PART II.
HYGIENE.
CHAPTER I.
HYGIENE DEFINED.--PURE AIR.
The object of hygiene is the _preservation of health_. Hitherto, we have considered, at some length, the science of functions, or _Physiology_, and now, under the head of _Hygiene_, we will give an outline of the means of maintaining the functional integrity of the system. It is difficult to avoid including under this head Preventive Medicine, the special province of which is to abate, remove, or destroy the many causes of disease.
The Greeks bestowed divine honors upon Aesculapius, because he remedied the evils of mankind and healed the sick. The word hygiene is derived from Hygeia, the name of the Greek goddess of health. As male and female are made one in wedlock, so Medicine and Hygiene, restoration and preservation, are inseparably united.
Hygiene inculcates sanitary discipline, medicine, remedial discipline; hygiene prescribes healthful agencies, medical theory and practice, medicinal agencies; hygiene ministers with salubrious and salutary agents, medicine assuages with rectifying properties and qualities; hygiene upholds and sustains, medical practice corrects and heals; the one is preservative and conservative, the other curative and restorative. These discriminations are as radical as health and sickness, as distinct as physiology and pathology, and to confound them is as unnatural as to look for the beauties of health in the chamber of sickness.
The true physician brings to his aid Physiology, Hygiene, and Medicine, and combines the science of the former with the art of the latter, that restoration may be made permanent, and the health preserved by the aid of hygiene. But when any one makes Hygiene exclusively the physician, or deals wholly in hygienic regulations with little respect for physiology, or lavishly advertises with hygienic prefixes, we may at once consider it a display, not of genuine scientific knowledge, but only of the ignorance of a quack. Some of the modern twaddle about health is a conglomeration of the poorest kind of trash, expressing and inculcating more errors and whims than it does common sense. Many persons dilate upon these subjects with amazing flippancy, their mission seeming to be to traduce the profession rather than to act as help-mates and assistants. We do not believe that there is any real argument going on between the educated members of the medical profession but rather that the senseless clamor we occasionally hear comes only from the stampede of some routed, demoralized company of quacks.
In the following pages we shall introduce to the reader's attention several important hygienic subjects, although there are many more that ought to receive special notice. Such as we do mention, demand universal attention, because a disregard of the conditions which we shall enumerate, is fraught with great danger. Our lives are lengthened or shortened by the observance or neglect of the rules of common sense, and these do not require any great personal sacrifice, or the practice of absurd precautions.
PURE AIR FOR RESPIRATION.
Ordinary atmospheric air contains nearly 2,100 parts of oxygen and 7,900 of nitrogen, and about three parts of carbonic acid, in 10,000 parts; expired air contains about 470 parts of carbonic acid, and only between 1500 and 1600 parts of oxygen, while the quantity of nitrogen undergoes little or no alteration. Thus air which has been breathed has lost about five per cent. of oxygen and has gained nearly five per cent. of carbonic acid. In addition the expired air contains a greater or less quantity of highly decomposable animal matter, and, however dry the atmospheric air may be, the expired air is always saturated with watery vapor, and, no matter what the temperature of the external air may be, that of the exhaled air is always nearly as warm as the blood. An adult man on a average breathes about sixteen times in a minute and at every inspiration takes in about thirty cubic inches of air, and at every expiration exhales about the same amount. Hence, it follows that about 16-2/3 cubic feet of air are passed through the lungs of an adult man every hour, and deprived of oxygen and charged with carbonic acid to the amount of nearly five per cent. The more nearly the composition of the external air approaches that of the expired air, the slower will be the diffusion of carbonic acid outwards and of oxygen inwards, and the more charged with carbonic acid and deficient in oxygen will the blood in the lungs become. Asphyxia takes place whenever the proportion of carbonic acid in the external air reaches ten per cent., providing the oxygen is diminished in like proportion, and it does not matter whether this condition of the external air is produced by shutting out fresh air from a room or by increasing the number of persons who are consuming the same air; or by permitting the air to be deprived of oxygen by combustion by a fire. A deficiency of oxygen and an accumulation of carbonic acid in the atmosphere, produce injurious effects, however, long before the asphyxiating point is attained. Headache, drowsiness, and uneasiness occur when less than one per cent. of the oxygen of the atmosphere is replaced by other matters, and the constant breathing of such an atmosphere lowers vitality and predisposes to disease.
Therefore, every human being should be supplied, by proper ventilation, with a sufficient supply of fresh air. Every adult individual ought to have at least 800 cubic feet of air-space to himself, and this space ought to communicate freely with the external atmosphere by means of direct or indirect channels. Hence, a sleeping-room for one adult person should not be less than nine by ten feet in breadth and length and nine feet in height. What occurred in the Black Hole at Calcutta is an excellent illustration of the effect of vitiated air. One hundred and forty-six Englishmen were confined in a room eighteen feet square, with two small windows on one side to admit air. Ten hours after their imprisonment, only twenty-three were alive.
VENTILATION OF SCHOOL ROOMS. The depression and faintness from which many students suffer, after being confined in a poorly ventilated school room, is clearly traceable to vitiated air, while the evil is often ascribed to excessive mental exertion. The effect of ventilation upon the health of students is a subject of universal interest to parents and educators, and at present is receiving the marked attention of school authorities. Dr. F. Windsor, of Winchester, Mass., made a few pertinent remarks upon this subject in the annual report of the State Board of Health, of Massachusetts, 1874. One of the institutions, which was spoken of in the report of 1873, as a _model_, in the warming and ventilation of which much care had been bestowed, was visited in December, 1873. He reports as follows: "I visited several of the rooms, and found the air in all, offensive to the smell, the odor being such as one would imagine old boots, dirty clothes, and perspiration would make if boiled down together;" again, in the new _model_ school-house the hot air enters at two registers in the floor on one side, and makes (or is supposed to make) its exit by a ventilator at the floor, on the other side of the room." The master said "_the air was supposed to have some degree of intelligence, and to know that the ventilator was its proper exit_." Thorough ventilation has been neglected by many school officials on account of the increased expense it causes. In our climate, during seven months at least, pure atmospheric air must be paid for. The construction of vertical ducts, the extra amount of fuel, and the attendant expenditures are the objections which, in the opinion of many persons, outweigh the health and happiness of the future generation. It is necessary for the proper ventilation of our school rooms that an adequate supply of fresh air should be admitted, which should be warmed before being admitted to the room, and which should be discharged as contaminated, after its expiration. The proper ventilation of the school room consists in the warming and introduction of fresh air from without, and the discharge of the expired and unwholesome air from within. This may be accomplished by means of doors, windows, chimneys, and finally by ventilators placed, one near the level of the floor, and the other near the ceiling of the room. The ventilators ought to be arranged on the opposite sides of the room, in order to insure a current, and an abundant supply of air. When trustees and patrons realize that pure air is absolutely essential to health, and that their children are being slowly poisoned by the foul air of school rooms, then they will construct our halls of learning with a due regard for the laws of hygiene, and students will not droop under their tasks on account of the absence of Nature's most bountiful gift, _pure air_.
VENTILATION OF FACTORIES AND WORKSHOPS. This is a subject which demands the immediate attention of manufacturers and employers. The odors of oil, coal gas, and animal products, render the air foul and stagnant, and often give rise to violent diseases among the operatives. From two to four hundred persons are often confined in workshops six hundred feet long, with no means of ventilation except windows _on one side only_.
The air is breathed and re-breathed, until the operatives complain of languor and headache, which they attribute to overwork. The _real_ cause of the headache is the inhalation of foul air at every expansion of the lungs. If the proprietors would provide efficient means for ventilating their workshops, the cost of construction would be repaid with compound interest, in the better health of their operatives and the consequent increase of labor. Our manufacturers must learn and practice the great principle of political economy, namely, that the interests of the laborer and employer are mutual.
VENTILATION OF OUR DWELLINGS. Not less important is the ventilation of our dwellings; each apartment should be provided with some channel for the escape of the noxious vapors constantly accumulating. Most of the tenements occupied by the poor of our cities are literally dens of poison. Their children inhale disease with their earliest breath. What wonder that our streets are filled with squalid, wan-visaged children!
Charity, indeed, visits these miserable homes, bringing garments and food to their half-famished inmates; but she has been slow to learn that fresh air is just as essential to life as food or clothing. Care should be taken by the public authorities of every city, that its tenement houses do not degenerate into foul hovels, like those of the poor English laborer, so graphically portrayed by Dickens. But ill-ventilated rooms are not found exclusively in the abodes of the poor. True, in the homes of luxury, the effect of vitiated air is modified by food, etc.
Men of wealth give far more attention to the architecture and adornment of their houses, to costly decorations and expensive furniture, than to proper ventilation. Farmers, too, are careless in the construction of their cottages. Their dwellings are often built, for convenience, in too close proximity to the barn. Because they do not construct a suitable sewer or drain, the filth and refuse food is thrown out of the back door, where it accumulates and undergoes putrefaction; the vitiated air penetrates the interior of the house, and, there being no means of ventilation, it remains to be breathed by the occupants. The result is, that for the sake of saving a few dollars, which ought to be expended in the construction of necessary flues and sewers, the farmer often sees the child he prizes far more than his broad acres gradually decline, or suddenly fall a victim to fevers or malignant disease. Parents, make your homes healthy, let in the pure, fresh air and bright sunlight, so that your conscience may never upbraid you with being neglectful of the health and lives of your little ones.
SITE FOR HOMES.
MALARIA. When about to construct our residences, besides securing proper ventilation and adequate drainage, we ought to select the location for a home on dry soil. Low levels, damp surroundings, and marshy localities not only breed malaria and fevers, but are a prolific cause of colds, coughs, and consumption. Care should be taken not to locate a dwelling where the natural currents of air, or high winds, will be likely to bring the poison of decayed vegetable matter from low lands. Certain brooks, boggy land, ponds, foggy localities, too much shade, all these are favorable to the development of disease. Then the walls of a building should be so constructed as to admit air between the exterior and interior surfaces, otherwise the interior of the house will be damp and unwholesome. In the dead of winter in northern latitudes the house ought to be kept slightly tempered with warmth, both night and day, a condition very favorable to the introduction and change of atmospheric currents. The invigorating tendencies of a dry, pure atmosphere are remarkably beneficial, while air charged with moisture and decay is exceedingly baneful, introducing diseases under various forms.
Neither should the dwelling be shaded by dense foliage. The dampness of the leaves tends to attract malaria. Trees growing a little distance from the house, however, obstruct the transmission of unhealthy vapors arising beyond them. Malaria generally lurks near the surface of the earth, and seems to be more abundant in the night time. Persons sleeping in the upper story of a house may escape its morbid influence, while those occupying apartments on the lower floor, become affected.
DAMP CELLARS.
Damp cellars, under residences, are a fruitful cause of disease. Dr.
Sanford B. Hunt, in an article in the _Newark Daily Advertiser_, speaking of the recent epidemic of diphtheria in New York City, says:
"Pestilences that come bodily, like cholera, are faced and beaten by sanitary measures. Those which come more subtly need for their defeat only a higher detective ability and a closer study of causes, many of which are known, but hidden under the cellars of our houses, and which at last are only preventable by public authority and at public expense in letting out the imprisoned dampness which saturates the earth on which our dwellings are built. Where wood rots, men decay. This is clearly shown in the sanitary map printed in the _Times_. In the great district surrounding Central Park, and which participates in its drainage system, there are no cases. On the whole line of Fifth Avenue there are none. The exempt districts are clearly defined by the character of the soil, drainage, and sewerage, and by the topography, which either has natural or artificial drainage, but most of which is so dry that only surface-water and house-filth--which does not exist in those palaces--can affect the health of the residents. But in the tenement houses and on the made lands where running streams have been filled in and natural springs choked up by earth fillings, diphtheria finds a nidus in which to develop itself. The sanitary map coincides precisely with the topographic map made by Gen. Viele. Where he locates buried springs and water-courses, there we find the plague spots of diphtheria and in the same places, on previous maps prepared by the Board of Health, we find other low types and stealthy diseases, such as typhoid and irruptive fevers, and there we shall find them again when the summer and autumnal pestilences have yielded place to those which belong to the indoor poisoned air in the winter. The experience of other cities, notably London and Dublin, once plague spots and now as healthy as any spot on earth, proves that most of the causations of disease are within the control of the competent sanitary engineer, even in localities crowded beyond American knowledge, and houses built upon soil saturated for centuries with the offal of successive and uncleanly generations. Wet earth, kept wet by the boiling up of imprisoned springs, is a focus of disease. Dry earth is one of the most perfect deodorizers, the best of oxydizers and absorbents, destroying the germs of disease with wonderful certainty. On those two facts rests the theory of public hygiene."
DUST AND DISEASE.
The air we breathe is heavily loaded with minute particles of floating dust, their presence being revealed only by intense local illumination.
Professor Tyndall says: "solar light, in passing through a dark room, reveals its track by illuminating the dust floating in the air. 'The sun,' says Daniel Culverwell, 'discovers atoms, though they be invisible by candle-light, and makes them dance naked in his beams.'"
After giving the details and results of a series of experiments in which he attempted to extract the dust from the air of the Royal Institute by passing it through a tube containing fragments of glass wetted with concentrated sulphuric acid, and thence through a second tube containing fragments of marble wetted with a strong solution of caustic potash, which experiments were attended with perfect failure, the Professor continues, "I tried to intercept this floating matter in various ways; and on the day just mentioned, prior to sending the air through the drying apparatus, I carefully permitted it to pass over the tip of a spirit-lamp flame. The floating matter no longer appeared, having been burnt up by the flame. It was, therefore, of _organic origin_. I was by no means prepared for this result; for I had thought that the dust of our air was, in great part, inorganic and non-combustile." In a foot note he says, "according to an analysis kindly furnished me by Dr.
Percy, the dust collected _from the walls_ of the British Museum contains fully fifty per cent of inorganic matter. I have every confidence in the results of this distinguished chemist; they show that the _floating_ dust of our rooms is, as it were, winnowed from the heavier matter." Again he says: "the air of our London rooms is loaded with this organic dust, nor is the country air free from its presence.
However ordinary daylight may permit it to disguise itself, a sufficiently powerful beam causes dust suspended in air to appear almost as a semi-solid. Nobody could, in the first instance, without repugnance, place the mouth at the illuminated focus of the electric beam and inhale the thickly-massed dust revealed there. Nor is the repugnance abolished by the reflection that, although we do not see the floating particles, we are taking them into our lungs every hour and minute of our lives." "The notion was expressed by Kircher and favored by Linnaeus, that epidemic diseases are due to germs which float in the atmosphere, enter the body, and produce disturbance by the development within the body of parasitic life. While it was struggling against great odds, this theory found an expounder and a defender in the President of this institution. At a time when most of his medical brethren considered it a wild dream, Sir Henry Holland contended that some form of the germ-theory was probably true." Professor Tyndall proposes means by the application of which air loaded with noxious particles may be freed from them before entering the air passages. The following embodies his suggestions on this point:
COTTON-WOOL RESPIRATOR.
"I now empty my lungs as perfectly as possible, and placing a handful of cotton-wool against my mouth and nostrils, inhale through it. There is no difficulty in thus filling the lungs with air. On expiring this air through a glass tube, its freedom from floating matter is at once manifest. From the very beginning of the act of expiration the beam is pierced by a black aperture. The first puff from the lungs abolishes the illuminated dust, and puts a patch of darkness in its place; and the darkness continues throughout the entire course of the expiration. When the tube is placed below the beam and moved to and fro, the same smoke-like appearance as that obtained with a flame is observed. _In short, the cotton-wool, when used in sufficient quantity, and with due care, completely intercepts the floating matter on its way to the lungs_.
The application of these experiments is obvious. If a physician wishes to hold back from the lungs of his patient, or from his own, the germs or virus by which contagious disease is propagated, he will employ a cotton-wool respirator. If perfectly filtered, attendants may breathe the air unharmed. In all probability the protection of the lungs and mouth will be the protection of the entire system. For it is exceedingly probable that the germs which lodge in the air-passages, or find their way with the saliva into the stomach with its absorbent system, are those which sow in the body epidemic disease. If this be so, then disease can be warded off by carefully prepared filters of cotton-wool.
I should be most willing to test their efficacy in my own person. But apart from all doubtful applications, it is perfectly certain that various noxious trades in England may be rendered harmless by the use of such filters. I have had conclusive evidence of this from people engaged in such trades. A form of respirator devised by Mr. Garrick, a hotel proprietor in Glasgow, in which inhalation and exhalation occur through two different valves, the one permitting the air to enter through the cotton-wool, and the other permitting the exit of the air direct into the atmosphere, is well adapted for this purpose. But other forms might readily be devised."
LIGHT AND HEALTH.
Our dwellings ought freely to admit the sunlight. Diseases which have baffled the skill of physicians have been known to yield when the patients were removed from dark rooms to light and cheerful apartments.
Lavoisier placed light, as an agent of health, even before pure air.
Plants which grow in the shade are slender and weak, and children brought up in dark rooms are pale, sallow, and rickety. It is a bad practice to avoid the sunlight through fear of spoiling the complexion, since the sun's rays are necessary to give to it the delicate tints of beauty and health. Air is necessary for the first inspiration and the last expiration of our lives, but the purity and healthfulness of the atmosphere depend upon the warming rays of the sun, while our bodies require light in order that their functions may be properly performed.
We know that without solar light, there can be no proper vegetable growth, and it is equally necessary for the beauty and perfection of animal development. Our dwellings should therefore be well lighted and made as bright and cheerful as possible. Women who curtain the windows, soften the light, and tint the room with some mellow shade, may do so in order to hide their own faulty complexions. The skin of persons confined in dungeons or in deep mines becomes pale or sickly yellow, the blood grows watery, the skin blotches, and dropsy often intervenes. On the other hand, invalids carried out from darkened chambers into the bright sunlight are stimulated, the skin browns, nutrition becomes more active, the blood improves, and they become convalescent. Light is especially necessary for the healthy growth of children. There is nothing more beautiful and exhilarating than the glorious sunlight. Let its luminous, warming, and physiological forces come freely into our dwellings, enter into the chemistry of life, animate the spirits, and pervade our homes and our hearts with its joy-inspiring and health-imparting influences.
CHAPTER II.
FOOD. BEVERAGES. ALCOHOLIC LIQUORS. CLOTHING.
The human body is continually undergoing changes, which commence with the earliest dawn of existence and end only with death. The old and worn-out materials are constantly being removed to make room for the new. Growth and development, as well as the elimination of worn-out and useless matter, continually require new supplies, which are to be derived from our food. To fulfill these demands it is necessary that the nutriment should be of the proper quality, and of sufficient variety to furnish all the constituents of the healthy body. In order that food may be of utility, like other building materials, it must undergo preparation; the crude substance must be worked up into proper condition and shape for use, in other words, it must be _digested_. But this does not end the process of supply, each different substance must be taken by the different bands of workmen, after due preparation in the workshop, to its appropriate locality in the structure, and there fitted into its proper place; this is _assimilation_. In reality it becomes a portion of the body, and is advantageous in maintaining the symmetry and usefulness of the part to which it is assigned; this constitutes the ultimate object of food, _nutrition_.