teeth. - -[Sidenote: How to care for the teeth] - -Never pick the teeth. You cannot make them clean by picking them. -Every morning and night brush your teeth with a stiff toothbrush -and a little tooth powder. Brush them both crosswise and up and -down, to get out everything from between them. Do not think you -have done your duty if you brush only your front teeth, the ones -that show. Brush the back teeth just as thoroughly as you do the -front teeth. Very few people will see your back teeth, but these -decay just as fast as your front teeth, if they are not kept clean. - -[Illustration: FIG. 24. A sanitary wash-basin with a separate bowl -for washing the teeth.] - -[Sidenote: How often one should go to the dentist] - -Twice each year you should have a dentist examine your teeth, to -see if there are any little spots where decay has started. If you -have kept your teeth perfectly clean all the time, and have not -chipped off little pieces, there will be none of these decayed -spots. But it is a safe plan to have the teeth looked over at least -twice a year, for you may have broken a tooth without knowing it, -and by the time a decayed spot is large enough to cause pain, or -has made a hole that you can feel with your tongue, it has advanced -much farther than it should have been permitted to do. - - =Questions.= 1. Why should you chew your food thoroughly? 2. - Why is it necessary to have baby teeth? 3. How are teeth easily - broken? 4. Why do teeth decay? 5. What must you avoid in order to - protect your teeth? 6. How should your teeth be brushed? 7. Why - should you have your teeth examined twice each year by a dentist? - - =Remember.= 1. Take care of your teeth and they will last you as - long as you live. 2. Do not pick them with pins, or toothpicks - of any kind. 3. Do not use them for nutcrackers or wire-cutters. - 4. Do not use them for tack pullers. 5. Keep them clean at all - times. 6. Brush them up and down as well as crosswise. - - - - -CHAPTER XI - -NECESSITY FOR PURE AIR AND HOW TO SECURE IT - - -We have learned how the cells of the body are killed by starvation. -Now let us learn how they are choked to death, or killed by lack of -air. - -[Sidenote: How air is changed in the body] - -The cells of the body need _oxygen_, and the only way we can give -it to them is by means of air. Every time we take air into our -lungs we are giving oxygen to the red corpuscles or cells in the -blood, which distribute it to the other cells in the body. The air -that goes into our lungs, if it is fresh and pure, contains a great -deal of oxygen and a very little of another gas called _carbon -dioxid_. The air that comes out of the lungs contains a very little -oxygen and a great deal of carbon dioxid. The blood not only takes -the oxygen out of the air, but gives carbon dioxid to the air. This -carbon dioxid is very poisonous, and would kill the cells if it -remained in the blood; hence we should never breathe the same air -twice. There is no lack of fresh air in the world, and no excuse -for anyone's ever breathing air that is not pure. - -[Sidenote: Effects of impure air] - -If you close all the windows and doors in the schoolroom and shut -up the ventilators, you will soon find that you are not able to pay -close attention to your studies, and in a little while you will -begin to feel drowsy. This is because you have used up so much of -the oxygen in the air that there is no longer enough to supply the -demands of the little cells, and because, in addition, you are -taking into your bodies the poisonous carbon dioxid that has been -breathed out into the room. It takes a great deal of fresh air to -supply the body with oxygen--about 1,250 cubic feet of air each -hour. With thirty or forty children in a room, it does not take -long to use up all the oxygen. So there should be a constant supply -of fresh air coming into the room. - -[Illustration: FIG. 25. Results of breathing good and bad air.] - -[Sidenote: Methods of ventilation] - -It is not only in the schoolroom that you need oxygen. When you -are out-of-doors you get an abundance of fresh air, but from a -great many houses every bit of fresh air is shut out. It is always -possible to let an abundance of fresh air into any house without -causing a draft. A piece of board can be made to fit into a window -frame so that when the window is raised, the air will be directed -upward and will not cause a draft. Hot-air furnaces are made with -cold-air pipes. The fresh air from outdoors comes through these -cold-air pipes and, after being heated, is driven into the rooms of -the house. Some people think they will save coal by closing these -drafts. Not only do they not save coal (for the furnace does not -give as much heat when this draft is closed), but they kill their -body cells by refusing to give them oxygen. The cold-air pipe in a -hot-air furnace should always be kept wide open. - -In houses heated with steam or hot water, either the windows must -be kept open, or some other way must be provided for admitting -fresh air and taking out foul air. These arrangements constitute -a system of ventilation. Houses heated with stoves must also be -provided with some means of ventilation. The stove, by its draft, -takes out a little of the foul air, but it will not take out more -air than one person poisons. - -[Illustration: FIG. 26. Restfulness: Effect of good ventilation in -a sleeping-room, with the right position for sleeping.] - -[Illustration: FIG. 27. Restlessness: Effect of poor ventilation in -a sleeping-room, with the wrong position for sleeping.] - -[Sidenote: Why windows should be kept open at night] - -Many people seem to think that they do not need fresh air at night, -and they close their bedroom windows as tight as they can. Those -people do not sleep well and often have bad colds. You should -always sleep with your windows open. If it is impossible for you -to have your windows open without having a draft, choose the -draft; it will do you no harm if you are well covered, and under -no circumstances will it do you as much harm as the foul air that -you breathe if your window is closed. Some persons (fortunately -they are few nowadays) will tell you that night air is dangerous. -I wonder what kind of air these people expect to breathe at night. -Do they expect to fill the room in the daytime with enough air for -use at night? Such air would certainly not be very fresh. Night air -is the only kind of air that it is possible to breathe at night. - -[Sidenote: The ventilation of public assembly rooms] - -Churches, theaters, and ten-cent shows are often very poorly -ventilated. You can always tell a poorly ventilated room by the -foul odor when you go into it from the fresh air, and it is not -wise to stay in such a room. You are killing the cells in your body -when you do so, and you will very probably come out of it with a -bad cold. When the fresh air strikes you, you feel chilly and you -may think you are taking cold then, but in reality you took cold in -that room full of foul air. - -[Sidenote: Ventilation of workshops] - -Workshops are often poorly ventilated. No person should ever work -in a badly ventilated place. The labor unions frequently strike for -higher wages, but until recently a strike for better ventilation -was rarely heard of. Better ventilation would be practically equal -to an increase in wages, because there would be fewer doctors' -bills to pay, and less likelihood of losing work through illness. -Always have plenty of pure, fresh air wherever you are--in school, -in bed, at work, or at play. - -[Sidenote: Why we should breathe through the nose] - -The cells in the skin of the nose secrete a watery fluid, and this -fluid serves to moisten the air as it passes through the nose. Dry -air irritates the mucous membrane which lines the nose, throat, and -lungs, and it is very important that the air be moistened before -it reaches the throat. Air is also warmed as it passes through the -nose. Cold air is irritating to the throat and lungs. The small -hairs in the nose catch the dust and dirt in the air and prevent it -from going into the lungs. - -The nose was made to breathe through, and all the air that goes -into your lungs should pass through your nose, in order that it may -be moistened, warmed, and cleansed. - -[Illustration: FIG. 28. Showing position of adenoids and tonsils in -the throat.] - -[Sidenote: Why some children breathe through the mouth] - -Frequently we see boys and girls breathing through the mouth. They -do this because there is something in the nose that prevents the -air from passing freely through it. If there were nothing in the -way, the child would breathe through the nose instead of the mouth, -because the natural way of breathing is through the nose. - -The most common reason for mouth-breathing is the growth of small -lumps in the throat just behind the nose. These little lumps are -called adenoids. They are not natural, and should be taken out. -We do not know why they grow in some children and not in others, -but we do know that they should be taken out so that the child can -breathe easily through the nose. Large tonsils also cause boys and -girls to breathe through the mouth. Tonsils that are large enough -to cause the child to breathe through the mouth ought always to be -taken out. Large tonsils and adenoids are often found in the same -child. - -[Sidenote: Effects of mouth-breathing] - -When a child breathes through his mouth all the time, his face -takes on a peculiar shape. His upper lip grows long, his lower -jaw drops back, and his whole face looks flat. His voice has a -peculiar sound, and he finds it very hard to keep up in his classes -at school. Children with adenoids and large tonsils are always -backward in their school work, and may become deaf if the adenoids -and tonsils are not removed. - -If you breathe through your mouth instead of through the nose, -go to the doctor and let him see if you have adenoids or large -tonsils; if you have, let him take them out. You cannot possibly -grow into a strong, healthy man or woman if you have adenoids and -do not have them removed. - - =Questions.= 1. What does the body take out of the air? 2. What - does the body put into the air? 3. What effect does impure air - have on the body? 4. Why should one sleep with windows open? 5. - What causes the unpleasant odor in a crowded room? 6. How would - workmen benefit by properly ventilated workshops? 7. Name the - helpful ways in which the air is changed while passing through - the nose. 8. Why do some children breathe through the mouth? 9. - What effect comes from mouth-breathing? - - =Remember.= 1. Impure air destroys health. 2. Never sleep in - a room where the window is closed. 3. Avoid going into public - places or workshops that are not well ventilated. 4. Air must - pass through the nose before it is fit for the lungs. 5. - Mouth-breathing is not natural and is usually due to some defect - that can easily be cured. - - - - -CHAPTER XII - -REST ESSENTIAL TO HEALTH - - -[Sidenote: Why exercise is necessary] - -Exercise is necessary to make our bodies grow and become strong. -If we stayed in bed all the time, our muscles would not grow and -we could not even walk. If we did not exercise them, the cells in -our brains would not grow and we should not know anything. Every -part of our body must have exercise, that is, each part must do -some work every day. If we used only one part of the body and did -not give the other parts any work to do, only the part that we used -would grow, while all the rest of the body would be small and weak. - -[Sidenote: Proportion of rest required] - -While every part should do some work each day, the whole body -needs also to have a proper amount of rest. Even the heart, which -seems to be working all the time, must rest. It rests between each -beat. The muscles with which we breathe rest between each breath. -Every person must have a certain amount of rest each day. A man -should have at least eight hours' sleep in every twenty-four hours; -boys and girls should have from nine to ten hours' sleep in every -twenty-four. It is only while we are sleeping that we have complete -rest. - -[Sidenote: Effect of overwork] - -Everybody should have some work to do. Boys and girls should learn -that work is a part of life, though they should not be expected to -do too much. They should not be required to get up at four o'clock -in the morning and work until eight, then go to school until four -in the afternoon, and then work again until dark. They cannot -do this and keep well. Such children will surely neglect their -lessons and will fail to keep up in their classes. It is not the -children's fault, but the fault of the people who give them so -much to do outside of school. - -Sometimes bright children fall behind in their classes and seem to -be sleepy during school hours. Very often these children do not -have to do any work at home, but play all the time they are out of -school. We usually find that these children not only play all the -afternoon, but also go to parties at night and often stay up until -midnight. - -[Illustration: FIG. 29. Children work when they play. The little -girl skipping rope is killing the body cells by overwork; she has -skipped more than one hundred times and is exhausted.] - -[Sidenote: Ways in which children overwork their bodies] - -You may think it is not work to go to a party, but it really is. -You are working the muscles and the cells of your brain when you -are playing games, and these get tired from play work just as they -do from working. It is more fun to do play work than to do real -work, but the cells are tired and need rest after either kind of -exercise. When you go to a party and stay up until midnight, you do -not get nine hours of sleep. How do you expect the cells of your -bodies to get enough rest when you treat them in this way? - -Another thing you do at parties is to eat food that tastes good, -but which is not good building material or nourishing for the cells -of the body. These things eaten late at night stay in your stomach -long after you have gone to bed, and the cells of your stomach do -not have a chance to rest at all. - -Children should have their parties in the afternoon. You can have -just as much fun at a party in the afternoon as you can at night, -and then your stomach will have time to dispose of the cake and -candies you have eaten, and will be ready to rest when you go to -bed. - -Small children should be in bed by eight o'clock at night, and even -big girls and boys should be asleep by ten o'clock every night. If -you do not give your bodies rest, you can never grow into strong -men and women. - -[Sidenote: The importance of regular meals] - -We have learned that every part of the body needs regular rest. -Your stomach is a part of your body. In the stomach and intestines -all the food is changed so that the little cells can make use of -it. Do you think the cook would serve good meals if she were kept -cooking all the time, both night and day? You know she would soon -stop cooking for you if you did not give her time to rest. Your -stomach does work that is even more important to you than cooking. - -[Sidenote: Why meals should be at least four hours apart] - -It takes about four hours for your stomach to dispose of what -you give it at a single meal. If you eat your breakfast at eight -o'clock, your stomach is going to be kept busy to get rid of it -by noon. Of course you expect to give it more work to do at noon; -that is, you expect to eat a good luncheon. It will be after four -o'clock by the time your stomach has finished the task you put on -it at noon, and there will be only about an hour and a half for -the stomach to rest before you will be ready to give it another -four hours' task, digesting your supper. This means that your -stomach cannot go to sleep until ten o'clock. If you eat three -meals a day, you will give your stomach just about two hours' rest -between eight in the morning and ten at night. If you let it rest -from ten at night until eight in the morning, it is not likely to -give you any trouble. - -[Sidenote: When and why candy eating is harmful] - -Some people will not let their stomachs rest at all. Often boys and -girls give their stomachs extra work to do by eating sweetmeats -in the middle of the morning while their stomachs are still busy -with breakfast. Then, as soon as school is out in the afternoon, -they want to eat more cake and candy, and thus take away from the -stomach the little rest it has a right to expect before it goes -to work on supper. Then suppose they go to a party and eat again -about midnight. How much time will the stomach have to rest before -breakfast? - -[Sidenote: When candy eating is not harmful] - -Now, I have not said that boys and girls must not eat candy; and -what is more, I am not going to say any such thing. You may go home -and tell your mother that candy is good for girls and boys and that -they like it so well they ought to have it--no, not all the time. -Here is the part that some of you will not like. Girls and boys -ought to have all they want just after eating luncheon or dinner. -If you have eaten a hearty meal, it is entirely safe for you to eat -candy then; you will not be giving extra work to your stomach, for -the candy will be taken care of along with the rest of the meal. - - =Questions.= 1. Why should we all take exercise? 2. How much rest - is needed each day? 3. Name some of the effects of overwork. 4. - How do children overwork their bodies? 5. Why should children - have their parties in the afternoon? 6. Why should meal hours - be regular? 7. When and why is candy eating harmful? 8. When is - candy eating not harmful? - - =Remember.= 1. Proper rest is necessary to health. 2. Rest from - play is as necessary as rest from work. 3. You must give the - stomach rest by having regular meal hours and by eating nothing - between meals. - - - - -CHAPTER XIII - -CARE OF THE EYE AND EAR - - -[Sidenote: The loss of sight] - -Sight is one of the greatest blessings we have. Think how dreadful -it is to be blind. If you take care of your eyes, there is no -reason why you should be blind; but if you do not take care of your -eyes, there is a possibility that you may lose your sight. Most of -the blind people in the world became blind because their eyes were -not given proper care, and most of this lack of care happened when -these people were babies. - -[Illustration: FIGS. 30 and 31. The roller towel is a common source -of infection of eyes in schools; every school should have properly -constructed wash-rooms, with individual towels.] - -[Sidenote: How germs get into the eyes] - -Many of the diseases that affect the eyes are catching. They are -not carried through the air, but are transmitted by the use of a -towel or handkerchief used by someone who had the disease. Never -use the towel or handkerchief that another has used. - -Germs may be rubbed into the eyes. Keep your hands away from your -eyes. Your hands may have disease germs on them, and when you rub -your eyes you may put the disease germs into them. - -[Sidenote: How eyes are overworked] - -Many boys and girls ruin their eyes by making them do too much -work. They do this by reading in a poor light, by reading where -the light strikes into the eyes, or by reading in a bad position, -as when in bed or lying down. When you are reading, drawing, or -doing any work with the eyes, always have the best light possible, -which means that the light should fall on your book or work over -your left shoulder. If you are only reading, it does not make much -difference which shoulder the light comes over, provided it comes -from behind. If you are writing or drawing, and the light comes -over your right shoulder, it makes the shadow of your hand fall -just where you want to see. - -[Illustration: FIGS. 32 and 33. Correct positions for reading and -writing.] - -Another way of working your eyes too much is by trying to see when -the eyes are not focused right. Sometimes people are said to be -near-sighted, because they cannot see very well at a distance. -This is due to the fact that the eyeball is too long, so that the -lens does not cause the rays of light to focus on the retina. Some -people are called far-sighted. This means that they can see well -at a distance, but that it is hard for them to see things close to -them. Far-sighted children can usually see things near by, but they -do this by making the muscle that rules the lens of the eye work -too hard. - -[Sidenote: Method of testing the eyes] - -Probably your teacher has a test chart and can tell you whether -your eyes are properly focused. If your eyes are not focused right, -that is, if you cannot see the line of letters marked =20= when -you are twenty feet from this chart, there is something wrong with -your eyes. In that case, you are not only injuring them by trying -to study, but you are hurting the whole body by overworking a part -of it. If you cannot see the letters on the test card clearly -at a distance of twenty feet, ask your father to send you to a -specialist who will fit you with the proper glasses or will treat -your eyes so that you can see well. - -[Sidenote: How to test the hearing] - -Sometimes children are backward in their school work because they -cannot hear well. Your teacher can test your hearing by holding a -watch near your ear. If you cannot hear a watch tick when it is -held six feet from your ear, ask your father to take you to your -doctor, that he may treat your ears. - -[Sidenote: How to care for the ears] - -If your hearing is perfect, the best way to take care of the ears -is to let them alone. Never try to dig into the canal that leads -to the middle ear. The ears must of course be washed to keep them -clean, but in washing the ear you should not touch the delicate -canal leading to the drum. A great specialist once said, "Never put -anything smaller than your elbow into your ear," to which another -great specialist added, "And wrap a towel around your elbow." -Never try to dig the wax out of your ears; it belongs in your ears; -it is there for a purpose, so let it alone. If it becomes hardened, -you cannot get it out and will only injure your ears in trying to -do so. An ear spoon is a dangerous thing. - - =Questions.= 1. State the chief cause of loss of sight. 2. How - can you keep germs out of your eyes? 3. Name three ways by which - you may overwork the eyes. 4. Tell how to take care of the ears. - - =Remember.= 1. Overworking the eyes is as injurious as - overworking the stomach. 2. Keep your hands away from your eyes; - germs on your hands may get into your eyes and cause them to - become sore. 3. You overwork your eyes when you try to read or - write in a poor light or in a bad position, as when lying down. - 4. You overwork your eyes when you try to study with eyes that - are not properly focused. 5. Keep your fingers out of your ears. - 6. Take care of your ears by letting them alone. - - - - -CHAPTER XIV - -CARE OF THE SKIN - - -If you break or cut the skin on your body, you make an opening -through which germs can get in. You cannot always help breaking -your skin, but you can always wash the break with soap and water, -and put a clean cloth over it to keep out germs. - -[Sidenote: The work of the sweat glands] - -The work of the little sweat glands is very important to your -health. These glands are just as important as the kidneys, and if -they did not do their work, you would die very quickly. If your -body is covered with dirt, the work of these glands is seriously -interfered with; and when the sweat glands are not doing their full -amount of work, the kidneys must do more than their share. It is -never right to make one part of your body do the work intended for -another part. - -[Illustration: FIG. 34. A model bathroom.] - -When the body is dirty, not only are the sweat glands interfered -with, but the little sebaceous (oil) glands become plugged up, and -blackheads appear on the face and body. - -[Sidenote: Importance of bathing] - -In order that the various glands of the skin may be kept in good -health, it is necessary for us to keep clean. To do this we wash -our faces and hands and bathe our bodies. Someone may ask, "How -often ought a person to take a bath?" The question cannot be -answered, except to say, "Just as often as may be necessary for -you to keep absolutely clean." Some people do not have to bathe as -often as others, but no one can keep clean unless he takes a bath -at least twice a week. - -[Sidenote: Hot or cold baths] - -Another question that is frequently asked is, "Is it better to -take a bath in cold or hot water?" This is another question that -cannot be answered in the same way for every person. A cold bath -is more stimulating than a warm bath. If, after you have taken a -cold bath and rubbed yourself briskly with a rough towel, the skin -becomes red and warm, a cold bath is best for you. But if, after -you have taken a cold bath and rubbed yourself for not more than -ten minutes, the skin appears bluish and cold, a cold bath is not -good for you, and you should not take it. A cold bath should always -be taken in the morning, just after getting out of bed, and a warm -bath should always be taken in the evening, just before going to -bed. - -[Illustration: FIG. 35. A nail properly cared for, and a nail not -properly cared for. Which should you prefer to have?] - -[Sidenote: How to care for the nails] - -The finger nails and toe nails are a part of the skin and they also -need to be taken care of. You will see at the root of your finger -nails a thin layer of skin that is inclined to grow out with the -nail. If this skin is not kept pushed back it becomes rough, breaks -into little shreds, and forms "hang nails." This little band of -skin should always be kept carefully pushed back. The finger nails -should be kept evenly and neatly trimmed, but they should not be -cut so close to the skin that the ends of the fingers project -beyond the nails. The nails are for the protection of the ends of -the fingers and toes. Nails that are trimmed unevenly and nails -that are bitten off are ugly and indicate untidy habits. The shape -of the nails should follow the outline of the ends of the finger. -Neither is it a sensible fashion to trim the nails to points or to -let them grow very long. - -The toe nails need attention just as much as do the finger nails. -They should be trimmed to follow the shape of the toe. Failure to -trim the toe nails properly will result in ingrowing nails. - -Dirt is very likely to collect under the nails. This should always -be carefully cleaned out. You cannot wash this dirt out unless you -use a stiff nail brush. If you clean your nails just after you wash -your hands, you will find that it will be much easier to get the -dirt out while the dirt and the nail are both softened by the soap -and water. In cleaning your nails, use a dull nail cleaner or a -smooth wooden stick. Do not scrape the inside of the nail with a -sharp knife. This scraping of the inside of the nails will cause -them to catch the dirt more easily, as well as to grow thicker and -thicker until they become very ugly. Neat, clean finger nails help -to make pretty hands; dirty, untidy nails spoil the prettiest hands. - - =Questions.= 1. What are the uses of the sweat glands? 2. How - often should people take baths? 3. How can you tell whether a hot - or a cold bath is better for you? 4. Tell how finger nails should - be cared for. 5. How should toe nails be treated? - - =Remember.= 1. If you do not keep your body clean, the glands of - the skin cannot do their work properly. 2. Every person should - take a bath at least twice a week; some persons need a bath - every day in order to keep clean. 3. If you take a bath in cold - water, and the skin does not become warm and pink when you rub - it with a rough towel, a cold bath is not good for you. 4. Cold - baths should be taken in the morning on getting up. 5. Warm baths - should be taken in the evening before going to bed. 6. Finger - nails should always be kept clean and neat; dirty, untidy nails - make ugly hands. - - - - -CHAPTER XV - -COMMON POISONS TO BE AVOIDED - - -Many people are killing the cells of their bodies by taking certain -poisons into them. There are many kinds of poisons that can be -taken into the body, but we are going to learn now about only two. -These are tobacco and alcohol. - -[Illustration: FIG. 36. Effect of cigarette smoking.] - -[Sidenote: Proof that tobacco is a poison] - -Tobacco is a poison. Those of you who have tried to smoke know -this, because it made you sick the first time you tried it. There -are many other indications that tobacco is a poison. We know that -it affects the red blood cells in such a way that they do not carry -the oxygen as well as do those of people who do not smoke. We know -that it has a very bad effect on the heart and that it interferes -with the action of the nervous system. - -[Sidenote: The extra work caused by tobacco] - -When certain poisons get into the body, the blood makes something -that will counteract the effects of those poisons. After one has -used tobacco for some time, the cells of the body will take care of -the tobacco poison by making an antidote for it. More than this, -they begin to want it all the time. The tobacco user forces the -cells of his body to make an antidote for this poison every time he -uses tobacco. Thus he makes the cells do work that is unnecessary, -and keeps them from doing work that is necessary. - -[Sidenote: Other bad effects of tobacco: (_1_) On the nose and -throat] - -Tobacco smoke irritates the cells that line the throat and nose -and causes inflammation. This is why so many smokers have catarrh. -Smoking is not the only cause of catarrh, for people who do not -smoke often have this trouble, but it is one of the most frequent -causes. Smoking also irritates the throat so badly that many of -those who smoke have "smoker's throat." This is a bad form of sore -throat that can be cured only by stopping the use of tobacco. - -[Illustration: FIG. 37. The athlete knows that alcohol and tobacco -are foes to speed, strength, and nervous control. (_From photograph -of "The Sprinter," modelled by Dr. R. Tait McKenzie._)] - -[Sidenote: (_2_) On the blood] - -People who smoke a great deal have fewer red corpuscles (the little -red cells of the blood) than those who do not smoke. Especially is -this true of cigarette smokers. It is the lack of red blood cells -that causes the cigarette smoker to look pale and sallow. - -It is probably not the direct effect of tobacco that causes the -loss of red blood cells, but something that is connected with the -act of smoking. When you take smoke into your mouth, you take in -at the same time a gas known as _carbon monoxid_. This gas is -very poisonous to the body, and combines with the red blood cells -in such a way that they cannot take up the oxygen in the lungs and -carry it to the rest of the cells in the body. The cigarette smoker -almost always inhales the smoke, and thus he absorbs a great deal -more of the carbon monoxid than the man who does not inhale the -smoke. Of course, the more of this gas he takes into his body, the -more red blood cells will be affected and the less oxygen will be -taken to the other cells. - -[Sidenote: (_3_) On the nervous system] - -We do not know just how tobacco affects the cells of the nervous -system. It may be that they are affected mostly by being deprived -of oxygen, or it may be that the tobacco affects them directly. -However the harm is done, we know that the cells of the nervous -system are affected by tobacco. One of the nerves that is most -commonly affected by the use of tobacco is the nerve of the eye, -the nerve that enables us to see. We know that when people use -tobacco a great deal they sometimes lose their sight. This does not -happen to everyone who uses tobacco, but you can never tell whom it -will affect in this way. The only safe thing to do is not to use -tobacco, and then you will know that you will not lose your sight -from this cause. - -[Sidenote: (_4_) On the stomach] - -The use of tobacco affects the stomach. People who use tobacco -a great deal are likely to have indigestion. The tobacco causes -this probably by depriving the stomach cells of oxygen through its -effect on the blood cells. - -[Sidenote: (_5_) On the heart] - -Tobacco has a very bad effect on the heart. People who use much -tobacco have what they call "palpitation of the heart," but doctors -call it "tobacco heart," because it is caused by the use of -tobacco. No insurance company will insure a person who has "tobacco -heart." - -Most boys grow up to be men before they manage to use enough -tobacco to cause tobacco heart. However, long before they are -grown, they show that the tobacco has affected their hearts, -because they are short of breath and stand about as much chance of -winning a race as does a mouth-breather. - -[Sidenote: Effects of alcohol:] - -The effect of alcohol is a subject on which I want to speak very -plainly and frankly, because I do not want the boys and girls who -read this to get the same idea that I got when I was in school, -or to be affected by it as I was. When I was a little boy I was -taught that if a person drank alcohol in any form the lining of his -stomach would be eaten up. In proof of this statement I was shown -a picture of an ulcerated stomach that was said to have resulted -from drinking whisky. Naturally I expected to find that people who -drank whisky would not be able to eat anything at all, or would be -troubled a great deal with pain in their stomachs. To my surprise, -I found that many people had ulcers of the stomach who never took -an alcoholic drink, while many of those who drank a great deal -seemed to have the best of appetites and were never troubled -with their stomachs. As a result, I came to the conclusion that -all this talk about the evil effects of alcohol was foolishness. -Later I studied medicine, and learned that the effect of alcohol -on the stomach is, in reality, the least of its evils. But I want -to impress upon you that, as a result of forty years' study, I -consider alcohol the most dangerous thing in the world to-day. By -"alcohol" we mean any drink that contains alcohol, such as whisky, -wine, brandy, beer, etc. - -[Sidenote: (_1_) On the stomach] - -When alcohol is taken into the stomach, it first causes a -congestion; that is, it causes an increase in the quantity of -blood in the blood vessels of the stomach. It might seem that -this would aid digestion in the stomach, but it does not, because -alcohol affects the food in the stomach in such a way that it -prevents the gastric juice from acting on the food. If the use of -alcohol is persisted in, it causes the little cells in the stomach -that make the gastric juice to become filled with fat, and then -those cells cannot make the gastric juice. Thus, continued use of -alcohol causes a smaller supply of gastric juice, and the food -passes from the stomach into the intestines without having been -acted upon by the gastric juice, as it should have been. The result -is that the food decomposes in the intestines and a poison is -formed. This poison is taken up by the vessels that carry the food -from the intestines and kills a great many of the cells of the body. - -Alcohol does not burn holes in the stomach, but it destroys the -usefulness of the stomach by its action on the cells that secrete -the gastric juice. - -[Sidenote: (_2_) On the liver] - -When alcohol is taken into the stomach, very little of it reaches -the intestines. It is rapidly absorbed by the lining of the stomach -and passes into the blood. The blood from the stomach goes directly -to the liver. The alcohol makes the cells of the liver hard and -causes them to become filled with fat, as it does the cells of the -stomach. In this way it destroys the action of these cells and -prevents their doing the work for which they are intended. From the -liver the alcohol goes with the blood to all parts of the body, and -it has its influence on all the cells in the body. This influence -is always harmful. - -[Sidenote: (_3_) On the body's powers of resistance] - -We know that when a man who is in the habit of drinking gets -pneumonia, he is far more likely to die than is one who is not -in the habit of using alcoholic drinks. The man who drinks cannot -resist the effects of disease as can one who does not drink. -This shows that the use of alcohol reduces our resisting powers, -and puts our cells in such condition that we cannot overcome the -effects of disease. - -People who are sick with a slow disease like consumption are often -advised by their friends to take whisky to brace them up. It is -true that the immediate effect of the whisky is to make the patient -feel a little better, but the final effect is to leave him in a -much weaker condition than before. More than this, the cells are -much less able to resist the disease germs than they were before -the alcohol was taken. When people are exposed to such diseases -as scarlet fever and smallpox, they may think that if they take a -drink of whisky they will not be so liable to contract the disease. -It is just the other way. The alcohol reduces the resisting powers -of the cells of the body, and anything that does this renders a -person more liable to contract any disease to which he is exposed. - -[Sidenote: (_4_) On the nervous system] - -The effect of alcohol on the cells of the nervous system is very -marked. Continued use will injure the nervous system and result -in a kind of insanity called delirium tremens. It will also cause -other forms of insanity. The effect of alcohol on the parent is -passed on to the children of the next generation, and even beyond -this. A large percentage of idiotic children are the offspring of -alcoholic parents. - -[Sidenote: (_5_) On the morals] - -The use of alcohol numbs the sense of right and wrong. More young -men have become criminals from the use of alcohol than from any -other one cause. Anyone who reads the daily papers can see that -many criminals give the use of alcohol as an excuse for having -committed a crime. - -[Sidenote: (_6_) On brain work] - -Some people will tell you that alcohol stimulates the brain, so -that one can work faster and better. This is not true. Tests have -been made in this matter, and it has been found that men doing -mental work will work about one tenth slower and make one fourth -more mistakes when given one drink of whisky a day, than they will -when not given any whisky. If _one_ drink of whisky a day thus -reduces a man's power and accuracy in doing mental work, what do -you think three drinks, or ten drinks will do? - -[Illustration: FIG. 38. The mind not clouded by alcohol works -quickly and makes few mistakes.] - -[Illustration: FIG. 39. The mind clouded by alcohol works slowly -and makes many mistakes.] - -[Sidenote: What business men think of men who drink] - -Many business men drink, and they know the results of alcohol not -only from the effects they have observed in others, but also from -the effect they know it to have on themselves. When a man applies -to them for a position, these business men almost invariably ask -him if he drinks. The man who does not drink stands nine chances -in ten of securing the position, while the man who drinks stands -only one chance in ten. This shows what business men think of the -effect of alcohol, even when taken in moderate quantities. They -know that it reduces a man's power to do mental as well as physical -work, that it causes him to make mistakes, and that it may finally -destroy his morals and result in his becoming a thief or a criminal. - - =Questions.= 1. How do we know that tobacco is a poison? 2. How - does tobacco make extra work for the body? 3. What effect does - tobacco have on the nose and throat? 4. What is the effect of - tobacco on the blood? 5. On the nervous system? 6. On the heart? - 7. Mention some of the false ideas about the effect of alcohol. - 8. How does alcohol affect the stomach? 9. The liver? 10. In - what ways does alcohol reduce the resisting powers of the body? - 11. How does alcohol affect the nervous system? 12. How does - it influence mental work? 13. What do business men think of - drinkers? 14. What influence has alcohol on the next generation? - - =Remember.= 1. Tobacco is a poison that has a very bad effect on - the nervous system, the blood, the heart, the stomach, the nose, - and the throat. 2. Alcohol is a poison and not a food. 3. Alcohol - injures the stomach, the liver, and the nervous system. 4. - Alcohol reduces the power to do accurate mental work. 5. Alcohol - numbs the sense of right and wrong, and encourages crime. - - - - -PART II - -THE ENEMIES OF HEALTH - - - - -CHAPTER XVI - -DISEASE GERMS - - -We have learned that the body is made up of cells, and that each -cell is alive. The cells in our bodies cannot live separately. -There are, however, certain animals and plants that are each made -up of a single cell. These animals and plants are called germs, and -some of them cause disease. - -[Sidenote: Different germs cause different diseases] - -These germs are so exceedingly small that we can see them only -with the aid of a microscope. They differ in appearance one from -another, as a pine tree differs from an ash, or an American child -from a Chinese child. When you plant your garden, you put sweet -peas in one place and asters in another, and you know that you will -have sweet peas growing where you planted the pea seeds, and asters -growing where the aster seeds were put. So it is with these little -germs; you will no more get tuberculosis from typhoid fever germs -than you would get asters from pea seeds. - -Now, while there are many, many kinds of germs in the world, there -are only certain ones that cause certain diseases, and we have -learned where these germs like to live and how to kill them. We -also know that they come only from some person or animal sick -with the particular disease which they cause. Typhoid fever germs -are not given off by a person suffering with tuberculosis, nor -are diphtheria germs given off by a typhoid fever patient, but -the germ of each disease is given off by some person or animal -suffering from that particular disease. - -[Sidenote: How sickness due to germs can be prevented] - -If we kill all the germs that come from people sick with a certain -disease, no one else can catch that disease. Knowing this, it seems -unnecessary for anyone ever to be sick with disease that is caused -by a germ. This is literally true, and the only reason that we have -germ diseases is because we do not kill the germs that come from -the sick people. - -Professor Irving Fisher of Yale University has said, "It is -entirely possible to wipe out consumption within a single -generation." It may not actually be done so quickly, but it is -certain that the disease can finally be wiped out, though it may -require many generations to accomplish it. - -Why, then, are germ diseases allowed to exist? Simply because -so many people do not know the facts; and because many who do -know will not take the trouble to kill the germs, even when they -realize that some one else may get the disease as a result of their -carelessness. What do you think of a woman who said, "I do not care -if my neighbor's children do get scarlet fever from us; she is not -a friend of mine, any way"? A woman has been heard to make such a -statement to a health officer. It is just such people as this who -spread disease. - - =Questions.= 1. How may germs be compared to seeds? 2. What do we - know about disease germs that will help us to get rid of them? - 3. How is it possible for us to get rid of consumption and other - germ diseases? - - =Remember.= 1. While there are many kinds of germs in the world, - only a few cause disease. 2. The germ that causes a certain - disease will cause that disease and no other. 3. It is entirely - possible to kill all the germs that cause disease. - - - - -CHAPTER XVII - -ENCOURAGEMENT OF DISEASE BY UNCLEANLY HABITS - - -We shall not try to learn here all the ways by which it is possible -to destroy the germs of disease as they come from sick people. -But there are certain rules (we sometimes call them fundamental -principles) that you must know, if you hope to keep well and to -prevent others from getting sick. - -[Illustration: FIG. 40. How diseases are frequently transmitted to -children.] - -[Sidenote: Why we should stay away from the sickroom] - -The first of these rules is: _Do not go into the room where any one -is sick unless it is absolutely necessary_. No one but the nurse -should sleep in the room with a sick person. We know that certain -diseases are communicable (catching), but it has not yet been -determined whether some others are communicable or not. It has not -been proved, for instance, that we cannot catch rheumatism from -another person. Only a few years ago it was believed that one could -not take consumption from another person, but now we know that this -is the very way to get it. Therefore, stay away from sick people -as much as possible. It is not good for the patient to have people -around him, and it is dangerous for the well to come in contact -with the sick. - -[Sidenote: Not using things used by the sick] - -The second rule is: _Do not use anything used by a sick person -until it has been washed_. This is a good rule to apply to things -used by a well person also. It is neither safe nor pleasant to eat -from the spoon or fork, or to use the napkin or towel which has -been used by someone else. - -Sometimes children think the food prepared for a sick person is -ever so much nicer than that set before themselves, and wish they -could have a little of it. How often have we seen a sick mother -give her little ones "a taste" from the spoon with which she is -eating. This is very dangerous, and if she knew it, the mother -would cut her hand off before exposing her children to this danger. - -[Sidenote: Reason for scalding things used by the sick] - -Third: _Everything taken from a sickroom should be boiled before -it is used again_. The knives, forks, and plates should not be put -with other dishes until after they have been separately washed and -boiled. Towels, napkins, bedding, and clothing from a sickroom -should not be washed with other bedding and clothing, but should be -washed and boiled separately. Some people send out the clothes from -the sickroom with the rest of their washing, and in this way give -disease to others. - -[Sidenote: How excreta from the sick should be treated] - -Fourth: _All discharges (sputum, urine, bowel discharges, and -matter from sores) from any sick person should be thoroughly -disinfected before being finally disposed of_. The sputum should be -received on little rags or paper napkins, and burned; and the other -discharges should be disinfected with some poison that will kill -the germs. We shall say more about disinfection when we come to -study the prevention of special diseases. - -[Sidenote: Necessity of washing the hands after touching the sick] - -Fifth: _Every person who touches a sick person, or handles anything -that comes from a sickroom, should immediately wash his hands_. -Unless he washes his hands at once, the germs which may be on them -may get into his mouth. - -[Sidenote: How dirt causes disease] - -Sixth: _Dirt, which is an indirect cause of disease, must not be -allowed to accumulate_. If your yard were full of dirt, garbage, -and manure, it would not cause disease unless the germs of some -disease became planted there. But such a place is an indirect cause -of disease, in that it furnishes a fine place for germs to grow in. -If a fly with typhoid germs on its feet were to alight in such a -yard, the germs would be planted in a most favorable spot and would -grow very fast. - -[Illustration: FIG. 41. A place that is an indirect cause of -disease, since it furnishes a fine place for germs to grow in.] - -None of the disease germs like sunshine; neither do they like -dry places. They die very quickly in the sunlight, and grow very -slowly, if at all, in dry places; but in damp, dark places they -grow very fast. Dirty back yards make ideal gardens for germs. - -Let a fly with germs on its feet alight in a clean yard where -sunshine can reach every corner, and what chance will the germs -have to grow? They will not even get a start. Hence, while disease -cannot be caused by dirt, disease germs stand a very good chance of -living where there is plenty of dirt and no sunshine. Filthy habits -are on an equality with filthy conditions, and go hand in hand with -them. One of the worst of habits, and a cause of much sickness, is -that of answering Nature's calls in places other than the closet. - - =Questions.= 1. Why should you never make unnecessary visits - to a sick person? 2. Why should you avoid anything used by a - sick person? 3. Why should everything taken from a sickroom be - scalded? 4. What should be done with all discharges from a sick - person? 5. How is dirt a source of disease? - - =Remember.= 1. Unless it is necessary, do not go into a room - where anyone is sick. 2. Never sleep in a room with a sick - person. 3. Never eat from a spoon or plate that has been used by - another. 4. Boil all the articles taken from the room of a sick - person. 5. Always wash your hands after touching a sick person or - anything that comes from his room. 6. Sunshine kills germs; let - the sunshine into every corner of your house. - - - - -CHAPTER XVIII - -FLIES AS CARRIERS OF DISEASE - - -[Sidenote: How germs get into our bodies] - -Disease germs get into our bodies in three principal ways: they are -eaten with our food; they are taken in with the air we breathe; and -they get in through breaks in our skin, even though these breaks be -very small, as when made by the bite of a mosquito or other insect. - -[Sidenote: How germs get into our food:] - -[Sidenote: (_1_) From the air] - -How do germs get into our food or drink? You must remember that -these germs are extremely small, so small that many of them can be -carried by a particle of dust that you can see only in a ray of -sunshine. When the germs become dried, they float about on these -particles of dust, the dust alights on our food, which is moist and -warm, and the germs immediately begin to grow. - -[Sidenote: (_2_) From the hands] - -Another way by which germs get on food is from the hands through -which it passes. Did you ever think how many people handle an -apple? First, the man who picks it from the tree; then the examiner -in the packing house where apples are taken to see that they are -the right kind to be packed in a certain box. Then it is wiped off -by a boy or girl--handling number three; then it is wrapped in -paper--number four. Next it is packed in a box, but in this case -the paper protects the apple from dirty hands. When the merchant -buys the apples he feels several of them, and puts them out on the -display shelf; this makes handling number five. Everyone who thinks -of buying apples will touch one or more of them, and when they are -sold the clerk handles them again. In other words, every apple goes -through the hands of at least seven people before you get it. Do -you not think it needs washing? - -Go into a butcher shop and see how many people will put their dirty -fingers on the meat. Some of them even keep their gloves on when -they do this. Imagine how many germs may be planted on the finger -of a glove. - -Our whole method of displaying foods for sale is wrong. The -customer can see the fruits, vegetables, and meats just as well -in a glass case as when they are on an open counter or shelf, and -nothing is gained by poking a dirty finger into a piece of beef, or -by rubbing your hands over the apples. A glass case not only will -protect the fruits and meats from such practices, but will keep out -germ-laden dust and flies whose feet are covered with germs. - -[Illustration: FIG. 42. The foot of a fly, highly magnified.] - -[Sidenote: (_3_) From flies] - -_Probably the most common source of germs on food is the fly._ Did -you ever watch a fly very closely for a long time? Did you ever -happen to see a manure pile early in the morning and notice how -many tiny flies are on it? These flies have just been hatched. - -[Sidenote: Breeding places of flies] - -Flies like manure because it is the best place they can find in -which to lay their eggs. Each female fly lays about three hundred -eggs. They do not hatch directly into flies, as hen's eggs hatch -into chickens, but when the fly's eggs hatch you find maggots, and -these maggots later hatch into flies. - -[Sidenote: The journey of the fly] - -Turn over the manure some spring morning, and you will see it full -of white specks. These specks are maggots that will hatch into -flies. Watch the flies as they leave the manure pile and see where -they go. If there is a dead dog or cat or a filthy garbage can -near, they will fly to it. Then they will go into the water-closet -and crawl over the filth there. Their next trip will probably bring -them to the kitchen, where they will crawl over the food. From here -they will go to the cuspidor and take a drink of water, and will -get their feet covered with the dirt that is in the cuspidor. Next -they will try a walk over the nipple of the baby's bottle, or they -will light on your face, or get into the butter or milk. - -After the fly has been in dirty places, he "washes" his face and -hands, that is, he rubs his feet together and then rubs them over -his head. Did you ever see a fly wash himself with water? No, you -never did. - -[Illustration: FIG. 43. Where a fly has walked; each little spot -represents a growth of germs left by the fly.] - -After a fly has made his journey, you would suppose that his feet -would be covered with dirt and germs, and so they are. Not only -does he carry germs on his feet and body but he also eats dirty and -diseased things. Moreover, fly specks contain the germs of disease, -and the fly is not at all particular about where he puts his specks. - -[Sidenote: Proof that the fly is a germ carrier] - -If you let a fly walk over a culture plate, there will be a growth -of germs wherever his feet touch. A culture plate is simply a -glass plate covered with gelatine or something else in which -these germs like to grow, and where they can easily be seen. Each -germ will multiply so fast that there will soon be a spot of them -large enough to be seen readily with the naked eye. In the picture -showing a culture plate over which a fly has walked (Fig. 43), the -little specks are not single germs, but each speck represents a -growth containing many thousands of germs. - -[Illustration: FIG. 44. Flies go from filth to food.] - -[Sidenote: How to get rid of the fly:] - -How are we going to get rid of flies? We cannot get rid of them -entirely, but there are a great many ways by which we can prevent -there being so many of them, and whereby we may keep them out of -our houses and away from our food. - -[Sidenote: (_1_) By removal of manure] - -We have learned that flies are always found about horse manure, -because it makes a good place in which to hatch their eggs. If we -could dispose of the manure, there would be one place less for the -fly to lay her eggs. Behind barns we usually find piles of manure. -It is in these heaps that the fly lays her eggs, not in the little -lumps found in the streets. Now, there is no sense in keeping this -great pile of manure about any barn. In towns the manure can be put -into a box with a cover, so that the flies cannot get at it. In the -country every well-managed farm has the barns cleaned out every -day, and it would not be much more trouble for the farmer to throw -the manure into a wagon and take it to the fields with him, than -it is to pile it up beside his barn. If he did this, he would find -that there would be few flies about his house. - -[Sidenote: (_2_) By covering garbage cans] - -Even if we were to take every particle of manure away as fast as -possible, we should still have some flies, for when flies do not -find manure for their hatching places, they will take the next best -thing. It must be something dirty; clean things will not answer -at all for a fly's home. Next to the manure pile, the fly likes a -dirty garbage can, a dead animal, or anything that is decomposing. -If she cannot find anything better, she will take a rotting apple; -but she does not really like this, and if she cannot find anything -better than an old apple in your yard, she will probably go -elsewhere to lay her eggs. - -[Sidenote: (_3_) By keeping clean yards] - -We cannot entirely stop the hatching of flies, but if we do -away with the old manure piles, keep fresh manure and garbage -cans covered, and keep our yards free from everything that can -decompose, we shall have very few flies about our houses. - -[Sidenote: How to keep flies out of the house] - -Since we cannot get rid of all the flies, the next best thing is -to keep the few that may be left out of our houses and away from -our food. This we can do by means of wire screens and netting. Wire -screens are very cheap, and if there are no wire screens on your -house, you should persuade your father to buy some. But a screen -will not keep flies out unless it is kept closed, so do your part -by never leaving the screen door open for a second longer than is -necessary for you to go in or out. - -Our houses are not the only places that need screens. -Slaughterhouses, butcher shops, candy stores, grocery stores--every -place where any kind of food is handled or sold--should be -screened. Flies should never be allowed to alight on anything which -is to be eaten. - - =Questions.= 1. Name three ways by which germs get into our - bodies. 2. How do germs get into our food? 3. Why should foods be - screened? 4. Trace the fly from his birth-place to our food. 5. - How do we know that flies have germs on their feet? 6. Tell how - we can get rid of most of the flies. 7. How can we keep flies out - of the house? 8. What can boys and girls do to help keep them out? - - =Remember.= 1. Always wash an apple, pear, or any other fruit - before you eat it. 2. All foods are handled by many people, and - are not clean until they have been washed. 3. Flies like to live - in dirty places, and their feet and legs are covered with germs; - get rid of the flies. 4. Flies hatch in manure piles and other - dirty places; keep your yard and lot clean so that flies will - have no place to lay their eggs. 5. Put screens on the house to - keep flies out, and keep the screens closed. - - - - -CHAPTER XIX - -HOW DISEASE GERMS GET INTO WATER - - -The water that we drink frequently contains disease germs. It is -not always the clearest water that is freest from disease germs, -for the germs do not make the water cloudy. - -[Illustration: FIG. 45. An improperly located well; notice lines of -seepage.] - -[Sidenote: Why sewage should not be put into streams] - -Water does not get disease germs from the ground, but from man. -Almost every town has a sewer system that empties into some stream. -This practice was started a long time ago when men thought that -running water would purify itself in the course of a few miles. We -have learned, however, that this is not true. Germs will continue -to live in running water just as they do in any other water, and -disease germs will live in a stream from twenty-five to thirty-five -days. Estimate how far a stream will flow in that length of time, -and you will know how far disease germs will travel in that way. No -sewage should ever be allowed to get into a stream until the germs -in the sewage have been killed. - -[Sidenote: Other sources of germs in streams] - -Sewage is not the only means by which disease germs are carried -into streams. Often we find people building barns, slaughterhouses, -and mills on the banks of a stream. The filth from barns and -slaughterhouses always contains disease germs, and often the filth -of mills contains poisons that are just as harmful as germs when -taken into our bodies. None of these things should ever be allowed -to get into a stream. Water is a very important article of food, -and we should take every care to keep it pure. - -[Illustration: FIG. 46. A properly located well.] - -[Sidenote: How germs get into wells] - -The water from most wells is clear and cool, but nevertheless -may contain many disease germs. "How does this happen?" you ask. -Because the well is too close to an out-house or some other source -of filth. When a man in the country or in a small town builds a -house, he immediately thinks of digging a well just as close to the -house as he can, so that he need not carry the water far. Next he -thinks of locating the closet, and this, too, he wants near the -house. The well and the closet are often near each other, and often -the closet is on higher ground than the well. The vault under the -closet is seldom water-tight. In fact, the intention of the owner -is that a great part of the vault contents shall soak away. - -In many localities the ground is an open gravel, and the vault -contents run through this gravel into the well, carrying disease -germs with them. In one little town, with wells as a source of -drinking water, the health officers found that the closet of every -house was draining directly into its well. In some countries vaults -can be used; but in any region where there is a gravel subsoil, the -contents of the closet will find their way into the well, unless -the closet is lower than the bottom of the well. In such places the -vault must be made water-tight, in order to keep the vault contents -out of the well.[2] - -[Sidenote: Why springs are not always pure] - -Springs are usually sources of pure water, but do not think that -every particle of water that oozes from the ground is a spring. -Near a certain town is a so-called "very fine spring." This -"spring" appeared after a man had made a cesspool on the hill -above, and is simply the drainage from the cesspool. Springs that -come from deep sources, however, nearly always contain pure water. - -[Sidenote: The safest sources of water] - -The safest source of water for domestic use is a stream that is -known to be free from contamination, or a well so deep in the -ground that it is hard for any polluting matter to reach it. But -remember that sewage may follow a well pipe along the outside and -thus reach even a deep well, if the well is not properly protected -at the top. - -Keep disease germs out of your drinking water. You cannot drown -them out and you cannot strain them out, so do not let them get in, -for you cannot drink water containing disease germs without running -the risk of becoming sick. - - =Questions.= 1. Mention more than one way in which germs get into - streams. 2. How long may disease germs live in running water? - 3. Mention some instances showing that running water does not - purify itself. 4. How do disease germs get into milk? 5. Describe - the proper location of a well in regard to refuse. 6. How may - springs become polluted? 7. What are the best sources of water - for domestic use? - - =Remember.= 1. Disease germs get into water from dirty places - along the banks of the streams; they do not come from the ground. - 2. Clear water is not always pure; germs do not make the water - cloudy or muddy. 3. Wells often become infected by matter from - closets seeping into them; make your closet water-tight. 4. - Spring water is usually pure, but not all water that oozes out of - the ground is spring water. - - - - -CHAPTER XX - -TRANSMISSION OF DISEASE THROUGH THE AIR - - -[Sidenote: Disease germs in the air] - -We take germs into our bodies with the air that we breathe. Since -we cannot stop breathing and live, we must see to it that the air -we breathe is kept pure. - -[Illustration: FIG. 47. (a) Prevalence of germs in air of thickly -populated districts. (b) Prevalence of germs in air of sparsely -populated districts.] - -There are always more germs in the air of places in which people -live closely crowded together than where there are only a few -people. This is proved by Figure 47, which shows that many more -germs were found on a culture plate exposed in the downtown part of -New York City than on another plate exposed far uptown, where there -are not so many people. Remember, however, that all germs are not -disease germs. - -[Sidenote: How we may keep disease germs out of the air:] - -How do the disease germs get into the air? When one sneezes, a -spray of droplets is thrown into the air. If the person sneezing -has the grip, these droplets contain the germs that cause grip. -Whenever a person with consumption coughs, he sprays droplets which -contain the germs that cause consumption. - -[Sidenote: (_1_) When coughing or sneezing] - -If a person would hold a handkerchief before his mouth when he -coughs or sneezes, these droplets of moisture would not be sprayed -into the air, and the disease germs in them would not be scattered -about. You ask, "Shall everyone who is sick hold a handkerchief -before the mouth when sneezing or coughing?" Everyone, whether -sick or well, ought to hold a handkerchief before the mouth when -sneezing or coughing. Learn to do this at once, and never forget it. - -[Sidenote: (_2_) When spitting] - -Another way by which disease germs get into the air is from the -sputum. People spit on the floor or the sidewalk, and the sputum -becomes dried; it is then blown about as dust. The germs of disease -are not killed by drying, and when they get into our bodies with -the dust which we breathe in, they immediately begin to grow. -Disease germs get into the air chiefly through careless habits of -coughing, sneezing, and spitting, and these careless habits can -easily be prevented. - -[Sidenote: Why well people should not spit on floor or sidewalk] - -A boy once said that if he saw a consumptive spit on the sidewalk, -he would want to hit him, and to emphasize his remarks he spat -on the floor of the room, just as you have seen boys spit on the -ground when they were thinking of fighting. There might have been -some germs of consumption in the sputum this boy left on the floor. -Of course he was very positive that he did not have consumption, -but this was no proof that his sputum was free from the germs of -this disease. - -Remember that it is not only the sick who should never spit on -the floor or sidewalk, but that no person should ever spit on -any floor or sidewalk, or into any place except into a cuspidor, -handkerchief, or spit-cup of some kind. If you spit into a -handkerchief, a paper napkin, or a bit of cloth, be sure to burn it -as soon as you can, before it becomes dry. - - =Questions.= 1. In what places do we find germs most abundant in - the air? 2. How do well-bred people avoid putting disease germs - into the air? 3. Why is it important for well people to take the - same precautions as sick people? - - =Remember.= 1. Every person should hold a handkerchief before - the face when coughing or sneezing. 2. Never spit except into a - cuspidor, handkerchief, spit-cup, or other special receptacle. - 3. If well people will practice clean habits, the sick will be - helped and encouraged to follow their example. 4. Remember: No - spit, no consumption. - - - - -CHAPTER XXI - -INSECTS AS CARRIERS OF DISEASE - - -[Sidenote: Some insects that carry disease] - -Certain diseases are given to human beings by the bites of insects. -We know that certain ticks and mosquitoes carry certain germs. It -is also probable that disease germs are transferred from diseased -to well persons by bedbugs and other insects that bite. - -[Sidenote: How yellow fever is transmitted] - -For a long time it was thought that yellow fever was carried -through the air, but now it has been proved that yellow fever is -not carried in this way. A well person can sleep with one who has -yellow fever and not catch the disease. Yellow fever infection is -carried from a yellow fever patient to a healthy person only by a -certain mosquito. Keep this mosquito away from the yellow fever -patients and there can be no spread of the disease. - -[Illustration: FIG. 48. The mosquito that carries yellow fever.] - -It is not many years since yellow fever was one of the most dreaded -diseases in warm countries. To-day there is not the same fear of -it, for the source of the disease has been discovered and practical -methods have been devised to get rid of the mosquito which carries -it. - -[Sidenote: How malaria is transmitted] - -Malarial fever is another disease transmitted by the bite of a -mosquito, but the mosquito that carries malarial fever is not -the same as the one that carries yellow fever. For a long time -it was supposed that malaria came from the gases which rise from -marshes. To-day it is known that it is not the gases that cause -the sickness, but a mosquito which lives and grows in the marshes. -Many countries that have heretofore been practically worthless on -account of malarial fever, are being made valuable by draining the -marshes and doing away with places where mosquitoes can hatch. - -[Illustration: FIG. 49. One of the places where mosquitoes hatch.] - -[Sidenote: How to get rid of the mosquito] - -It might seem a very hard task to get rid of mosquitoes in -countries where there are so many of them; but it can be done. -The mosquito must have still water in which to lay her eggs. In -countries where there is danger of yellow fever or malaria, the -rain barrel and the cistern should be screened, and the swamps and -water holes filled up. Puddles of water should not be allowed to -form anywhere, and low places where water might stand should be -drained. By giving her no place in which to lay her eggs, we can -get rid of the mosquito; and when the mosquito disappears, yellow -fever and malaria disappear also. - -[Sidenote: How wood-ticks transmit disease] - -In certain portions of Montana, Washington, Idaho, Utah, and -Wyoming, there is a peculiar disease known as Rocky Mountain -spotted (tick) fever. It is now known that this disease is -transmitted to people by the bite of a wood-tick. Not all -wood-ticks carry this fever, and for people living in districts -where this disease does not exist there is no danger in the bite -of a wood-tick; but in a part of the country where the disease -prevails, the wood-tick should be avoided. - -[Sidenote: How disease-bearing insects can be destroyed] - -All insects that are known to transmit diseases can be destroyed. -If we will do away with stagnant water, the mosquito cannot hatch; -if we will cut out underbrush and oil the domestic animals, the -wood-tick will not find a place to grow. If we wish to get rid of -disease, we must spend money and labor; but it is worth while, for -human life is at stake. - - =Questions.= 1. What insects are known to transmit diseases to - man? 2. How is yellow fever transmitted? 3. Malarial fever? 4. - What disease is transmitted by the wood-tick? 5. How can we get - rid of the mosquito? 6. How can we get rid of ticks? - - =Remember.= 1. It is a proved fact that diseases are transmitted - to man by the bites of mosquitoes and wood-ticks. 2. It is - possible to do away with both the mosquito and the wood-tick - almost completely, although it requires a great deal of work and - the expenditure of a large amount of money. 3. Health is the most - valuable thing we have, and it is foolish to hesitate in giving - the work and money necessary to exterminate disease-bearing - insects, as well as the many other causes of sickness. - - - - -CHAPTER XXII - -HOW TO KEEP GERMS OUT OF WOUNDS - - -[Sidenote: How germs get through the skin] - -Germs get into our bodies through breaks in the skin. These breaks -may be made by a cut or a scratch, by the bite of an insect, or -even by the pulling out of a hair. There are some special germs, -such as those which cause yellow fever, which are introduced by the -bite of an insect; but at present we will consider only those germs -that would naturally enter through any break in the skin. - -[Illustration: FIG. 50. Small, deep wounds are very liable to -become infected.] - -[Sidenote: Effect of germs in wounds] - -The skin of the human body acts as an armor against certain germs -that are constantly trying to get through it. There are several -germs of this class. Some of them cause white pus, or matter, but -this is the least dangerous kind of all. Another kind causes boils -or even blood poisoning, and another kind causes erysipelas. - -We cannot get rid of these germs, for they are everywhere, to a -greater or less degree; but they are more abundant in dirty than -in clean places. They cause every degree of inflammation, from -a slight redness of the skin to the blood poisoning that brings -death. - -[Sidenote: Real cause of suppuration] - -Sometimes you will hear people say that a wound suppurated (that -is, became inflamed and full of matter) because the blood was -in bad condition. As a matter of fact, there would have been no -suppuration if germs had not got into the wound. It was not the -condition of the blood that caused the suppuration, but the germs. - -Sometimes, when only a few germs get into a wound, and when the -cells of the body are all in good condition and doing their work -properly, the suppuration will be very slight, because the healthy -cells of the body will kill the germs. But if very many germs get -in, even healthy body cells cannot kill them all. - -We have said that the germs which cause suppuration are everywhere, -so it would seem almost impossible to keep them out of a wound. -This is true in a sense; but even after they have got into a -wound, you can wash them out if you use plenty of soap and water -to cleanse the wound thoroughly. When I said that it is impossible -to keep them out of a wound, I meant an accidental wound, for -it is quite possible to keep them out of a wound that is made -intentionally, as is done by the surgeon. - -[Sidenote: How the surgeon prevents suppuration] - -Do you know how a surgeon gets ready to do an operation? The first -thing he does is to see that the room is perfectly clean. He has -the carpet taken up, the curtains taken down, and the floor and -walls washed. This is to get rid of all the dirt and germs in the -room. If you should look at the surgeon's instruments, so clean and -bright, you would think it impossible for a germ to find a place -to live on; but the surgeon knows how closely the germs cling, and -therefore he boils all the instruments he is going to use. Then he -puts the towels into a place where they are made so hot by steam -that all the germs on them are killed. After everything in the room -is perfectly clean, the surgeon cleans his patient with a very -stiff brush, using plenty of soap and water which has been boiled -to kill all the germs in it. He scrubs the part where the wound is -to be made and the skin around it until it is red. Even then he is -not satisfied, for he washes it off with alcohol and ether, to be -sure that any germs that might be sticking in the fat are removed. -He scrubs his hands in the same way. After all this is done, he -can perform the operation without fear that any of the germs which -cause suppuration will get in, for he knows that he has killed all -of them that would touch the wound. - -[Illustration: FIGS. 51 and 52. Always wash the simplest cut with -soap and water; failure to do this may result in infection and much -suffering.] - -[Sidenote: How to prevent suppuration] - -Boys and girls cannot do all this before they cut their hands or -skin their shins, but they can do the next best thing--they can -keep their hands and the rest of their bodies clean at all times, -and thus have as few germs on them as possible. Then, when they -have cut themselves, they can go straight to some place where there -is soap and water, and can wash the wound thoroughly. After this is -done, a clean bandage should be placed on the cut part to prevent -any other germs from getting in. If this is done every time you cut -yourself, you will probably never have an infection--that is, a -wound that suppurates. - -Two boys were playing together one day. They ran into each other -and each got a little cut on his hand. One boy went home at once, -washed the wound, and put on a clean bandage. He lost a little -time from his play, but was soon back and never had any trouble on -account of the cut. The other boy thought it was foolish to quit -his play to take care of such a little thing, so he tied his hand -up in a dirty handkerchief. Two weeks later he was very ill. His -arm was badly swollen and had to be cut open in several places; -indeed, he came near losing his arm. It always pays to take care of -a wound, be it never so slight. - -Deep wounds made with small instruments, such as small knives, -nails or toy pistols, are especially dangerous, because they are -hard to clean and because they quickly heal up on the surface and -leave the germs to grow at the bottom of the wound. Such wounds as -these are dangerous for another reason. - -[Sidenote: Where germs of lockjaw grow] - -There is a germ that gets into wounds but does not cause -suppuration. It is the germ of tetanus, or lockjaw. It lives in -the ground, especially in the ground about barns, and its peculiar -feature is that it will not grow in the air. If it gets into a -large, open wound, it is easily killed, because it cannot grow -where there is air. But when it gets into a small, deep wound -where it cannot be reached, it stays there until the wound heals -over on the surface, and then it begins to grow. It does not make -the parts swell, as the germs of suppuration do, but quietly -continues to grow, without the wound showing any sign of infection. -Finally it develops a very severe poison that is taken up by the -blood; then the victim suddenly begins to have spasms about the -face, and finally these spasms extend to the entire body and -kill him. Whenever you get a wound so deep that you cannot wash -it thoroughly, go to a doctor and let him clean it out with some -medicine that will kill the germs that cannot be reached by washing. - -[Sidenote: How boils are caused] - -Sometimes the germs that cause suppuration get under the skin at a -point where a hair has been pulled out, or even work down beside -the hair itself. When this happens, they cause suppuration under -the skin, and the result is a boil. A boil is merely an infection -with the germs that cause suppuration. - - =Questions.= 1. How do germs get through the skin? 2. Can we - get rid of all the germs that cause suppuration? 3. Why is it - impossible for "bad blood" alone to cause suppuration? 4. How - does the surgeon prevent suppuration? 5. How may you prevent - suppuration? 6. What is the danger of cutting corns with an - ordinary knife or razor? 7. Where do germs of lockjaw grow? 8. - What causes boils? - - =Remember.= 1. Germs and not "bad blood" are the cause of - suppuration. 2. Always keep as clean as possible, and immediately - wash any cut, no matter how small. 3. If you have a deep wound, - go at once to a doctor, and let him clean it out and kill the - germs that may be at the bottom of the wound. - - - - -CHAPTER XXIII - -TRANSMISSION OF DIPHTHERIA - - -[Sidenote: How germs may cause sickness without entering the body] - -Some germs that cause disease do not get into the body, but grow -upon its surface, that is, they grow on the mucous membranes--the -skin of the mouth, the throat, and the nose. As they grow, they -develop poisons that are absorbed by the body, and that make us -very sick. The germs that cause diphtheria belong to this class. - -[Sidenote: Prevalence of diphtheria] - -Diphtheria is one of the most common of all the preventable -diseases. It causes more deaths than any of the other diseases -that can be prevented, except tuberculosis. The great prevalence -of diphtheria is due to lack of care on the part of those who have -this disease and of those who come in contact with them. - -[Sidenote: Where the diphtheria germ comes from] - -The germ that causes diphtheria always comes from some person or -animal that has diphtheria. It never "just happens." If you went -into your yard in the morning and found some beets growing in your -flower bed, you would know positively that beet seeds had got into -your flower bed in some way. You would not say that the beets just -happened to grow there. So diphtheria will not "just happen." -Diphtheria is always caused by germs that come from some one who -has diphtheria. They may have come in a letter that was written in -the room with the sick person. They may have come from the library -in a book that had been used by some one ill with diphtheria. They -may have come on some toy that had been played with by a child that -had the disease. There are a thousand ways by which the germs may -be brought to you without your knowing where they come from. - -[Sidenote: How to confine diphtheria germs] - -The public health officers try hard to keep these germs from -being brought to you. In order to do this, they have to shut away -from other people those who have diphtheria germs; that is, they -make the sick ones stay at home until they are free from the germs -of the disease. We call this _quarantine_. Quarantine means that -you must stay away from other people when you are sick with a -communicable disease, and that other people must stay away from -you. People are not put in quarantine because they are sick, but -because they are dangerous, and because we are trying to prevent -other people from getting the same disease. Do not think the health -officers unreasonable when they tell you that you must stay at home -and that no one can come in to see you. This is done to protect -other people and to keep them from getting the same disease that -you have. If you ever have diphtheria, or any other communicable -disease, you must remember that if any of your playmates come in to -see you, they may get the same disease. - -[Illustration: FIG. 53. Disease germs are as deadly as guns.] - -[Sidenote: Seriousness of breaking quarantine] - -Diphtheria kills a great many children, and to play with your -friends after you have had diphtheria, and before the health -officer tells you that you may, is almost like trying to kill -them. They might be very sick and die, or they might be very sick -and get well, or they might not be sick at all; but you never can -tell what will happen if they are exposed to the disease. If you -were to take a gun and shoot at a friend, you might kill him, or -you might shoot his leg off, or you might not hit him at all; but -you would be trying to hit him, and it would not be your fault if -you did not. It is just the same if you play with a friend when you -have a communicable disease; you shoot the disease germ at him, and -if you do not hit him, it is not your fault. - -[Sidenote: Why quarantine is not raised sooner] - -Sometimes people who have been sick with a communicable disease -feel perfectly well, but the health officer tells them he cannot -let them out of quarantine. This is because he knows that such -people still have in their bodies the germs that cause the disease, -and that as long as these germs are there they can give the disease -to other people. It is not pleasant to have to stay in quarantine -when you feel that you are well, and children, as well as older -people, are very likely to become restless under the circumstances. -You see an illustration of such a patient in Figure 60, where the -little girl, who is under quarantine for scarlet fever, but who is -feeling quite well, is giving a book to two of her friends. The -book contains the germs that cause scarlet fever, and the boys are -very likely to contract the disease by handling the book. - -[Sidenote: Why some cases of diphtheria escape quarantine:] - -[Sidenote: (_1_) From failure to detect mild cases] - -If every case of diphtheria were quarantined, and the people obeyed -the health officer, there would soon be no more diphtheria. But how -does it happen that every case of diphtheria is not quarantined? -Diphtheria is a very peculiar disease. Sometimes it makes people -so sick that they die in spite of everything that can be done for -them; sometimes it makes the throat only a little sore, and the -child seems so slightly ill that his mother says to herself, "He -is fretful," and does not call the doctor. In the latter case the -child often keeps on going to school, and exposes other children -to the disease; some of them catch it, and become very sick or -even die. In still other cases, the mother thinks that a child has -only a case of tonsillitis and does not call a doctor; the child's -brothers and sisters go to school and may carry the germs to other -children. I have known a great many cases of diphtheria to be -spread in this way. - -[Illustration: FIG. 54. The old, insanitary slates and sponges -have gone out of use, but many people of to-day still follow the -dangerous habit of putting pencils into their mouths.] - -Sometimes a dairyman thinks that his child has nothing more serious -than tonsillitis, and goes on selling milk. A great many epidemics -have resulted from such cases. Sore throats should not be treated -lightly, for the most severe forms of diphtheria may develop from -germs that come from a throat that is only slightly sore. If there -is a case of diphtheria in the town where you live, and if your -throat feels the least bit sore, have your doctor examine it at -once. If you do not wish to have your family doctor look at your -throat, go to the health officer. Had you not rather stay at home -for a week or two than see your best friends ill or dead because of -your carelessness? - -[Sidenote: (_2_) From diphtheria germs in throats that are not sore] - -There is another peculiar thing about the germ of diphtheria. It -will often get into a throat and grow a little, just enough to keep -alive, but without making the throat sore at all. The person in -whose throat the germs are will have no idea that they are there, -but when he comes in contact with some one who has a delicate -throat, he may give diphtheria to that person. The disease does not -develop in some throats because the body cells are all healthy and -doing their work so well that, when the diphtheria germs try to -take hold, they are driven off and not allowed to grow. This is the -reason that, before he raises the quarantine, the careful health -officer takes a "culture" from the throat of everyone in a house -where there has been diphtheria. - -[Sidenote: How mild cases may be detected] - -The health officer takes a culture by wiping the throat with a -little cotton on a long stick, which he then puts down into a long -glass tube containing some substance that diphtheria germs like to -grow on. If there are any diphtheria germs in the throat, they will -soon show on this culture material. Then the health officer will -say, "No, we cannot let you out yet, for the germs are still in -your throat." No person who has been staying in a house where there -is diphtheria should be allowed to go out until a culture proves -that his throat is free from the germs of diphtheria. - -You see how hard it is to quarantine all cases of diphtheria, when -children are sometimes allowed even to go to school with sore -throats that are really diphtheritic. Only two things are necessary -for getting rid of diphtheria: one is to quarantine every case, and -the other, to have the people do just what they are told when under -quarantine. This latter is just as important as the quarantine -itself, for people often do not obey the health officer's -directions. Now let us see what are some of these directions. - -[Illustration: FIG. 55. How pets may become carriers of disease.] - -[Sidenote: Rules of quarantine] - -If you are the patient, the health officer will say that you must -be put in a room where there is just enough furniture to make you -comfortable, and that no one except the nurse and the doctor is to -go into that room. He will say that the nurse must stay in your -room all the time, or that she must at least not go into any other -room in the house; that your meals must be left outside your door, -and that the person who brings them must go away before the door is -opened by the nurse. Furthermore, as everything in the room that -cannot be boiled, or otherwise disinfected, will have to be burned -when you are well, your pet books and toys had better not be taken -in. - -Finally, nothing is to be carried from the room until it has been -put into a solution that will kill the germs, and this means not -only dishes, bedding, and clothing, but even books and letters. The -nurse must see that all discharges from the throat and nose are -received on little cloths, which are to be burned immediately. - -[Sidenote: How quarantine rules are broken] - -These are the things that the health officer will tell your parents -must be done. Now let us see what sometimes happens. Your mother -will want to see her little child so much that she cannot wait -until you are well, so she will slip into your room, kiss your -forehead, and hold you tight against her. When a little later she -kisses your baby brother, and is so thankful that he is not sick -too, she does not realize that she is kissing the very same disease -into his little throat. Or, perhaps your mother is the nurse, and -in the night she hears your little brother crying; she thinks, -"Surely I can slip out and just cover him up; it will not hurt him -just for once," and she does so. What happens? In a few days your -doctor tells you that your little brother will have to come in and -stay with you. - -Perhaps your father grows anxious to see you, and one morning he -says he cannot stand it another minute, so he slips in for a few -moments before going to business. In a few days one of his clerks -fails to come to work. Your father sends a messenger to see what -the trouble is, and the word comes back, "He has diphtheria." Then -your father says, "What are these health officers doing that they -do not stop this thing?" He is very indignant, but it never occurs -to him that he himself has spread the disease by doing just what he -promised the health officer he would not do. - -[Sidenote: How dogs and cats carry disease germs] - -The doctor told your mother not to take anything from the room -until it had been disinfected. But you do not consider Towser, your -dog, and Tabby, your cat, "anything," so you persuade your mother -to let them come in, and you have a good play with them. You let -them rub against your face and romp on your bed, and do everything -that pet dogs and cats like to do, and in the meantime their fur -is getting full of diphtheria germs. Then Towser and Tabby run -out-of-doors and play with the boys and girls of the neighborhood. -Soon the parents are wondering why the health officers do not stop -the spread of the disease. No dog or cat should ever be permitted -to come into a house where there is a contagious disease. - -These are not all the ways in which people disobey the orders of -the health officer and of the doctor, but these are enough to show -you that it is a very important thing to do just what they tell -you. It is not always easy to follow all these rules, but it is far -better to follow these, and many more, than to have to think that -you have caused the death of either a friend or a stranger. - - =Questions.= 1. How does the poison of diphtheria get into the - system? 2. Where does the diphtheria germ come from? 3. What is - quarantine? 4. What is the danger in breaking quarantine? 5. - Why is quarantine continued after you feel well? 6. How does it - happen that some cases of diphtheria are not quarantined? 7. What - is a diphtheria culture? 8. What rules should you observe while - in quarantine? 9. Tell some of the ways by which quarantine is - broken. 10. How do pet dogs and cats sometimes get disease germs? - - =Remember.= 1. The germs that cause diphtheria always come - from some person or animal that carries diphtheria germs. 2. - Diphtheria is always caused by the diphtheria germ, and the - diphtheria germ cannot cause any other disease. 3. People are - quarantined to prevent other people from getting the disease. - 4. If there is diphtheria in your neighborhood, and your throat - becomes sore, have the doctor examine it. 5. Every person who - has been staying in a house where there is a case of diphtheria - should have his throat examined to make sure he is not carrying - germs. 6. Never play with dogs or cats when you have a contagious - disease. 7. People who do not obey quarantine regulations cause a - great deal of suffering and many deaths. - - - - -CHAPTER XXIV - -THE CURE OF DIPHTHERIA - - -[Sidenote: Nature of diphtheria poison] - -The germs of diphtheria do not get into the blood through the -skin, but grow on the surface of the mucous membrane (skin of -the throat), and there produce a poison that gets into the blood -through this membrane. It is this poison that makes you sick, -and it is called a _toxin_. You already know that when people -have diphtheria, they are sometimes very sick and sometimes only -slightly sick, and that the germ can live in some throats without -causing any ill effects whatever. - - -[Sidenote: How diphtheria toxin is fought] - -As soon as the diphtheria germ begins to grow in a throat, the -little cells of the body begin to make a certain substance and to -pour it into the blood. This substance we call _antitoxin_, which -means opposed to the toxin in the blood. If the little cells make -the substance fast enough, the germs will stop growing, or in some -cases they never really get started growing, because they cannot -exist where there is much antitoxin. Antitoxin looks like clear -water. The following experiment will show you something that acts -in very much the same way that antitoxin does. - -If you take a solution of litmus that is made alkaline, it will -be very blue, like indigo; but if you drop a few drops of lemon -juice into this solution it will turn red.[3] Lemon juice is acid, -and is just the opposite of alkali. Now, if you put a few drops of -ammonia, which is alkali, into the red solution, it will turn blue -again. If you put a little more lemon juice, very carefully, drop -by drop, into the blue solution, it will gradually turn lighter, -until it is entirely clear. - -[Sidenote: How antitoxin acts] - -We will suppose that the blue is due to the toxin produced by the -diphtheria germ, and that the lemon juice is the antitoxin produced -by the cells in the body. If the antitoxin is made fast enough, -the blue disappears; but if the toxin is made faster than the -antitoxin, the blue remains. It is the same way in the body, only -it is not litmus and acids and alkalies that we have to deal with. -If the toxin is made faster than the antitoxin, the germs grow, and -we get sicker and sicker; but if the antitoxin is made faster than -the toxin, then the germs cannot grow, and we soon get well, or -perhaps do not get sick at all. - -[Sidenote: How antitoxin was discovered] - -Doctors knew that this was what happened, but for a great many -years they could not discover the composition of the antitoxin that -is made in the body. One day a doctor suggested, "If we cannot -find out the chemical nature of this thing that is made in the -body, why can we not make it in the body of some animal and then -use the blood of the animal?" And that is just what they did. They -put diphtheria germs into beef tea, and let them grow very fast -and make all the toxin they could. Then the doctors strained the -germs out by passing the beef tea through a fine filter, in this -way getting the poison, and not the germs. Then they gave a strong, -healthy horse a small quantity of this poison; they did not feed -it to him, but injected it into his blood. Of course the horse was -sick for a while, but soon he began to get well again, for the -cells in his body immediately went to work making antitoxin. - -When the horse was well, the doctors gave him more of the poison; -this time he was not so sick and got well even more quickly. This -treatment with toxin was repeated in gradually increasing doses -until the poison did not affect the horse at all. Then the doctors -said, "His blood is full of antitoxin, and we will see what it will -do when injected into some other animal." So they drew off some of -the horse's blood and took out all the little red cells, leaving -nothing but the clear fluid of the blood. They planted diphtheria -germs in a rabbit's throat, and when the rabbit became very sick, -they gave him some of the antitoxin from the horse. The rabbit -immediately got well. Afterward they gave some of this antitoxin to -a little boy who was very sick with diphtheria, and he, too, got -well. Ever since then the doctors have been saving many lives by -the use of antitoxin. - -[Illustration: FIG. 56. Showing the number of deaths in 100 cases -of diphtheria when antitoxin is used on the first, second, third, -fourth, and fifth days.] - -[Sidenote: Evidences that antitoxin saves lives] - -Someone may ask, "How do we know that it is the antitoxin that -saves lives?" In just this way: before we knew anything about -antitoxin, about half of all the people with diphtheria died; but -since we have had antitoxin, only about twelve die out of every -hundred who have this disease. More than this, we know that when -the antitoxin is given within the first twenty-four hours after the -patient is taken sick, there is only about one death for every one -thousand cases of diphtheria. Do you not think that this is strong -proof that antitoxin saves lives? - -[Sidenote: How antitoxin saves lives] - -Antitoxin saves lives not only by curing those who have diphtheria, -but by preventing others from having it. If a person who has been -where there is a case of diphtheria is given a dose of antitoxin, -he will not have the disease, because his blood will contain enough -antitoxin to destroy the diphtheria toxin present. If you will -watch a careful doctor when he makes his first visit to a case -of diphtheria, you will notice that, as soon as he gets through -treating the patient, he gives all members of the family who have -been near the patient a dose of antitoxin to keep them from getting -sick. - -[Sidenote: Antitoxin not a poison] - -Some people may tell you that antitoxin is a poison and should not -be used. The statement that it is in itself a poison is true. But -it is also true that in your body there are many things that would -poison you if you got too much of them. For instance, there is a -gland in your throat (the thyroid) which secretes a substance that -is necessary for your health, but if you were to take the secretion -of ten such glands it would kill you at once. Now, if the cells in -your body make antitoxin when you have diphtheria, it is probable -that antitoxin is the very thing needed. And if you can help these -cells by giving them antitoxin, ready-made, does it not seem a -reasonable thing to do? People who give the name of poison to a -substance which is known to have saved many lives are not worthy of -attention. Anything may prove a poison if taken in excess; too much -play will prove a poison, and too much work also. - - =Questions.= 1. What is the poison of diphtheria called? 2. What - is antitoxin? 3. Compare the action of antitoxin on the blood - with the action of an acid on the litmus solution. 4. Tell about - the discovery of antitoxin. 5. How do we know that antitoxin - saves lives? 6. How does antitoxin prevent diphtheria? 7. Why - should antitoxin not be regarded as a poison? - - =Remember.= 1. Antitoxin is what the cells in your body make - when you have diphtheria. 2. By using the antitoxin taken from - a horse, you save your own cells the struggle necessary to make - it fast enough to kill the diphtheria germs. 3. If you have - diphtheria, and antitoxin is given promptly, you will get well. - 4. If you have been exposed to diphtheria, antitoxin will prevent - your having the disease. 5. Antitoxin is no more a poison than - are many other medicines. - - - - -CHAPTER XXV - -HOW TYPHOID FEVER GERMS ARE CARRIED - - -[Sidenote: How typhoid fever germs get into the system] - -There are certain diseases, the germs of which get into bodies -through our mouths. That is, we eat or drink them. Some of these -diseases are typhoid fever, cholera, the summer complaints of -children, tuberculosis, and diphtheria. At present we shall learn -about the germ that causes typhoid fever, how it gets into our food -and drink, and how we may prevent the disease by getting rid of -this germ. - -Typhoid fever, like all other diseases caused by germs, is caused -by one kind of germ, and one kind only. You cannot get typhoid -fever by eating cholera germs any more than you can get diphtheria -from typhoid germs. - - -[Sidenote: Animals free from typhoid] - -So far as we know, there is no animal except man that has typhoid -fever. Since the germs of any disease must come from an animal -suffering from that disease, and as man is the only animal that -has typhoid fever, it naturally follows that the only way to get -typhoid fever is from some person who has the fever or has had it. - -[Sidenote: How typhoid germs leave the body] - -We know that typhoid fever germs get into the body with food, but -how do they get out? Once in a great while germs are found in the -matter that the patient vomits, or spits up, but this is a rare -occurrence, so rare that we need hardly consider it. The germs are -present in the blood of the sufferer, but other people do not get -his blood on their hands or in their food. There are two things -that come from the patient that are loaded with these germs, and -these are the urine and bowel discharges. In these two excretions -of the body are found practically all the typhoid germs that come -from the patient, and these are the causes of other infections. -In other words, it is from these two excretions that the germs get -into food and drink. - -[Sidenote: How typhoid germs get into water] - -How do the typhoid germs get into our food? What is done with the -excretions after they come from the body? You will probably say -that the nurse throws them into the sewer. Very true; but where do -they go when they are thrown into the sewer? The sewer must empty -somewhere, and in most instances it empties into a stream, the -water of which is used for drinking purposes. - -[Illustration: FIG. 57. Pollution of a stream with sewage.] - -[Sidenote: The widespread evil due to the sickness of one person] - -You may think that the germs from one person would not make much -difference, but that is where you are mistaken. There is a town -in Pennsylvania of about eight thousand inhabitants, which gets -its water from a stream that flows down from the mountains. One -cold winter, while the stream was frozen, a man living on the bank -of the stream was taken sick with typhoid fever. His nurse threw -the urine and the discharges from his bowels on the ice on the -bank of the creek. When the ice melted, the typhoid germs in the -discharges found their way to the stream that furnished drinking -water to people farther down, and in a very short time there were -over one thousand cases of typhoid fever in that town. Before the -ice melted there had not been a single case of typhoid, and every -one of the thousand cases came from the water into which had been -allowed to flow the discharges from one man with typhoid fever. You -see what germs from one person may do. - -[Sidenote: How long typhoid fever germs live in a stream] - -Sometimes people say that a stream purifies itself every few miles. -It does purify itself of some things, but disease germs live from -twenty-five to thirty-five days in water, and a stream flows a long -way in thirty days. - -[Sidenote: The pollution of streams with sewage] - -Sometimes we hear people say that it is safe to put sewage into -a certain stream, because no town uses that stream for drinking -water. But of this they can never be sure. Not long ago certain -people said that the water from the river which flowed through -their town was used only by two dairymen and a vegetable gardener, -and therefore there was no danger in running sewage into the -stream. Yet the dairymen and the gardener sold all their produce -in that very town. The townspeople never considered that the water -into which they ran their sewage was used by the dairymen for -washing their milk vessels (and perhaps for diluting the milk), and -by the gardener for washing his lettuce and other vegetables. Thus -the germs of disease were brought directly back to the town. - -Do not think that you are safe in polluting a stream with sewage -because no town uses the water from that stream. The individual on -the farm is entitled to protection just as much as the individual -in the town. Always remember that when you pollute with disease the -water used by the farmer, he may bring that disease back into the -town with the produce of his farm. - -No sewage, no matter how small the amount, should ever be -permitted to go into a stream until all the disease germs it -contains have been killed. This can be done, though it will cost -something; but we cannot get rid of disease germs without work, and -work cannot be done without being paid for. - -There are other ways of scattering typhoid germs besides running -sewage into streams. Sometimes the nurse does not throw the -discharges from a typhoid fever patient into a sewer at all, but -into a closet vault. Remember how the material from a closet vault -goes through open ground into a well, and you will understand what -happens. The germs get into the well, and the whole family may then -have typhoid fever. - -Let us suppose that the nurse did not throw the discharges either -into the closet or into the sewer, but carelessly threw them out -on the ground behind the house, where, as it was winter time, they -froze as hard as rocks. It does not seem to hurt typhoid germs -in the least to be frozen; when they get warm again they are as -lively as ever. Let us suppose these particular germs lay there all -winter, but in the spring when everything melted the germs were -still alive and ready to spread disease. It happened that they did -not get into the well or into the milk, but they did get on your -food, and made you ill with typhoid fever. - -[Sidenote: How flies carry typhoid germs] - -How did the germs get to your food? About the time that the germs -were thawed out, and were beginning to double in number every -hour or two, along came a fly and thought that spot an attractive -one for a lunch. Accordingly he walked over this mass of filth, -collecting a supply of germs on his feet, and then came in and -tracked them over your bread and butter or other food. - -[Illustration: FIG. 58. Flies crawling on the edge of the glass or -falling into the milk leave germs that cause disease.] - -[Sidenote: How typhoid germs get into milk] - -That is how you got the fever; but the trouble did not stop with -you. When you fell sick, your father thought it was time to clean -the yard, but he was not very careful what he did with the dirt, -including the typhoid fever discharges which the nurse threw out on -the snow during the winter. There was a low place in the barnyard -and there he dumped the dirt. One of the cows thought this fresh -pile of dirt would make a comfortable place to lie down in. The -next morning the milkman milked her without first washing her sides -and udder, and hundreds of little particles of dirt, each one -loaded with germs, fell into the milk. The milk from all the cows -was mixed together, and by the time it got to town these germs had -grown into many thousands. Some of the people who drank the milk -became ill with typhoid fever and wondered afterward where they had -taken this disease. - -[Sidenote: Why the recovered patient is dangerous] - -The discharges from a typhoid fever patient contain typhoid germs -not only while the disease lasts, but for many months after the -patient is well. In some cases they are present for years after the -illness is over. - -[Sidenote: The story of the careless nurses] - -Here is a story about typhoid fever that illustrates the importance -of washing and boiling everything that comes from a sickroom. A few -years ago there was an epidemic of typhoid fever in a certain town. -One of the hospitals was very much crowded, and it became necessary -to employ several extra nurses. All the nurses knew the importance -of washing their hands after handling the patients, and the old -nurses had seen so many bad results from failure to observe this -rule that they were very careful. Three of the new nurses, however, -thought it a great deal of trouble to be washing their hands all -the time, so more and more they neglected this important duty. The -result was that all three of these girls got typhoid fever and -died. They paid the penalty for neglecting the duty that they well -knew they should have performed. - -Typhoid fever can be wiped out by attention to neglected -details--that is, by disinfecting discharges before throwing them -away; by disposing of excretions only in places that are made for -them; by adding lime to the closet vault every day to kill any -germs present; by making the closet in such a way that flies cannot -get into it; and by not permitting sewage to enter any stream until -all the disease germs have been killed. All these things can be -done. It will require a little work; but had you not rather take -a little extra care than run the risk of catching or spreading -typhoid fever? - - =Questions.= 1. How do typhoid fever germs get into the body? 2. - What is one source of these germs? 3. How do these germs leave - the body? 4. Name several ways by which typhoid germs in a stream - may get into foods. 5. How do flies carry typhoid fever germs? 6. - How do these germs get into milk? - - =Remember.= 1. Typhoid germs come from people who have typhoid - fever; they are found in the urine and bowel discharges. 2. No - one should ever answer Nature's calls except in a place provided - for that purpose. 3. No sewage should be allowed to go into any - stream until all the germs in it have been killed. 4. Disease - germs will live in running water fully as long as they will in - still water. 5. The discharges from a single person may infect a - whole city. 6. When typhoid fever germs get into milk, they grow - very rapidly; hundreds of people have been given typhoid fever by - drinking the milk from a dairy where there was a single person - sick with this disease. 7. People who have had typhoid often - carry the germs for several months after they are well. - - - - -CHAPTER XXVI - -HOOKWORM DISEASE AND AMOEBIC DYSENTERY - - -Hookworm disease and amoebic dysentery resemble typhoid fever in -one respect, in that they, too are spread by the improper disposal -of human excreta. - -[Sidenote: Where hookworm disease prevails] - -Hookworm disease is found almost exclusively in tropical or -subtropical climates. In the United States it is rarely seen north -of the Potomac and Ohio rivers. - -[Illustration: FIG. 59. A full-grown hookworm, magnified; the short -line shows the average length of the hookworm.] - -[Sidenote: What the hookworm is] - -This disease is not caused by a germ, as is typhoid fever, but by -a worm from a quarter to half an inch long, and about as thick -as a small hairpin. These worms get into a person's intestinal -canal, and there lay their eggs, which are later given off in the -bowel discharges. When these discharges are thrown on the ground, -or are put into an open water-closet, they may be carried about -by chickens, flies, and pigs. Then the eggs hatch in the soil and -tiny hookworms result. When human excreta are not properly disposed -of, in climates where hookworm disease prevails, the soil becomes -practically full of these little worms, and from the soil they find -their way into the bodies of the people. - -[Sidenote: How it enters the body] - -There are two principal ways by which the hookworm may enter -the body. One is through the mouth, which these worms reach in -practically the same way as do typhoid fever germs. The hookworm -may enter the body through the skin also. Some authorities state -that the worm bores its way in; but it is probable that it does not -actually bore through sound skin, but enters at some point where -there is a small break. - -[Sidenote: Where it lives in the body] - -After the worm gets through the skin, it is taken into the blood -and carried to the lungs, and from there it finds its way to -the throat and is swallowed. It makes no difference whether the -hookworm is swallowed or enters the body through the skin; it -finally reaches the intestinal canal, where it then makes its home. -Sometimes thousands of these worms are found in a single person, -and each one of them entered the body through the mouth or through -the skin. The worms do not multiply in the body, and the eggs they -lay never hatch until after they have left the body. - -[Sidenote: How it affects the patient] - -When the hookworm gets into the intestinal canal, it fastens itself -to the wall and sucks the blood from it, at the same time giving -off a poison that enters the blood of the victim. The loss of -blood and the effects of the poison soon cause the person in whose -body these worms are living to become weak, pale, and thin. He is -not able to do much work, if any, and the result is that people -suffering from this disease are often called lazy. They are not -lazy; they are sick, and many of them die. - -[Sidenote: How hookworm disease can be prevented] - -All this sickness and all these deaths might be prevented simply -by the proper disposal of human excreta. No human excreta should -ever be put anywhere except into a properly constructed sewer or -properly constructed privy. If this rule were always observed, both -hookworm disease and typhoid fever would be abolished. - -[Sidenote: Where amoebic dysentery prevails] - -Amoebic dysentery is another disease that is confined almost -entirely to tropical and subtropical climates, though cases -sometimes occur in colder regions. - -[Sidenote: How it is spread and how it may be prevented] - -This disease, like typhoid fever, is caused by a germ that leaves -the body with the bowel discharges. The germ makes its way into -the body in the same way that the typhoid germ enters; that is, it -is taken in with food or drink. The various means by which this -germ gets into our food are the same as those by which the typhoid -germ gets in; and the precautions that will prevent the spread of -typhoid fever will also prevent dysentery. Amoebic dysentery kills -a great many people in warm climates, though it does not kill as -many as does typhoid fever. If it does not cause immediate death, -it often leaves the patient very weak and sickly for months or -years. - - =Questions.= 1. In what climates are hookworm disease and amoebic - dysentery commonly found? 2. In what respects do they resemble - typhoid fever? 3. How does the hookworm enter the body? 4. Where - do the hookworm eggs hatch? 5. How can hookworm disease be - prevented? 6. What other diseases can be prevented by the same - precautions? - - =Remember.= 1. Typhoid fever, hookworm disease, and amoebic - dysentery are all caused by the improper disposal of human - excreta. 2. Most of the sickness that can be prevented is the - result of dirty habits; if all people would keep clean and see - that everything about them was kept clean, a great deal of - sickness would be prevented and a great many lives would be saved. - - - - -CHAPTER XXVII - -HOW SCARLET FEVER IS CARRIED - - -There are certain diseases that we know to be communicable (that -is, "catching"), but as yet we do not know the germ that causes -them, and therefore we cannot tell just how they are carried about. -We do know that they are transferred from one person to another; -but not being able to locate the cause, as we can in the diseases -of which we do know the germ, we cannot explain how it is done. - -[Sidenote: How scarlet fever is like diphtheria] - -Among the diseases of this class we find scarlet fever. In one -respect scarlet fever acts much the same as diphtheria. A person -may have it and not be very sick, sometimes hardly sick at all. -At night a child may have a high fever, with a slightly sore -throat, and the next morning he may feel perfectly well. The mother -supposes that the fever was due to an "upset stomach," thinks no -more about it, and sends the child to school. The next time the -child takes a bath, he perhaps notices that the skin peels off over -some parts of the body. This means that the high fever was due to -scarlet fever, but the breaking-out (rash) was so fine that it was -not noticed. It also means that all the children in the school have -been exposed to the disease. These very mild cases are the most -dangerous because so often they are not recognized. - -[Sidenote: Why mild cases are dangerous:] - -[Sidenote: (_1_) For the severe cases they cause] - -There are two things to be remembered in connection with these mild -forms of scarlet fever, as well as of every other communicable -disease. The first is that the same cause which produces a mild -form of the disease in one child may produce its most severe form -in another child. You can contract a mild form of the disease from -exposure to a severe case; and you can contract a severe form from -exposure to a mild case. The character of the case to which you are -exposed will give no indication of the form the disease will assume -in your body. - -[Sidenote: (_2_) For the bad after effects] - -The next thing to be remembered about the mild form of scarlet -fever is that, though the child may not be made very sick at the -time, there may later be very bad results. A child who has had -scarlet fever in such a mild form that he hardly knew he was sick, -may, for a while, appear to be quite well; then suddenly he has an -earache, and an abscess forms. This abscess is due to the scarlet -fever germs which have gone from the throat to the ear, and as a -result the child may lose his hearing entirely. - -The child may not, perhaps, have an abscess, but after a time he -may begin to lose flesh, and to grow pale. He does not care for -his meals, does not care to play, says he is tired, and wants to -lie still all the time. Finally his mother thinks it might be a -good idea to have a doctor see him. The doctor examines his body -carefully, and then asks for a sample of his urine. When he has -examined this, he looks very serious and asks the mother when the -child was sick last, and what the disease was. Perhaps she has -forgotten all about the slight attack of fever, and the doctor -must question her very carefully before she recalls it. At length -it occurs to her, and then the doctor asks, "After this attack of -fever, did you notice that the skin came off his hands and body?" -She replies that she did, and then the doctor tells her that the -child really had scarlet fever, and, owing to lack of care, he now -has kidney disease. This is a very serious trouble, from which -he may never recover, or, in case of recovery, he may always be -weak and sickly. Even a mild attack of scarlet fever is not to -be neglected; it is a severe and dangerous disease in its very -mildest form. It not only kills a great many boys and girls, but -it makes delicate in health for all their lives many of those who -apparently recover. - -[Illustration: FIG. 60. One of the ways by which quarantine is -broken.] - -[Sidenote: How confusion of names causes mild cases to go -undetected] - -We often hear people speak of two diseases which they think are -not scarlet fever. These two diseases are scarlatina and scarlet -rash. Now scarlatina is simply the scientific name for scarlet -fever. Some doctors will tell you that you have scarlatina and that -it is not exactly scarlet fever. A doctor who says this either is -deceiving you or does not know any better. In either case, he ought -not to be a doctor, for he lets children be exposed to a disease -that is likely to kill many of them. It is the same with scarlet -rash. This, too, is simply another name for scarlet fever. Changing -the name does not change the disease, and you may call it scarlet -fever, scarlatina, or scarlet rash--it makes no difference which; -the disease is one and the same. - -[Sidenote: Why quarantine is necessary for scarlet fever] - -Quarantine is the only way known for preventing the spread of -scarlet fever, as well as of diphtheria. If every case of scarlet -fever were quarantined, we could soon stop this disease; but every -case is not quarantined, because some of them are so mild that -they are not recognized. - -[Sidenote: How breaking quarantine shows selfishness] - -Even when a case is quarantined, the people sometimes neglect -the instructions given, just as they do when there is a case of -diphtheria. Then there are cases that are known to be scarlet fever -but are not reported to the health officers, because the people -do not want to be quarantined. They simply do not want to be put -to any inconvenience themselves, and although this seems a very -strange way for people to act, it happens very often. There are -many selfish people in the world; there are even people who will -not report a case of scarlet fever because to do so might prevent -their going to a party. Selfishness is at the bottom of it. - -It is extremely important that a child should be absolutely free -from all the little scales of skin which are thrown off after -scarlet fever, before he returns to school or mingles again with -others. If there is a discharge from the nose or ears after the -scales have disappeared from the skin, there is still danger of -spreading the disease, for these discharges often retain the -infection for many months. - - =Questions.= 1. Give two reasons why mild cases of scarlet fever - should be carefully treated. 2. Why is quarantine necessary? 3. - How does selfishness lead people to spread scarlet fever? 4. When - is it safe to let a scarlet fever patient mingle with well people? - - =Remember.= 1. If you have scarlet fever and are not very sick, - do not think that you will not be dangerous to others; severe - cases sometimes come from exposure to the mildest cases. 2. - Mild cases of scarlet fever often leave very bad results, if - the patient is not cared for. 3. Be very careful until you are - entirely well. 4. Scarlatina and scarlet rash are nothing but - scarlet fever; keep away from people who have them. 5. Quarantine - is the only way by which we can prevent the spread of scarlet - fever; there is no medicine that will prevent it. 6. People who - violate quarantine regulations are both selfish and stupid. - - - - -CHAPTER XXVIII - -MEASLES AND WHOOPING COUGH DANGEROUS DISEASES - - -Measles is a disease in the same class as scarlet fever. We do not -know the cause, but we do know that it is communicable. - -[Sidenote: Why measles should be avoided] - -Measles is usually not a severe disease; that is, it does not -kill as many persons in proportion to the number of cases as does -scarlet fever. It does, however, kill more people than most of us -think; a great many little babies die of it. How often we hear -mothers say, "I wish my children would have measles and be done -with it." It would be very convenient if they could have measles in -a mild way and "be done with it." The trouble is, that we cannot -tell whether it will take a mild form, and, worse than this, we do -not know when they will be done with it. - -If you should go into the children's wards of a large hospital, -you would know why measles should be avoided. There you would hear -the doctors questioning the mothers about the previous diseases of -the little ones. You would be surprised at the number who replied, -"He has not had anything but measles." Then you would hear the -question, "How long since he had the measles?" "He was just over it -when he was taken sick with this trouble." What is "this trouble"? -Follow the doctor along from bed to bed and see the cases of -pneumonia that started when the child "was just over measles"; see -how many cases of empyema (abscess in the chest) began just after -the measles ended; how many cases of abscess in the bone, how many -cases of disease of the kidneys appeared after the child recovered -from the measles. Then go down into the eye and ear wards and see -how many diseased eyes and ears have followed an attack of the -measles. The children would not have had these troubles had they -not first had measles. - -[Sidenote: Necessity of care in measles] - -If you have measles, do not let others come near you, and do not -think that, because you do not feel very sick, you can run about -as usual. If you do not take good care of yourself, you may have -some of the diseases that so often begin when children are getting -over measles. Measles causes more deaths than is commonly supposed, -especially among young children and very old people; and a great -many children die of diseases which they never would have had if -they had not first had the measles. Avoid people who have measles, -and if you should get the disease, do not treat it as a slight -thing, but consult your doctor at once. - -[Illustration: - - _Whooping Cough_ _Scarlet Fever_ _Measles_ _Smallpox_ - _4,856_ _4,309_ _4,302_ _74_ - -FIG. 61. Deaths in 1907 from four common communicable diseases -reported to the United States Census Bureau.] - -[Sidenote: Evil effects of whooping cough] - -Whooping cough is much the same as measles in this respect. It -kills many children, and, in cases where it does not kill them, -their bodies become so weakened that they are liable to contract -some other disease that may prove fatal. Avoid people who have -whooping cough. - - =Questions.= 1. Why should people avoid measles? 2. Why should - one take care of himself when he has measles? 3. Why is whooping - cough to be avoided? - - =Remember.= 1. Measles is more fatal, especially among babies, - than people realize. 2. Measles causes more diseases of the - bones, ears, and eyes than any other communicable disease. - 3. Measles is not dangerous if properly cared for, but when - neglected, it causes much suffering and many deaths. 4. Whooping - cough causes almost as many deaths as does measles. - - - - -CHAPTER XXIX - -HOW SMALLPOX IS PREVENTED - - -We now come to the study of a disease, the cause of which has not -been positively recognized. We know that it is very communicable; -but we know also that there is absolutely no reason for anyone's -ever contracting it, since there is a way by which it may easily be -prevented. - -[Sidenote: Fatality of smallpox before the discovery of vaccination] - -Something over a hundred years ago, smallpox was one of the most -fatal diseases known. It is estimated that during the eighteenth -century it killed over 60,000,000 people. - -Up to the time when the Spaniards invaded Mexico, there had been -no smallpox there. The Spaniards brought the disease with them, -and historians tell us that out of the 12,000,000 people living in -Mexico at that time, at least 6,000,000 died from smallpox. At that -time the disease was considered fatal throughout the world; when -it broke out in a community, people fled without stopping to bury -their dead. It was a rare thing to see a person not more or less -disfigured by the marks the disease leaves on the face and body. - -To-day we find a very different condition. There are now fewer -fatalities from smallpox than from almost any other communicable -disease. During 1906 and 1907 only 169 deaths from smallpox were -reported from all over the United States to the Census Bureau at -Washington. What has caused this marked falling off in the fatality -of the disease? - -[Sidenote: Discovery of vaccination] - -During the time that smallpox was killing so many people, all the -doctors were trying to find something that would cure the disease -or that would prevent it. In the latter part of the eighteenth -century Dr. Edward Jenner, an English physician, noticed that -milkmaids did not have smallpox as much as did people of other -occupations. He also noticed cows with little sores on their udders -that looked very much like the sores that come with smallpox. He -therefore tried making on the arms of people sores just like those -on the udders of the cows. He did this by taking a little of the -matter from the sores on the cows and putting it into the scratches -on the people's arms. After these sores had healed, the people who -had been thus treated did not have smallpox. This simple practice -has caused one of the most deadly diseases known to man to become -one of the most easily controlled. - -[Sidenote: Prevention of smallpox by vaccination:] - -Though it is well known that before the discovery of vaccination -smallpox was a fatal disease, there are still some persons who say -that vaccination has done nothing to reduce the mortality. When you -learn some of the facts, you can judge for yourself whether or not -vaccination does prevent smallpox. - -[Sidenote: (_1_) In the Franco-Prussian War] - -During the Franco-Prussian War in 1870-71, the German soldiers were -all vaccinated, and only a part of the French army was vaccinated. -Smallpox broke out in the two armies. As a result, 6,000 of the -French died from smallpox and only 278 of the Germans. In many -instances, the German and the French soldiers were confined -in the same hospitals, with exactly the same opportunities to -contract the disease. But, you might ask, if vaccination prevents -smallpox, how did it happen that there were _any_ cases among the -German soldiers? In order to prevent smallpox, vaccination must -be successful; that is, it must "take." We will tell you about -different kinds of vaccination a little later. - -[Illustration: FIG. 62. In Sweden, before vaccination, smallpox -caused 2,050 deaths per million population (represented by the -large square). Since the introduction of vaccination the death rate -has dropped to 2 per million population (represented by the two -small squares).] - -[Sidenote: (_2_) In Sweden] - -In Sweden we find strong evidence that vaccination prevents -smallpox. Up to 1801, before vaccination was introduced into that -country, the yearly death rate from smallpox was 2,050 out of each -million of the population. In 1801 vaccination was introduced -into Sweden, but the people were allowed to be vaccinated or not, -just as they pleased. During the ten years ending with 1811, the -annual death rate from smallpox had dropped from 2,050 per million -of the population to 686 per million. Later, vaccination was -made compulsory (that is, everybody in Sweden was obliged to be -vaccinated), and in 1894 the death rate had dropped to only two -deaths a year per million population. Is it merely a coincidence -that this great falling off in deaths from smallpox came after -vaccination was discovered, or was it due to vaccination? - -[Sidenote: (_3_) In the Philippine Islands] - -Before the Philippine Islands were occupied by the Americans, -vaccination was very little practiced, and a large percentage -of the deaths in those islands was caused by smallpox. In 1897 -smallpox caused about 40,000 deaths. A few years later the -Americans enforced vaccination among the inhabitants of the -Philippines, and the result was that in 1907 there were only 304 -deaths from smallpox. There has been practically no quarantine for -smallpox and no disinfection; the only cause of the suppression of -the disease in the Philippine Islands is vaccination--nothing else. - -[Sidenote: (_4_) In Gloucester, England] - -In Gloucester, England, there used to be a great many people who -did not believe in vaccination, though it is doubtful if they -themselves could have explained why they did not. They seem to -have been much like the man who, when asked, "What do you think of -this?" replied, "I don't know anything about it, but I am against -it." In 1890 Gloucester had a population of 42,000 people, most -of whom had never been vaccinated. In the latter part of 1895, -smallpox broke out. Quarantine was strictly carried out, but the -disease continued to spread. As the people saw the number of -victims rapidly increasing, many of them concluded that they had -rather be vaccinated than have smallpox, even though they did -not really believe in vaccination. By the first of April, 1896, -over 36,000 people had been vaccinated in Gloucester, and by the -first of August there was not a case of smallpox in the city. But -what had happened in the meantime? There had been 1,979 cases -of smallpox; a very large amount of money had been expended in -quarantining; hundreds of persons had been disfigured for life; and -439 lives had been lost. And all this simply because the people did -not believe in vaccination. - -Quarantining smallpox is a most expensive luxury, which may -possibly retard the progress of this disease, but was never known -to check an epidemic of it. Every epidemic of smallpox during the -last one hundred years has been checked by vaccination. - -[Sidenote: Why some diseases do not return] - -There are certain diseases which you are not likely to have more -than once; one attack protects against another. Why and how does -one attack of a certain disease protect against another? When a -person is taken sick with one of these diseases, the cells of his -body immediately begin to make a substance called antitoxin. We -learned something about antitoxin when we were studying diphtheria. -In diseases like scarlet fever, measles, and smallpox, in which -one attack protects against another, the antitoxin that is formed -in the body when you are sick stays there for a long time, in some -cases as long as you live. While this antitoxin is present in the -blood, the cause of the disease cannot live in the body; hence you -cannot have the disease again. After some diseases this antitoxin -seems to disappear from the blood in a short time; after others, -it seems to remain for several years; and after still others it -remains as long as you live. After diphtheria it stays in the blood -only a short time, so that one may have diphtheria a second time -within a few years. Some people have smallpox, measles, or scarlet -fever a second time, but with most people these diseases never -return. - -If we knew how to make the cells of our bodies produce this -antitoxin and keep it stored up in the blood all the time, we -should never have any of these diseases. But in many cases we do -not know how to cause the cells to manufacture this antitoxin. -However, in one or two diseases we do know how to persuade them to -make the antitoxin, and the one in which we know how to accomplish -this best is smallpox. This is just what is done by vaccination. - -[Sidenote: How vaccination prevents smallpox] - -The object of vaccination is to put the cells of the body to work -making antitoxin. To do this, it is necessary to get some of the -toxin into the body. We want to get in just enough to make the -cells work, and no more. Therefore we make a very small scratch, -and put into it some of the vaccine which contains the toxin of -smallpox. It is impossible to have these germs in your body and -not be affected by them to some degree. If you did not feel a -little sick, the cells would not be making antitoxin, for the thing -that makes you sick is what makes the cells go to work. But this -sickness is only a matter of a day or two, and after the cells have -made the antitoxin, it will stay in your body a long time, longer -in some cases than in others. - -Some people, after they have once been vaccinated, can never be -successfully vaccinated again; neither can such people ever have -smallpox. Most people, however, can be successfully vaccinated -every five to seven years, and there are a few people who will -"take" if vaccinated every year or two. These conditions indicate -the length of time that the antitoxin of smallpox will live in -the bodies of these different persons. If vaccination, properly -performed, does not take, the person is not in a condition at that -time to catch smallpox; and if vaccination, properly performed, -does take, it is positive evidence that if this person had been -exposed to smallpox, he would have taken the disease. - -[Sidenote: Necessity of repeated vaccination] - -It is frequently asked, "How long will vaccination protect against -smallpox?" You can no more answer this question than you can tell -how long the antitoxin will live in the blood of any particular -person. The only safe thing to do is to be vaccinated every few -years, and if smallpox is present in your community, get vaccinated -every year until the vaccination takes. If it takes, it shows that -you were in a condition to catch the disease; and if it does not -take, you may feel safe from smallpox for a while, at least. - - =Questions.= 1. Why was smallpox formerly more widespread and - more often fatal than it is now? 2. Tell of the discovery - of vaccination. 3. Give instances to show the influence of - vaccination on smallpox epidemics. 4. Why must there be repeated - vaccinations? 5. Show how vaccinating for smallpox is like taking - antitoxin to prevent diphtheria. - - =Remember.= 1. Before the introduction of vaccination, smallpox - was one of the most dangerous diseases known. 2. All evidence - of history tends to show that vaccination has caused smallpox - to become a very mild disease and a comparatively rare one. 3. - Successful vaccination repeated at proper intervals will prevent - smallpox. 4. Vaccination must be repeated because we do not know - just how long the material developed in the body from a single - vaccination will last. - - - - -CHAPTER XXX - -WHY VACCINATION SOMETIMES SEEMS A FAILURE - - -[Sidenote: What constitutes a successful vaccination] - -How does it happen that those who have been recently vaccinated -sometimes have smallpox? It is _successful_ vaccination that -prevents smallpox, not recent vaccination; there is a vast -difference between the two. A _successful_ vaccination is one that -results in a sore identical with the sores of smallpox. Such a sore -is secured only as a result of the action of the germs that cause -smallpox. - -If the arm is red from the shoulder to the wrist and so swollen -that you cannot use it for weeks, it does not necessarily mean that -you have had a successful vaccination. - -Such arms are not the result of vaccination itself, any more than a -railroad wreck is the result of the fact that there is steam in the -engine. The railroad wreck is caused by carelessness on the part -of some operator, and the badly inflamed and swollen arm is due -to lack of care or knowledge on the part of the vaccinator or the -person vaccinated. - -[Sidenote: Some pretended vaccinations] - -A fly blister is not a successful vaccination. Such a statement -may not seem necessary, until you hear this story. A man showed a -sore on his arm, asserting that it was a successful vaccination. He -was told that it was nothing but the result of a blister, and not -vaccination, and that the work had been done by putting a small bit -of blistering plaster on his arm. He admitted this to be the fact, -and said that the "doctor" who did it told him that it was a new -way of vaccinating. The doctors who say that vaccination will not -prevent smallpox belong to the class who use fly blisters and call -them vaccinations. When the patient gets smallpox, those who are -opposed to vaccinations say that here is an illustration of their -claim that vaccination will not prevent smallpox. - -[Illustration: FIG. 63. How vaccinated arms are sometimes infected.] - -Some people who honestly think they were vaccinated have smallpox. -There are sometimes instances in which a person recently vaccinated -with apparent success nevertheless contracts smallpox; there are -still other cases in which the disease develops after a vaccination -that would not take. Here is an example: - -A doctor vaccinates a child in the usual manner. At the end of -four or five days, the dressing is taken from the arm, and the -only thing to be seen is a little black scab. The child scratches -this off. In a few days the spot becomes red and a small abscess -forms, resembling a smallpox sore. Naturally, this is taken for -a completely successful vaccination, but it is not really so. -When the child scratched off the scab, the vaccination wound was -nearly healed, and the little abscess was caused by some very -mild pus germs, which were under the finger nails with which he -scratched the wound. The abscess was in no wise connected with the -vaccination, but was simply such an infection as a child might get -at any time that he scratched his arm. No one has ever claimed that -such an abscess will prevent smallpox any more than that a boil -will prevent it. - -_A successful vaccination will prevent smallpox._ The length of -time for which it will prevent the disease varies in different -individuals. Some it will protect only for a year or two, while in -others it will last through life. - -Dr. H. W. Bond, Health Commissioner of St. Louis, Missouri, states: - -"The experience of this department, based on the observation of -thousands of cases, is that a well-pitted mark gives at least ten -years' immunity. We have never seen a case of smallpox in a person -with a well-pitted scar less than ten years old--that is, the scar -less than ten years old." - -[Sidenote: A sore arm not always due to successful vaccination] - -One of the strongest objections made against vaccination is that -the arm sometimes becomes very sore from it. This is true, but -the sore arm is not a common occurrence and is never caused by -vaccination properly performed. There is always some cause for the -bad arm besides the vaccination. - -[Sidenote: Cause of sore arms] - -The usual cause of a bad arm is improper vaccination; this means -the lack of proper precautions on the part of the person who does -the vaccinating. Years ago, before vaccination was performed with -the great care which is given it to-day, bad arms could not be -prevented; but to-day the cause of the trouble is not the vaccine, -but the vaccinator. Sometimes a father thinks he will save a dollar -by vaccinating his child himself, and he is likely to injure the -child by attempting to vaccinate him without taking antiseptic -precautions. The same surgical preparations must be made for a -vaccination as for an operation. If this is not done, a bad arm -will result, not because of the vaccination, but because of the -negligence of the vaccinator. - -Never allow any person, doctor or otherwise, to vaccinate you until -the skin surface has been well washed with soap and water, rinsed -clean, and wiped off with alcohol. See that the vaccine is fresh -and has been properly kept. When it begins to "take," keep the spot -absolutely clean and covered with a clean cloth, renewed daily. -_Never scratch or rub it._ These precautions will prevent the -dreaded soreness of the arm. - -[Sidenote: How people themselves infect their arms with pus germs] - -The person operated on is himself often responsible for the bad -arm. A careful doctor will put a dressing on the arm, after he has -supplied the vaccine, and will tell you to let that dressing alone, -for he wishes to take it off himself. About the third or fourth -day after the vaccination, your arm begins to itch. Possibly you -have forgotten what the doctor told you; at any rate, you pay no -attention to directions and take the dressing off to scratch the -arm. When you scratch the wound, you introduce pus germs into it, -and you have no reason to expect anything but a sore arm. In this -case, it is not the fault of the vaccinator or of the vaccination; -it is your own fault. Never touch a vaccination sore; in fact, it -is dangerous to touch any sore. - - =Questions.= 1. How is a successful vaccination determined? 2. - What are some pretended vaccinations? 3. Mention some of the - things that cause bad arms after vaccination. - - =Remember.= 1. A successful vaccination causes a sore identical - with the sores that result from smallpox. 2. A fly blister is - not a vaccination in any sense of the word. 3. A very sore arm - does not result from a properly performed vaccination, but - from carelessness on the part of the vaccinator or the person - vaccinated. - - - - -CHAPTER XXXI - -CONSUMPTION, THE GREAT WHITE PLAGUE - - -Tuberculosis, or consumption, has been known for many centuries. It -was known long before Rome was ever heard of. Hippocrates, a Greek -physician, studied it, and said that if it were treated in its -early stages, it could be cured. - -[Sidenote: Why consumption is called the Great White Plague] - -Tuberculosis is called the Great White Plague. It is called the -Great Plague, because it kills more people than does any other one -disease; the White Plague, because people who suffer from it become -so pale and white. - -[Sidenote: Consumption more destructive than war] - -It is estimated that nearly 200,000 people die from tuberculosis -every year in the United States. This means that in this country -there is one death from consumption every two minutes and -thirty-six seconds. Is it not fearful to think of nearly 200,000 -people dying every year, in the United States alone, from a disease -that we know can be prevented? Do you not think that we ought to do -everything we can to prevent this disease from spreading? - -During the Civil War 205,070 soldiers were killed in both armies. -This war lasted four years. During the same length of time there -were 640,000 deaths from tuberculosis in the United States. This -means that consumption killed over three times as many people as -were killed during the same length of time in the Civil War. In -some parts of the country one out of every seven deaths is caused -by this disease, but the average throughout the country is one -death out of every ten. - -[Illustration: FIG. 64. Comparing 640,000 deaths from tuberculosis -the United States during four years with the 205,070 deaths in the -Civil War.] - -[Sidenote: Prevalence of tuberculosis] - -There are more than 700,000 people sick from tuberculosis every -year in the United States alone. Of this number nearly 200,000 die -every year. Tuberculosis is a disease that can be prevented. It may -take a long time to get rid of it, but it can be abolished. When -you think of all the people that are sick from tuberculosis, and of -all those who die from it every year, you will surely want to do -all you can to help prevent this suffering and death. - -[Sidenote: Tuberculosis a disease of various parts of the body:] - -When people speak of consumption they usually mean tuberculosis of -the lungs; but tuberculosis is not confined to the lungs. The germs -that cause tuberculosis may attack any part of the body, and from -one part may go to other parts, setting up a growth wherever they -go. - -[Sidenote: (_1_) Of the throat] - -Tuberculosis of the throat is a common form of the disease. When -the germs of tuberculosis settle in the throat, they destroy the -tissues very rapidly and, as a rule, kill the patient much more -quickly than they do when they start in the lungs. - -[Sidenote: (_2_) Of the joints] - -Another frequent form of tuberculosis in occurs in the knee; this -is popularly called "white swelling." It quickly destroys the knee -joint and results in a stiff leg. The growth may stop there, but -more often it extends from the knee to other parts of the body. - -Often we see a little boy or girl wearing one shoe with a sole much -thicker than the other. This is because one leg is shorter than the -other, and we notice that the shortened leg is deformed as well. -This condition sometimes results from an injury, but it is far -more likely to be caused by tuberculosis of the hip joint. - -[Sidenote: (_3_) Of the spine] - -Again we see boys and girls with diseases of the spine, so -that they have "hunch backs" or are twisted to one side. These -conditions result from tuberculosis of the bones of the spine. - -[Illustration: FIG. 65. One of the effects of tuberculosis.] - -[Sidenote: (_4_) Of the glands] - -Sometimes we see children and grown people with swellings on their -necks. These swellings may look smooth, but they feel as if they -were made up of little bunches of grapes or plums under the skin. -They are almost always due to the growth of the germs that cause -tuberculosis of the little glands of the neck. - -[Sidenote: (_5_) Of the stomach] - -Any one of the other glands of the body is just as liable to -become affected by tuberculosis as are the glands of the neck. -Tuberculosis of the stomach or bowels is not at all uncommon. - -The germs of tuberculosis are likely to attack any of the tissues -of the body, especially if the cells composing these tissues are -for any reason weakened so that they cannot do the work required -of them. When the tuberculosis germs grow in tissues, the tissues -finally break down and an abscess forms. A tubercular abscess is -sometimes called a "cold abscess." - -All such abscesses finally break and an open sore results. The -matter that comes from the open sore and from the abscess when it -is first opened is full of the germs that cause tuberculosis. If -this matter is allowed to become dry, the germs are blown about in -the dust. Then other people may inhale them or take them into their -bodies through the mouth or skin and thus contract consumption. - -[Sidenote: The old belief that consumption is inherited] - -Until a few years ago it was generally believed that consumption -was inherited. That is, it was thought that children whose father -or mother had consumption were born with the disease. Even to-day -many people hold to this idea, because they have not studied or -learned of the discoveries made in recent years. These people still -believe that if a child's father or mother dies of tuberculosis, -the child will die of tuberculosis, too, no matter how careful he -may be or how much of a fight he may make against it. - -It is true that many people whose parents have died of consumption -also die from this disease; but this does not prove that they were -born with consumption. It merely shows that they had a good chance -to catch the disease by being continually with some one who had it. -It is also true that a great many people die from consumption whose -parents did not have it. If consumption is an inherited disease, -where did these people get it? - -[Sidenote: How the germ of tuberculosis was discovered] - -About thirty years ago, Dr. Robert Koch discovered that all -consumptives have in their sputum a long, slender germ which he -called the tubercle bacillus. Some of these germs he injected -into guinea pigs, and he found that they caused the pigs to have -consumption. Then he made many other experiments, and proved beyond -question that it is this very germ that causes tuberculosis, and -that no one has consumption unless he has this germ in his body. - -[Sidenote: Evidence that consumption is not inherited] - -Then the question arose, "Is the baby whose parents have -consumption born with this germ in its body?" This question -could not at first be answered; but tests were made by taking -the children of consumptive parents away from their parents, and -keeping them in homes where there were no consumptives. It was -found that these babies did not develop the disease. From these -and many other tests, it has been proved that consumption is not -inherited, and that the reason the child of the consumptive so -often has consumption is because he lives with people having the -disease. - -[Sidenote: Evidence that consumption is a house disease] - -Consumption seems to be confined to certain families, and this has -led many people to think that the disease is inherited, regardless -of the proof that it is not. When we carefully study the facts -in various cases, we find that the disease is not confined to a -certain family, so much as it is to the _house_ in which the family -lives. - -The record of a single house will illustrate how tuberculosis -sticks to the house rather than to the family. From 1880 to -1901, a particular house was occupied by a father, mother, and -six children, of whom four died of consumption. From 1902 to -1903 the house was occupied by another father and mother with -eight children. They moved away because of the great amount of -sickness in the family. At present this father and one of his -children have tuberculosis. In 1904 the house was occupied by -still another family, consisting likewise of a father, mother, -and eight children. Now it is known that four of the children -have tuberculosis, and it is feared that three others have also -contracted the disease. In 1905 a son of the first occupant, with -his wife and two children, returned to live in the house. The -father of this family died of tuberculosis. Up to 1906 the total -results from this house, scattered through four families, were as -follows: five deaths, six cases in people still living, and three -suspected cases. - -[Illustration: FIG. 66. The constant danger of infection in railway -cars, where germs can live as well as in a house.] - -[Sidenote: Why consumption is a house disease] - -When the consumptive coughs, he sends fine droplets of moisture -into the air. These droplets contain the germs that cause -tuberculosis. The moisture evaporates and the germs are left -sticking to the floors, the walls, the curtains, and the furniture -of the room. When the room is swept or dusted, the germs are -stirred up with the dust and people inhale them. The germ that -causes consumption will live for a long time in a house; you cannot -see it, but it is there. Wherever a consumptive has lived, he has -left the germs of this disease behind him. - -[Sidenote: How to disinfect houses] - -If a house in which a consumptive has lived is thoroughly -disinfected, all the germs he left there will be killed. Scattering -disinfectants about a room does no good. The only proper way to -disinfect is to close the house, for if the disinfectant is strong -enough to kill the disease germs, no human being can stay in the -house while it is being used. Disinfecting should be done by the -health officer, because he knows how much disinfectant is needed to -kill every germ in the house and how it should be used. - -[Sidenote: Fraudulent disinfectants] - -Sometimes you will see an advertisement saying that certain -disinfectants will kill the germs of disease but will not affect -the people. Always remember that any disinfectant that is strong -enough to kill the disease germs will also kill human beings, and -do not be fooled by such advertisements. - -_Never move into a house that has been previously occupied, until -the house has been disinfected._ Do not take it for granted that -the people who lived there before had no communicable disease. -Do not take the word of the agent or of any one else that there -has never been sickness in the house. People sometimes have -tuberculosis without knowing it; people sometimes have tuberculosis -or other communicable diseases without telling of it. - -It does not cost much to disinfect a house, and if the disinfection -is properly done the disease germs will be killed. "An ounce of -prevention is worth a pound of cure." Try to convince your father -that by having the new home disinfected he may save not only -doctor's fees, but perhaps the lives of himself and his family. - -There are a great many things that boys and girls can do to help -fight this disease. This "scourge" can be wiped out; but if the -boys and girls do not help in this great work, it will never be -done. - - =Questions.= 1. Why do people call consumption the Great White - Plague? 2. What is the annual death rate from consumption in the - United States? 3. Compare the fatality from consumption with the - number of soldiers killed during the Civil War. 4. What amount of - illness in the United States is due to consumption? 5. Describe - at least four forms of tuberculosis. 6. What determines the part - of the body in which the germ of tuberculosis grows? - - =Remember.= 1. Tuberculosis and consumption are the same disease. - 2. This disease kills more people than war, although it might be - prevented. 3. Tuberculosis is not confined to the lungs but may - attack the tissues of any part of the body. 4. Consumption is not - inherited; it is a house disease rather than a family disease. 5. - A house should be disinfected by the health officer before it is - occupied by a new tenant. - - - - -CHAPTER XXXII - -HOW CONSUMPTION IS SPREAD AND HOW PREVENTED - - -[Sidenote: How tuberculosis germs leave the body:] - -The sputum (spit) of the consumptive and the discharges from -tubercular sores contain the germs that cause tuberculosis. -Sometimes these germs are so numerous that thousands of them would -be found clinging to the point of a needle dipped into the sputum -or discharges from a patient. When the consumptive coughs, he sends -into the air many of the germs that cause tuberculosis. - -We cannot kill the germs while they are in the body of the -consumptive; but we can kill them after they have left the body, by -seeing that none of the sputum or discharge from tubercular wounds -or sores is allowed to become dried and blown about as dust. - -[Sidenote: (_1_) In discharges from sores] - -When the discharge from a tubercular sore becomes dried and blows -about with the dust, the germs are inhaled into the lungs of -other people, or fall into other sores and cause them to become -tubercular. Since this is one of the most frequent ways by which -this dread disease is spread, you will say at once, "Why, every -particle of matter from a tubercular sore ought to be burned, so -that there would be no possibility of the germs being scattered." -This of course ought to be done, but this is not enough. - -People sometimes have consumption and are not aware that they have -it. Others may have tubercular sores and not know them to be such. -Any sore, whether it is tubercular or not, contains disease germs. -They may not be the germs of tuberculosis, but even the least -dangerous of them is the germ that causes pus (matter). - -Since we are trying to get rid not only of the germs that cause -tuberculosis, but also of the germs that cause all communicable -diseases, it would be better to say, "All discharges from _any_ -sore should be burned immediately." - -[Sidenote: (_2_) In the sputum] - -When people spit on the sidewalk or on the floor, the sputum will -of course become dry. Sometimes a lady drags her dress through the -sputum on the sidewalk or on the floor; it sticks to her dress and -she takes the germs home with her. The sputum of the consumptive is -loaded with the germs that cause tuberculosis, and if this sputum -is allowed to be blown about with the dust, people will inhale it -and thus get the germs into their lungs. Certainly the consumptive -should never spit on the sidewalk or on the floor, or in the mine, -workshop, or in any place where the sputum may become dry and form -dust. Of course he should not fill the air about him with germs by -coughing into it; everybody knows that. - -[Illustration: FIG. 67. A sputum cup of waterproof pasteboard.] - -[Sidenote: Why everybody should be careful about spitting and -coughing] - -But _no_ man or woman, boy or girl, should ever spit on the floor -or sidewalk. In the first place it is bad manners. No person does -this who is well brought up. In the second place, we must remember -that the consumptive does not like to have others know that he has -consumption; this feeling is a part of the disease. If you expect -the consumptive to refrain from spitting on the floor or sidewalk, -you must help him by your example. You cannot expect him to be the -only one to hunt up a cuspidor, when you yourself are spitting -on floor or sidewalk. If you expect the consumptive to take the -precaution necessary to protect you from this disease, you must -take the same precaution yourself. - -In the matter of coughing, the same rules hold true. If you expect -the consumptive to hold a handkerchief before his mouth when he -coughs, you must do the same. - -[Sidenote: How to avoid spitting on the floor or sidewalk:] - -Since it is not right that the consumptive should spit on the floor -or sidewalk, it will naturally be asked, "What is the consumptive -to do with what he coughs up?" - -[Sidenote: (_1_) By using paper napkins] - -At a very small cost he can buy paper napkins and envelopes -which have been treated with paraffin to prevent moisture going -through them. If every one with a cough or with any such trouble -as catarrh, which makes him want to spit frequently, would carry -a supply of these paper napkins and paraffin envelopes, he would -always have a suitable place in which to spit. When you cough up -anything, spit into one of these little napkins, put the napkin -into the envelope, and when you get home burn the whole thing. - -[Illustration: FIG. 68. A pocket cuspidor.] - -[Sidenote: (_2_) By using pocket cuspidors] - -There are other conveniences which can easily be carried in the -pocket, called pocket cuspidors. Some are made of thin cardboard, -treated with paraffin, and filled with cotton to hold all the -moisture of the sputum; others are made of glass, shaped like a -bottle, with a wide mouth. Those made of cardboard should be burned -as soon as possible and the glass ones should be thoroughly washed -with boiling water. - -[Sidenote: (_3_) By having public cuspidors] - -In some cities cuspidors have been placed at the edge of the -sidewalk in an effort to lessen the spread of disease caused by -spitting. These cuspidors have a stream of water running through -them constantly and are connected with the sewer. They are so made -that they cannot easily be kicked over or upset, and they are -placed on stands just high enough to make it easy to spit into -them. If properly made, they are not unsightly. Would it not be a -good thing if your town would put such cuspidors on your streets, -and if the merchants would put them into their stores? Every -office, every workshop, every store, every railway and street car -should be provided with cuspidors. - -[Illustration: FIG. 69. The common drinking cup--a fruitful source -of infection.] - -[Illustration: FIG. 70. The individual drinking cup--each cup clean -and free from disease germs.] - -[Sidenote: How consumption is spread from the lips:] - -We know that the substance which people cough up when they have -consumption contains the germs that cause this disease. When they -spit this matter out, many of the germs stick to the lips. This is -true not only of consumption, but of the germs of other diseases, -such as diphtheria, measles, and scarlet fever. - -[Sidenote: (_1_) By drinking cups] - -When there are disease germs on the lips, it is impossible for a -person to drink and not leave some of the germs sticking to the -edge of the cup or glass. If the germs of disease are in the mouth, -every time that the person suffering from this disease drinks from -a cup, he leaves some of the germs on the edge of it. The next -person to drink from that cup may get the germs into his mouth. - -[Illustration: FIG. 71. A sanitary drinking fountain for public -places.] - -Always avoid drinking from a cup or glass from which another person -has been drinking. You can never tell who may have disease germs in -his mouth, or when you may get them on your lips by drinking from -the same cup. Each individual should have his own cup and should -never let any one else drink from it. - -[Sidenote: (_2_) By putting pencils into the mouth] - -When you put the point of your pencil into your mouth, you will -leave germs on it just as you do on the edge of a cup when you -drink. Never put your pencil into your mouth; never use any other -person's pencil; never trade pencils. - -[Sidenote: (_3_) By the common bite] - -Sometimes we see a child giving his friends a bite of his apple or -candy or cake. Of course when disease germs are in the mouth of the -one who takes a bite, the germs will be left on the apple, candy, -or cake. By no means should a boy or girl be selfish, but if you -have something to share with your friends, break it or cut it into -pieces. Never take into your mouth anything from which another -person has taken a bite. - -[Sidenote: How tubercular cows cause consumption] - -Milk that comes from consumptive cows may contain the germs that -cause tuberculosis. When you drink the milk from such cows, you -take these germs into your body. They find their way from the -stomach and intestine into the blood, and there they travel about -until they find a spot where the cells are dead or are not doing -their work properly. When they find such a place, they settle down -and begin to grow; and the first thing you know, you will have -tuberculosis in that part of your body. Sometimes the germs do not -have to go out of the stomach or intestines to find a favorable -opportunity to take hold and grow. When this happens, we have -consumption of the bowels. - -One cannot tell by looking at milk or by tasting it whether or not -the germs of tuberculosis are present. They do not make the milk -sour; neither do they make it look different from pure milk. - -One cannot tell by looking at a cow whether or not she has -tuberculosis. Sometimes a cow will have tuberculosis and yet look -very healthy. There is, however, a way by which we can tell when a -cow has this disease, no matter how healthy she may look. This is -what is known as the tuberculin test. - -[Sidenote: How to detect tuberculosis in a cow] - -If a little tuberculin is injected under the skin of a cow that has -tuberculosis, it will make her have a fever and appear sick for a -day or two. If she is free from tuberculosis, it will not make her -sick at all. - -It would seem as if all people who sell milk would want to know -whether their cows have consumption so as not to run any risk of -conveying the disease to their customers. Some of them do take this -precaution, but a great many of them do not want to go to this -trouble. Sometimes you will hear them say, "Oh, I do not believe in -this tuberculin test." They do not want to believe in it because -they know that the cows, if tested and found to have tuberculosis, -will have to be killed. - -The reason that dairymen sell us milk from tubercular cows is the -same that makes the man with scarlet fever in his house fail to -tell the health officer about it; the same that makes the butcher -buy and sell meat from diseased cattle; the same that makes some -people absolutely regardless of the welfare of others--it is -selfishness. - - =Questions.= 1. How does a patient give off tuberculosis germs? - 2. Why should even well people refrain from spitting in public? - 3. Why should the sputum be taken care of? 4. Why should we avoid - the common drinking cup? 5. What is the danger from putting - pencils into the mouth? 6. Is it safe to use another person's - pencil? 7. What is the best way of sharing food? 8. How can one - be protected from tubercular milk? - - =Remember.= 1. The sputum and discharges from all sores should - be immediately burned or disposed of in such a way that they - cannot become dry and be blown about as dust. 2. Consumption - may be contracted by the use of the common drinking cup, or by - putting into your mouth such things as pencils and coins. 3. The - milk from a cow suffering from consumption contains the germ of - tuberculosis. 4. A cow may have tuberculosis and not appear to be - sick. 5. The only way to determine whether a cow has tuberculosis - is by using the tuberculin test. 6. Every milch cow should be - tuberculin tested. - - - - -CHAPTER XXXIII - -HOW CONSUMPTION IS CURED - - -[Sidenote: Consumption should be recognized early] - -When people first get consumption, they seldom realize that they -are seriously sick. Most of them think they have a bad cold, or -are overworked, or that they have been staying too closely in the -house. Often they will not even see a doctor until they are so sick -that the doctor cannot do much for them. - -When you have a slight cough that "hangs on"; when you feel -feverish every afternoon; when you are short of breath; when you -get tired very easily; when you do not feel like eating anything -except candies and cakes--then you should think of consumption. -These are not all the signs, but they are enough to make you go at -once to a doctor. - -A long time ago the doctor would have felt badly if he had been -obliged to tell you that you had consumption; but now he knows that -if you go to him early in the disease and follow his directions, -you will get well. - -[Sidenote: How consumption is cured: (_1_) By rest] - -When the doctor finds that a person has consumption, the first -thing he orders is rest. By this he means absolute _rest_. He does -not mean that the patient can go to school or to the office part of -the day and rest the remainder of the day. The doctor will want to -watch him constantly. Then there comes a time when he must begin to -take a little exercise; the doctor tells him just how much exercise -to take, and just what form of exercise is best for him. - -[Sidenote: (_2_) By fresh air] - -The consumptive must have plenty of fresh air all the time; he must -be out-of-doors as much as possible. You will wonder how the doctor -expects him to be out-of-doors when he has been told that he must -have absolute rest. Later we will show you how one can practically -be out-of-doors and yet at the same time be in bed. - -[Sidenote: (_3_) By sunshine] - -Sunshine will kill the germs of any disease more quickly than -almost anything we know of, and a consumptive must have all the -sunshine that he can get. Of course it cannot get into the body to -kill the germs, but it strengthens the cells of the body so much -that they can fight with just that much more energy. - -[Illustration: FIGS. 72 and 73. Living outdoors in cold weather.] - -[Sidenote: (_4_) By nourishing food] - -Nothing is more important than pure food in building up the body -and in making heat and power. In consumption the food that is -stored up in the body burns itself up very fast. The consumptive -must therefore take not only the food needed to supply the usual -demands of the body, but enough to make something extra for the -disease to burn up without drawing on the reserve fund stored in -the body. In order to do this, he will have to eat a great deal, -and what he eats must be of the kind that makes the best building -material and the most nourishing material. He cannot tax his -stomach by eating things that are not nourishing; all the work his -stomach can do must be devoted to the foods he really needs. - -The weapons with which we fight consumption are rest, good food, -fresh air, and sunshine. These will do more good than all the -medicine in the world. Fresh air is not only one of the best things -for the cure of consumption, but it is one of the best things for -the prevention of consumption. You should always breathe plenty of -fresh air night and day, and there is plenty of fresh air to be had -if you will take it. - -[Illustration: FIG. 74. A window tent. (Invented by Dr. W. E. -Walsh.)] - -[Sidenote: How to have fresh air at home:] - -If you have only a single window in your room, try to sleep with -your head in the fresh air. It is not always easy to arrange a room -in such a way that you can have fresh air without placing your bed -in a draft, but even this difficulty can be overcome. - -[Sidenote: (_1_) By window tents] - -There are several devices, called window tents, which you can buy. -By the use of such a tent, your head will be out-of-doors all the -time; yet the draft cannot strike your body, because a part of the -tent fits around your neck and cuts off the air from the rest of -your body. One of these tents is shown in Figure 74. You do not put -your head out of the window; your head is on your pillow just as if -the tent were not there. Your bed is placed directly in front of -the window and the tent comes down over your pillow, allowing your -head practically to be out-of-doors, but keeping the cold air out -of the room. Sleeping under a window tent is the next best thing to -sleeping out-of-doors. - -[Illustration: FIG. 75. A sleeping porch built in a house.] - -[Sidenote: (_2_) By sleeping porches] - -Many of our modern houses are built with sleeping porches on which -one can sleep outdoors summer and winter. Where there is not a -special sleeping porch on the house, an ordinary porch may often be -made to serve the purpose, or a very inexpensive sleeping porch can -be added to the house. - -[Sidenote: (_3_) By tent cots] - -Sometimes people cannot get the use of a porch of any kind. In such -cases it may be possible to put up a tent in the yard. If the yard -is very small, a tent cot may be used. This is simply a cot with -a tent on it, which can be closed up and put away in the daytime -and set up again at night. In a large city where the houses have -no yards at all, this arrangement can be used by setting it up on -the roof of the house. There is almost always some way of securing -fresh air at night if we will only give a little thought to the -matter. - -[Sidenote: Fresh air in schoolrooms] - -Unfortunately, many of our school buildings are not provided with -good ventilating plants. A proper system of ventilation furnishes -at least 1200 cubic feet of fresh air per hour for each child in -each room. - -[Illustration: FIG. 76. An open-air schoolroom for consumptive -children.] - -[Sidenote: The necessity for playgrounds] - -In large cities it is often impossible to find outdoor space in -which boys and girls may play during recess. Even this difficulty -can be overcome by turning the roof of the school building into a -playground, with a high wire netting around it. - -Every school yard should be provided with swings, bars, and -gymnasium apparatus to encourage the children to take plenty of -exercise. Children who live in crowded towns need exercise during -vacation as well as during school days, and the school yards should -be open to them at all times. A summer teacher who shows the -children the best way to exercise, has work fully as important as -that of any other teacher during the school term. - -A sound body is more valuable than education itself, but a good -education and a sound body together are the best assets any man or -woman can have. - - =Questions.= 1. State the four things necessary to cure - consumption; show the value of each. 2. What is the value of - fresh air to every one? 3. How may an abundance of fresh air be - secured in the home? 4. In the school? - - =Remember.= 1. Rest, fresh air, sunshine, and nourishing food - are the cures for consumption. 2. All these things can be - secured in any climate and by every person. 3. =Tuberculosis is - a communicable disease.= 4. =Tuberculosis can be prevented.= 5. - =Tuberculosis can be cured.= - - - - -APPENDIX[4] - -A SUMMARY OF ANATOMY - - -BONES AND JOINTS - -[Sidenote: The framework of the body] - -The framework of the body is composed of bones. There are 206 bones -(not including the teeth) in the body. The bones of the body are -divided into four classes--long bones, short bones, flat bones, and -irregular bones. - -[Sidenote: Construction of bones] - -Regardless of their shape, all bones are composed in the same way. -Every bone has an outer and an inner portion. The outer portion -is a dense layer called _compact bone_. The inner portion is more -open, and is much weaker; this is called _cancellated bone_ (from -_cancella_, a sponge). In the smaller bones, the marrow, which is -quite soft, runs through the spongy bone; in the larger long bones, -the marrow is distinct and is enclosed by the spongy bone. - -[Sidenote: The periosteum] - -Every bone is covered by a thick, tough layer, the _periosteum_, -which has three uses. When the bone is injured by disease or -accident, the periosteum makes new bone to fill in and repair the -break. It also builds new bone on the surface of the old as long as -the body is growing. Finally, the periosteum gives strong and firm -attachment to the muscles, which send tendons into it. - -[Sidenote: Joints] - -Every bone in the body (except the hyoid bone, to which the tongue -is attached) is joined with some other bone. Most of them join with -two or more bones. In most instances the end of a bone which joins -with another is rounded off and made very smooth, so that it can -slide easily over the other bone. There are three principal kinds -of joints in the body. They are called the _ball and socket_ joint, -the _hinge_ joint, and the _serrated_ or _saw-tooth_ joint. - -[Illustration: FIG. 77. The skeleton.] - -[Sidenote: The ball and socket joint] - -The ball and socket joint is one that can move freely in all -directions. We see it illustrated in the joints of the shoulder -and hip. In these joints one of the bones has a deep depression -in it, and this depression forms the _socket_. The other bone has -a rounded head that fits into the depression. We call this rounded -head the _ball_. - -[Illustration: FIG. 78. The structure of a bone.] - -[Sidenote: The hinge joint] - -The hinge joint is illustrated in the knee and elbow joints. These -joints can move backward and forward in one plane like a hinge, but -they cannot move in a circle like the ball and socket joints. You -cannot swing your forearm about on a pivot at the elbow as you can -your whole arm, nor will the knee joint bend in every direction as -does the joint at the hip. - -[Sidenote: Serrated joints] - -Serrated joints do not move. The bones having serrated joints are -fitted tightly together so that they form practically one bone. We -find this kind of joint illustrated in the way the bones of the -skull are put together. - -[Sidenote: Ligaments] - -The joints of the body are not held together by rivets, pins or -bolts as are the joints of a machine, but by bands of very tough -tissue placed about a joint in such a way as to allow it to move -freely, although the bones are all the time held firmly together. -These bands are called _ligaments_. Ligaments are much better than -bolts or pegs would be, because they stretch a little, and thus -prevent the breaking of the bones when the joint is put under a -severe strain. - -[Illustration: FIG. 79. The muscles.] - - -MUSCLES AND TENDONS - -[Sidenote: What muscle is] - -The lean meat of any animal is composed entirely of muscle tissue. -It is the function of the muscles to move the body. - -[Illustration: FIG. 80. The biceps muscle contracted.] - -[Sidenote: How the muscles work] - -The muscles are nearly all attached to the bones. They are just -long enough to let the joint straighten out when the muscles are at -rest, but when the joint bends the muscle contracts. When a muscle -contracts it becomes shorter and thicker. Sometimes it becomes very -much thicker in one place. Every boy knows how much thicker the arm -muscle (_biceps_) becomes when he bends his elbow hard. He calls -this "showing his muscle." - -[Sidenote: Tendons] - -There is not room enough on most of the bones for all the muscles -to be attached directly to them. Instead of being thus attached -directly to the bone, they end in what we call _tendons_. These -tendons are hard and strong, and a very small tendon will lift as -much without breaking as quite a large muscle. The muscles are soft -and would have to be attached over a large area in order to secure -the required strength. The tendons, being so much stronger than -the muscles, can be attached to a very small area and yet secure -the same amount of power as would result from attaching the muscle -itself. - -The tendons pass directly into the periosteum, the thick, strong -covering of the bones. So strong is this attachment that the bone -will often break before the tendon will pull loose. - - -THE SKIN - -[Sidenote: The skin as an armor] - -The entire body is covered with skin, which regulates the heat of -the body and acts as an armor against blows and cuts which would -otherwise injure the delicate nerves and blood vessels beneath. It -also serves to some extent to keep out the germs of disease. The -skin appears to be smooth, but if you examine it through a strong -magnifying glass you will see that it is divided into little areas. -The dividing lines do not run straight, however, and the areas are -not square like those you find on a checkerboard. - -[Illustration: FIG. 81. A section of the skin, highly magnified.] - -[Sidenote: Sweat glands] - -After looking at the skin with a strong magnifying glass you will -think that you must have seen all its irregularities, but if you -will look at it with a powerful microscope you will find out many -other things. In the first place you will see many little openings -in the skin. These little openings make the ridges which divide the -skin into little areas. Some of the openings are _sweat glands_, -and there is always some perspiration coming out of them. When you -are very warm you can see, without the aid of the glass, the drops -of perspiration as they come out on the surface of the skin. When -you are not very warm you cannot see these drops of perspiration, -but they are nevertheless coming out all the time. When the -perspiration comes so slowly that you cannot see it, it is called -_insensible perspiration_. - -[Sidenote: Hair] - -The whole body is covered with hair. You can see the hair on your -head and some of the hair on your arms and the backs of your hands, -but most of the hair on the body is so fine that you cannot see it -without a microscope. Each of the fine hairs on the body has a root -that goes through the skin just as the root from each hair on your -head goes through it. - -[Sidenote: Sebaceous glands] - -Opening into the little pockets in which the hairs stand, are -glands that secrete a kind of oily material. They are called -_sebaceous glands_ or _follicles_. Sometimes these follicles -become stopped up; then the material they secrete becomes thick -and cheesy, and the little black points appear on the skin which -we call _blackheads_. The white matter which comes out of these -blackheads is merely the secretion of the glands from which the -water has been absorbed, leaving the solid or cheesy portion. - -[Sidenote: Nails] - -There is a part of the skin that we do not usually think of as -skin. We mean the _nails_. The finger nails and the toe nails do -not look like the rest of the skin of the body, but they are made -of just the same kind of cells. The cells of the nails are flat, -dead, and closely packed together. There are no sweat glands, or -sebaceous glands, or any hairs in the nails. - - -THE DIGESTIVE SYSTEM - -[Sidenote: The alimentary canal] - -The digestive system is the part of our bodies in which the food we -eat is so changed that it can be made use of by the little cells -in the body. It is composed of a long canal with many parts and -enlargements, each part necessary for a certain required work. This -canal as a whole is called the _alimentary canal_. - -[Sidenote: Teeth] - -The mouth does the first part of the work for the digestive system. -Here we find the teeth, which are used for grinding the food. The -teeth are composed of three parts, the _head_ (or _crown_), the -_neck_ and the _root_. The head, or crown, is very hard. Each -tooth is hollow, and in the hollow portion there are nerves and -blood vessels. - -[Sidenote: The salivary glands] - -Opening into the mouth are three pairs of glands known as _salivary -glands_. One pair of glands is located just above the angle of the -jaw. It is these glands that become swollen when we have mumps. -Another pair of glands is placed just inside the jaw bone, near the -root of the tongue, and the third pair is located under the tongue. -These three pairs of glands secrete the saliva which moistens the -food and aids in digesting the starch. - -[Illustration: FIG. 82. The alimentary canal.] - -[Sidenote: The esophagus] - -The food passes from the mouth; through a passage called the -_esophagus_, or gullet, to the _stomach_. - -[Sidenote: The stomach] - -The stomach is one of the enlarged parts of the alimentary canal. -Its walls are quite thick, and in these walls are thousands of -little glands. These glands secrete a fluid called _gastric juice_. -When the food enters the stomach it is held there for a long time, -and the walls of the stomach squeeze upon it so that the food is -mixed with the gastric juice until every bit of it that will be -of any use to the body has become fluid in character. Not only -does the gastric juice make the food liquid, but it acts on it -and changes some of it so that it will be suitable for use by the -little cells of the body. As fast as the food is made liquid by -the juices of the stomach it is allowed to pass into the intestine -through an opening called the _pyloric opening_. - -[Sidenote: The intestine] - -The intestine is a long, narrow, twisting and turning tube that is -divided into two principal parts, the large and small intestine. In -the walls of the intestine are many little glands that secrete a -fluid that helps in digesting the food. Two fluids, one made by the -liver, the other by the pancreas, are brought into the intestine by -two small tubes, which come together in the wall of the intestine -six or seven inches below the pyloric opening. These fluids perform -a very important part in the digestion of all the different -foodstuffs. - -[Sidenote: Villi and lymphatics] - -Besides the little glands in the walls of the intestine there -are many thousands of little finger-like projections standing up -from the walls. These are called _villi_. Each villus has in it -very small vessels, into which the food passes after it has been -digested. These vessels are of two sorts: blood vessels, which -take up the digested starch and proteid foods, and another sort -known as _lymphatics_, which take up the fats. All the lymphatics -combine into a single vessel which empties into the great vein at -the base of the neck. Thus the fatty foods pass into the blood and -are mingled with the food materials taken up directly by the blood -vessels. - - -CIRCULATION OF THE BLOOD - -[Sidenote: Two kinds of blood vessels] - -There are two kinds of blood vessels in the body. We call them -_arteries_ and _veins_. The arteries serve to carry the blood from -the heart to all parts of the body, and the veins serve to carry -the blood back to the heart. The heart is really a part of the -blood vessels, half of each side being like the veins and half like -the arteries. - -[Sidenote: Arteries and veins] - -The walls of the arteries are thicker than those of the veins. Two -sets of arteries leave the heart, one from each side. The artery -that starts from the right side of the heart goes to the lungs and -carries _venous blood_, which has a very poor supply of oxygen and -is full of impurities. We call this the _pulmonary artery_. The -artery that leaves the left side of the heart goes to all parts of -the body but the lungs and carries _arterial blood_, which has much -more oxygen and is much more free from impurities. - -[Sidenote: Capillaries] - -If we follow the blood as it circulates we will see how it reaches -all parts of the body. The big artery that leaves the left side of -the heart divides into smaller and smaller arteries until there -are branches going to every part of the body. These branches keep -dividing until they are so small that we call them _arterioles_, -and these little arterioles again divide and become so small that -we call them _capillaries_. - -[Sidenote: Changes in the blood] - -While the blood is passing through the arterioles and the -capillaries, something is happening to it. The little cells with -which these small vessels come in contact have been taking the -oxygen and the nourishing material out of the blood. At the same -time they have been putting something into the blood. In place of -the oxygen they have been putting in carbon dioxid and in place -of the nourishing material they have been putting in the worn-out -materials from the cells. As the blood passes through certain parts -of the body, such as the kidneys, the worn-out materials from the -cells are taken out of the blood and sent out of the body. The -carbon dioxid is left in the blood until it goes to the lungs. - -[Illustration: FIG. 83. The white vessels represent the circulation -of the arterial blood; the gray, the circulation of the venous -blood.] - -[Sidenote: Venous blood] - -The blood has now been followed to the capillaries, where oxygen -and nourishing material have been taken out of it, and where -something else has been added to it. As we follow a little -capillary, we find that instead of dividing again, it joins others -and gradually grows larger. As these blood vessels grow larger the -walls do not become so thick as the walls of the arteries of the -same size. These larger vessels formed by the union of capillaries -are called _veins_. In other words, the veins are simply -continuations of the arteries that have divided into extremely -small branches and have now come together again. The blood which -has been changed is now called _venous blood_. It has much less -oxygen in it, but has received a great deal of carbon dioxid. The -veins continue to come together, until finally they form a single -large vein which empties into the upper half of the right side of -the heart. From there the blood is driven into the lower half of -the right side of the heart and thence to the pulmonary artery, -which goes to the lungs. The blood is not changed in the heart, so -what goes into the pulmonary artery is still venous blood. - -[Sidenote: Arterial blood] - -The blood goes straight from the heart to the lungs and there it is -changed into arterial blood. The change consists in taking oxygen -from the air and giving off carbon dioxid to the air. From the -lungs the blood goes through the capillaries again into the veins, -the small capillaries in the lungs uniting to form the pulmonary -veins. These veins finally unite into one vein that empties into -the upper half of the left side of the heart, and from there the -blood goes to the lower half of the same side. The blood has now -reached its starting point and is ready to begin its journey again. -The journey of the blood is as follows: - -[Sidenote: Entire circulation] - -From the right side of the heart to the arteries; from arteries -into arterioles; from arterioles to capillaries; from capillaries -into veins; from veins into the heart; from the heart to the lungs; -and from the lungs back to the heart again. - - -THE RESPIRATORY SYSTEM - -[Sidenote: Use of the respiratory system] - -That portion of the body by which we breathe is called the -respiratory system. This system is composed of the _nasal passage_, -the _pharynx_, the _larynx_, the _trachea_, the _bronchi_, and the -_lungs_. The mouth is not a part of the respiratory system; we -should never breathe through our mouths. - -[Sidenote: The use of the nose in breathing] - -As the air passes through the nasal passage it is warmed and -moistened, and a great deal of dust and dirt is taken out of it. -Thus the nasal passage serves to warm, to moisten, and to clean the -air we breathe, and is a very important part of the respiratory -system, since either cold or dry air is very irritating to the -lungs. - -[Illustration: FIG. 84. The air passages of the head and throat.] - -[Sidenote: Pharynx, larynx, and trachea] - -There is only one tube leading from the back of the nasal passage -to the lungs. Different parts of this tube are given different -names. The pharynx is that part that extends from the back of -the nose to the vocal chords. The larynx is the part of the -throat where the vocal chords are located. We sometimes call it -the "Adam's apple." It is very prominent in some men, but seldom -noticeable in women. The trachea is the part of the tube leading -down from the larynx. At the lower end of the trachea the tube -divides into two parts that we call the bronchi, one leading to -each lung. - -[Sidenote: The bronchi] - -The bronchi carry the air from the trachea to the lungs. They -divide again and again until they become so small that there is a -branch for each little air cell in the lungs. - -[Illustration: FIG. 85. The lungs.] - -[Sidenote: The lungs] - -The lungs are the most important part of the respiratory system. -They are made up of lobes. There are two lobes in the left lung -and three in the right. Each lobe is divided into _lobules_, which -means small lobes. Each lobule is divided into air spaces. In these -air spaces, or cells, the work of the lungs is performed. - -[Sidenote: Air cells] - -The capillaries run in the thin walls of the air spaces. The walls -of these fine blood vessels are so very thin that the air in the -air cells comes in almost direct contact with the blood in the -vessels. While the blood is passing through the vessels in the -walls of the air spaces, something happens to both the blood and -the air. The air we take into our lungs contains a great deal of -oxygen and very little carbon dioxid. The air that comes out of our -lungs contains a great deal of carbon dioxid and much less oxygen. -In other words, the oxygen from the air goes into the blood, and -the carbon dioxid from the blood goes out into the air. - -[Sidenote: Necessity of pure air] - -If the air we breathe is not pure and does not contain enough -oxygen, the blood cannot get all the oxygen we need, and the cells -of the body become sick and die. If, when we breathe, we do not -fill each little air cell in our lungs with air, a great deal of -the blood sent to the lungs for oxygen cannot get it. If we wear -very tight clothing we cannot take a full breath and hence cannot -fill all the air spaces with air. If the air spaces in the lungs -are not filled, the blood does not get the oxygen it needs, as -there is no other place in the body to get it. - - -THE EYE AND THE EAR - -[Sidenote: The eye compared to a camera] - -The eye is one of the most important organs in the body and also -one of the most delicate. It is very much like a camera. - -[Sidenote: The cornea and the sclera] - -When you look at an eye you are likely to think that the front of -it is blue or brown. The colored part is not the front of the eye. -If you look at the eye from the side you will see that there is a -curved part in front of the colored part and that the curved part -is perfectly clear. This curved clear part of the eye we call the -_cornea_. The cornea connects with the white part of the eye, and -this white part extends all around the rest of the eye, except at a -small point in the back where the _optic nerve_ comes through. This -white part we call the _sclera_. - -[Sidenote: Aqueous humor] - -The space between the cornea and the colored part of the eye is -filled with a clear fluid that is called the _aqueous humor_, which -means watery fluid. The space occupied by this fluid is called the -_anterior chamber_ of the eye. - -[Sidenote: The iris] - -The iris, which is the colored portion of the eye, is a curtain -that is hung between the anterior and posterior chambers of the -eye. It prevents any light getting into the posterior chamber -except that which passes through a round hole in the iris called -the _pupil_. The pupil grows larger or smaller according to the -amount of light needed by the eye. If you look away from a bright -light at something in the dark, the pupil grows larger; if you -look back at the light, it grows smaller. You can see this in a -hand mirror. - -[Sidenote: Lens] - -Behind the pupil is a clear mass shaped like a very strong -magnifying glass. This is the _lens_. The lens causes to be formed -on the back of the eye a clear picture of whatever you are looking -at. When you focus a camera, you move the back towards or away from -the lens. When you focus your eye you cannot move the back of the -eye, but you can make the lens more or less convex as may be needed -to make a clear picture. - -[Illustration: FIG. 86. A cross-section of the eye.] - -[Sidenote: Vitreous humor] - -Behind the iris and the lens, we find the posterior chamber of -the eye. This occupies by far the greater portion of the ball -and corresponds to the dark chamber of a camera. This chamber is -filled with a clear fluid called the _vitreous humor_, which means -jelly-like fluid. It is a clear, gelatinous substance. - -[Sidenote: The retina and the optic nerve] - -The optic nerve enters the eyeball from the back and spreads -its fibers out in a thin membrane called the _retina_, which -corresponds to the sensitive plate in a camera. The lens focuses on -the retina the image of any object you look at. The impression made -on the minute nerve endings in the retina is carried by the optic -nerve fibers to the brain. When this impression reaches the brain -we see the object. - -[Sidenote: Movements of the eye] - -Each eye has six muscles that turn it in whatever direction you -want to look. These muscles are very delicate, and for true -sight they must be exactly adjusted. If the muscles on one side -of the eye are stronger than those on the other side, you will -be cross-eyed or wall-eyed. If one of the muscles in one eye is -stronger than the corresponding muscle in the other eye, it pulls -the eyeball out of place and you "see double." - -[Sidenote: The use of the outer ear] - -The portion of the ear that you see on the side of your head has as -much to do with hearing as the outer rim of the horn into which you -speak has to do with making a record for the phonograph. You know -that the record is really made at the little end of the horn, while -the big end simply collects the sound. The outside portion of the -ear simply collects sounds, and the real hearing is done with the -portion of the ear that is not seen. - -[Illustration: FIG. 87. The ear, showing the outer, middle, and the -inner part.] - -The outer ear connects with the short tube that leads to the -_drum_, which is a thin membrane that separates the middle ear from -the outer ear. This drum does not have so much to do with hearing -as is supposed. To have a hole in the drum does not mean that you -cannot hear. - -[Sidenote: The middle ear] - -The middle ear is that portion which is just inside the drum. In -this we find a chain of little bones. The one attached to the -drum is shaped much like a hammer, and is called the _malleus_, -which means mallet or hammer. The next one is shaped like an anvil -and is called _incus_, which means anvil, and the third is called -_stapes_, which means stirrup. The flat part of the stapes fits -into a small opening that leads to the internal ear. - -[Sidenote: The inner ear] - -The internal ear is shaped like a snail shell. It makes several -turns, which are hollow like the ends of a conch shell. In these -channels the nerve that receives the impressions made by the sounds -is distributed. This nerve carries the impressions to the brain. - -[Illustration: FIG. 88. The nervous system.] - - -THE NERVOUS SYSTEM - -[Sidenote: Importance of the nervous system] - -This system is so important in its use and so difficult to -understand in its details, that a description of it should have -more space than can be given in this summary. Can you imagine -having no feeling and being unable to move? This would be your -condition if you had no nerves. - -[Sidenote: Nerves compared to telegraph system] - -Briefly, the nerves might be called the telegraph system of the -body. There is a great central station called the brain where -messages are received and sent out; there are many sub-stations -that make up the spinal cord. Twelve great nerves pass directly -from the brain to the body; all others pass from the spinal cord. - -[Sidenote: Extent of nervous system] - -Every nerve leaving these centres divides and sub-divides into -little threads as the arteries divide and sub-divide into -arterioles and capillaries, until every part of the body--every -muscle and part of the skin--has its nerve. - -[Sidenote: Voluntary and reflex action] - -Every time you _choose_ to move your hand, your brain sends to the -necessary muscles an instantaneous order to act. This is called -_voluntary action_. If you put your finger against a hot stove -you jerk it away before you could have time to _choose_ to do it. -This happens as an order from a sub-station and is called _reflex -action_. - -Messages travel both ways and it is necessary that the nervous -connection with every part of the body remain unbroken, and -important that the nervous condition be kept healthy. - - - - -NOTES TO THE TEACHER - - -A false delicacy has often prevented the teaching of vital lessons -to growing children. The day is how at hand when foolish sentiment -must no longer prevent the spread of any knowledge which is -necessary to exterminate the plagues that have afflicted the race. - -In chapters 17, 18, 19 and 32, unpleasant facts are given in plain -language. They are facts that parents do not teach their children -and that most teachers will not frankly treat with classes in a -school. Though they are disagreeable to discuss, they are essential -for children of school age to know. Now that the dependence of -public health upon personal hygiene is recognized, personal habits -and sanitary conditions are more frankly dealt with than formerly. - -It is an excellent thing occasionally, to have one or two points of -an assigned lesson answered in writing. Any topic that the teacher -may think advisable to treat in this manner may be discussed on -paper at the beginning of the recitation, five or six minutes being -allowed for that purpose. Even a whole chapter may be assigned to -be studied with a view of answering in writing the questions at the -end of the chapter. The written test can then take the place of the -usual oral recitation. This method is suggested to the teacher who -hesitates to discuss orally certain plain but essential facts. - -Chapter 32 on the Spread and Prevention of Consumption can be -treated with best results orally, if the pupils are first made -to _feel_ the great danger of consumption and to realize the -possibility of preventing the vast havoc wrought by that dread -disease. The attitude of teacher and pupils should be that while -the discussion may be disagreeable, the disgusting habits referred -to in the text are so commonly practised that unless their dangers -are taught this disease can never be wiped out. - - - - -INDEX - - - Adenoids, 49, 50 - - Air, amount necessary for health, 45; - effects of impure, 45-48; - fresh air, when needed, 45-48; - how secured, 46, 47; - how changed in body, 45; - necessity of pure air, 45-48 - - Air cells, 175 - - Alcohol, effect of, on body, 67-70; - on brain work, 70; - on consumptives, 69; - on descendants, 69; - on liver, 68; - on morals, 69; - on nervous system, 69; - on powers of resistance, 68; - on stomach, 67; - false ideas about effects of, 67; - what business men think of, 70 - - Alimentary canal, 169, 170 - - Amoebic dysentery, how prevented, 122; - how spread, 122; - where prevalent, 122 - - Animals free from typhoid fever, 113 - - Antitoxin, how it acts, 108-110; - how discovered, 109; - sometimes considered a poison, 111; - prevents diphtheria, 110; - saves lives, 110 - - Aqueous humor, 177 - - Arterial blood, 172 - - Arteries, 171 - - Articles used by the sick, dangers from, 75; - how to treat, 76 - - - Bathing, importance of, 60; - frequency of, 60 - - Baths, hot, 61; - cold, 61 - - Bedtime for children, 51 - - Blood, arterial, 172; - how changed in the body, 174; - venous, 171, 172 - - Boils, how caused, 95, 99 - - Bones, 163 - - Bronchi, 175 - - Building foods, 14, 15 - - - Candy, when harmful, 54; - when not harmful, 54 - - Canned meats, why poisonous, 32 - - Capillaries, 172 - - Cells, are alive, 6; - body made of, 6; - body needs new, 14; - how killed, 7; - must not be killed, 6; - size of a, 5; - what they are like, 5 - - Circulation of the blood, 171-174 - - Clothing, effect of damp, 11; - promotes health, 9; - proper weight of, 10 - - Common drinking cup, 153 - - Consumption. _See Tuberculosis_ - - Cooking, effects of improper, 34, 35; - fatty foods, 34; - meats, 35; - starchy foods, 34 - - Cornea, 177 - - Coughing, dangers from, 147, 150-153; - how to prevent dangers from, 152, 153 - - Cuspidors, in public buildings, 152; - pocket, 152; - street, 152 - - - Dairy, sickness about a, 26, 103, 115 - - Decomposed foods dangerous, 30, 32 - - Decomposition, cause of, 30; - effect of cold on, 31; - of foods, 30-32 - - Desserts, when harmful, 40; - when not harmful, 40 - - Dining table, effect of dirty, 37; - cheerfulness at, 37 - - Diphtheria, cure of, 108-111; - germs present after recovery, 101, 102; - germs present when throat is not sore, 104; - how to confine germs, 100; - how poison is fought, 108-110; - mild cases, how detected, 104; - nature of the poison, 108; - prevalence of, 100; - where germs come from, 100; - why some cases are not quarantined, 102-104 - - Dirt, a cause of sickness, 77, 78; - getting into milk from cows, 23, 117; - from cow barns, 23-25; - from milk cans and bottles, 26, 27; - from milkmen, 25; - from flies, 28, 80, 81 - - Diseased animals, effect on meats, 19-21; - effect on milk, 28; - tuberculosis from, 28, 155 - - Drafts, evil effects of, 10; - how to prevent harm from, 10 - - - Ear, care of, 58; - drum, 179; - inner ear, 181; - middle ear, 179; - outer ear, 179 - - Esophagus, 170 - - Excreta from sick, how dispose of, 76, 118 - - Exercise, necessity of, 51, 161 - - Eye, how germs get into, 56; - how overworked, 57; - method of testing, 58 - - - Far sight, 58 - - Flies, breeding places for, 77, 80; - as germ carriers, 80, 81, 116; - how to get rid of, 82, 83; - how to keep out, 83 - - Fly screens, where needed, 83 - - Foods, advertised, 16; - building, 14-16; - decomposition of, 30-32; - heat-producing, 14-16; - improper cooking of, 34, 35; - cost of suitable, 16; - uses of foods, 14-17; - uses of starches, 14; - uses of fats, 15; - value of meat as a, 15; - value of milk as a, 14 - - - Garbage cans, should be covered, 83 - - Germs, cause of poison in meats, 31, 32; - carried by dogs and cats, 106; - effect of, in wounds, 95-99; - how, get through the skin, 95; - how, get into the body, 79; - how, get into foods, 79, 80; - how put into the air, 147, 150; - how kept out of the air, 151, 152; - how to fight, 74; - of lockjaw, 98; - man's greatest foe, 1; - nature of a, 73; - not alike, 73; - not killed by running water, 115 - - - Hair, 169 - - Hearing, how tested, 58 - - Heat, how kept up in the body, 14 - - Hookworm disease, character of the worm, 120; - how it enters the body, 121; - how prevented, 122; - nature of the disease, 121; - where worm lives in the body, 121; - where prevalent, 122 - - - Insects that carry disease, 92-94 - - Intestines, 171 - - Iris, 177 - - - Joints, 163 - - - Larynx, 174, 175 - - Lens, the, 178 - - Ligaments, 165 - - Lungs, 175 - - Lymphatics, 171 - - - Malaria, how transmitted, 92; - how prevented, 93 - - Manure, a hatching place for flies, 80, 82; - how to dispose of, 82 - - Meal times, frequency of, 53; - regularity of, 53; - should be pleasant, 37, 38 - - Measles, after effects of, 128; - fatality of, 128; - necessity of care in, 129; - seriousness of, 128; - why to avoid, 128 - - Meats, characteristics of good, 18; - Clean Meat League, 19; - from diseased animals, 19-21; - germs cause poison in, 19, 32; - how kept clean, 18; - should be cooked, 35; - value of, as a food, 18 - - Milk, as carrier of disease, 22, 117; - effect of germs on, 22; - effect of disease in cow on, 28; - flies in, 28; - how germs get into, 23-28; - impure, dangerous, 22; - polluted water in, 27; - typhoid fever carried by, 117; - value of, as a food, 14, 20 - - Mosquitoes, as disease carriers, 92, 93; - how to get rid of, 94 - - Mouth, why some breathe through, 49 - - Mouth-breathing, effect of, 50 - - Muscles, attachment of, 167 - - - Nails, how to care for, 61, 62 - - Near sight, 57 - - Nerves, compared to telegraph system, 181; - distribution of, 181 - - Nose, importance of breathing through, 48 - - - Overcoats, necessity of, 12 - - Overwork, effect of, 51, 52 - - - Paper napkins for consumptives, 152 - - Parties, time for, 53 - - Pencils in mouth, 155 - - Pharynx, 175 - - Play a form of work, 52 - - Playgrounds, 161 - - Pocket cuspidors, 152 - - Ptomaines, 19 - - - Quarantine, breaking, shows selfishness, 126; - how broken by family, 105; - rules of, 105; - seriousness of breaking, 101; - when safe to raise, 102; - why necessary, 101; - why some cases escape, 102-104 - - - Reflex action, 181 - - Respiratory system, 174-177 - - Rest, proper amount of, 51 - - Retina, 178 - - Rocky Mountain Spotted (Tick) Fever, how transmitted, 94 - - Rubbers, necessity of wearing, 11 - - - Saliva, effect of, on starches, 39, 41 - - Salivary glands, 170 - - Scarlet fever, a dangerous disease, 124; - mild cases dangerous, 123, 124 - - Scarlatina, 125 - - Scarlet rash, why quarantine is necessary in, 125 - - School lunches, 37 - - Sclera, 177 - - Sebaceous glands, 169 - - Sewage, effect of, on water, 85-87, 115 - - Sickness about a dairy, 26, 103, 115; - due to germs, how prevented, 3 - - Sick room, stay away from, 75 - - Skin, care of, 60, 61 - - Smallpox, fatality of, 131; - how prevented, 135-137; - during Franco-Prussian War, 132; - in Sweden, 133; - in Gloucester, 134; - in the Philippine Islands, 134 - - Spitting, dangers from, 151; - how avoided, 152; - where to spit, 152, 153; - where not to spit, 151 - - Springs, how polluted, 87 - - Street cuspidors, 152 - - Sunshine, effect of, on germs, 77, 78 - - Suppuration, how the surgeon prevents, 96; - how you may prevent, 97; - real cause of, 96 - - Sweat glands, the work of, 60 - - - Teeth, brittle, 42; - dangers from poor, 41-43; - how to care for, 43; - necessity of baby teeth, 41; - uses of teeth, 41; - why, decay, 42 - - Tendons, 167 - - Tobacco, a poison, 64; - effect of, on blood, 65; - on heart, 66; - on nervous system, 66; - on nose and throat, 65; - on stomach, 66; - extra work caused by, 64 - - Toilets, improper construction of, 86; - proper construction of, 87; - relation to wells, 85-87 - - Tonsils, 49, 50 - - Trachea, 175 - - Tuberculin test, 155, 156 - - Tuberculosis, can be prevented, 142, 148, 157; - fatality of, 142; - fresh air in, 157, 158; - germ, discovery of the, 145; - how to get, out of a house, 147, 148; - how germs leave the body, 150, 151; - how spread from cows, 28, 155; - how spread from the lips, 153-155; - how detected in cows, 155; - a house disease, 146, 147; - not inherited, 146; - of the glands, 144; - of the joints, 143; - of the spine, 144; - of the stomach, 144; - of the throat, 143; - prevalence of, 142; - pure food in, 158; - rest in, 157; - should be recognized early, 157; - sunshine in, 158; - why called the Great White Plague, 142 - - Typhoid fever, animals free from, 113; - carried by flies, 80, 81, 116; - carried by milk, 22, 117; - effect of a single case, 114; - how germs leave the body, 113; - how germs get into the body, 113; - how germs get into water, 114; - importance of cleanliness, 117, 118; - life of germs in a stream, 115; - recovered patient dangerous, 117 - - - Umbrellas, necessity of, 11 - - - Vaccination, cause of sore arms after, 140, 141; - discovery of, 132; - how, prevents smallpox, 135; - necessity of repeating, 137; - pretended vaccination, 138; - when successful, 138 - - Ventilation, in homes, 46, 159; - in public buildings, 48, 161; - in workshops, 48 - - Veins, 171 - - Venous blood, 171, 172 - - Villi, 171 - - Vitreous humor, 178 - - Voluntary action, 181 - - - Water, avoid polluting, 85-88, 115; - effect of sewage on, 85, 115; - how germs get into, 85-88; - polluted, in milk, 27; - safe sources of, 88 - - Wells, how polluted, 86, 87; - relation of toilets to, 86, 87 - - Windows, should be kept open, 45-47; - should be screened, 83 - - Wood-ticks, as disease carriers, 93; - how abolished, 94 - - Wounds, importance of keeping clean, 97 - - - Yards should be clean, 77 - - Yellow fever, how transmitted, 92; - how prevented, 92 - - - - -FOOTNOTES: - -[1] Bujar and Baier state that the nourishing power of bacon is -represented by 2,767, while the nourishing power of butter is -represented by 2,610. - -[2] The cleaning out of these cemented vaults is an exceedingly -unpleasant task. Some prefer to have a strong, water-tight box -placed under the closet seats. When this box is nearly full, it -can be removed to some place where fertilizer is needed, and there -emptied, the contents being plowed into the ground. In order to -make this task as simple as possible, it is a good plan to put the -box on skids, and have a heavy strip in one end with a bolt and -ring through it, so that a horse can be hitched to the box to draw -it away. If a little dry earth or lime is put into the box each -day, there will be no unpleasant odor. - -[3] The teacher should demonstrate the action of acids and alkalies -on a solution of litmus. - -[4] At the request of many practical teachers the author has -appended this brief summary of anatomy. The material is intended to -be used for reference or to be assigned as lessons in connection -with the chapters of the book, at the discretion of the teacher. - - - - - - -End of Project Gutenberg's Principles of Public Health, by Thos. D. 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