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Full text of "Handbook of health in war and peace : a manual of personal preparedness"

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FOR THE PEOPLE 

FOR EDVCATION 
FOR SCIENCE 






LIBRARY 

OF 

THE AMERICAN MUSEUM 

OF 

NATURAL HISTORY 





lound at 

IA.MJ4.H. 

191/ 



AMERICAN MUSEUM OF NATURAL HISTORY 



HANDBOOK OF HEALTH 
IN WAR AND PEACE 

A MANUAL OF PERSONAL 
PREPAREDNESS 



ISSUED AT THE 

OPENING OF THE HEALTH AND FOOD EXHIBITION 

OF THE 

AMERICAN MUSEUM OF NATURAL HISTORY 
MAY 23, 1917 



PRICE 25 CENTS 



HANDBOOK SERIES, NO. 6 



AMERICAN MUSEUM OF NATURAL HISTORY 

HANDBOOK OF HEALTH 
IN WAR AND PEACE 



bl.r.O'L 
A MANUAL OF PERSONAL 



PREPAREDNESS 



1 



BY 



C-E. A. WINSLOW 



WITH FOREWORD BY 



HENRY FAIRFIELD OSBORN 



PREPARED AND ISSUED BY 



departments of public health and public 

education of the american museum 

of Natural History 



NEW YORK, 1917 



FOREWORD 

There has never been a period in American history when 
diffusion of knowledge of the laws of nature was a more im- 
mediate and a more imperative duty than at the present 
time. Hundreds of thousands of young men and young 
women are ready to offer their services and, if need be, 
their lives for their country and for the great principles of 
loyalty, truth, justice, humanity and liberty for which our 
President has enlisted us in this world war. But let not a 
single life be lost needlessly. Let no constitution be broken 
by disease through ignorance. The patriotic opportunity of 
all men of science is to spread the truth, and to spread it as 
quickly as possible. Let us speak plainly of all the dangers 
and enemies which surround the soldier and the sailor, of 
those that kill the soul as well as those which destroy the 
body. The loss to the world of the finest strains of manhood 
is the most awful curse of the many curses attending this 
war. Every young man, if single, must think of his future 
wife, of his future home, of his future children and so live 
that, if his life is spared, he may some day give to his coun- 
try one of the greatest gifts it is in a man's and woman's 
power to give — healthy and patriotic offspring. It is a 
scientific, no less than a religious principle, that to serve 
one's country one must be sound in body, sound in mind, 
and sound in spirit. 

In opening a food and health exposition, the American 
Museum is in cooperation with the Council of National 
Defence and especially with its Medical Board, also with 
the National Food Commission under Herbert C. Hoover. 

Henry Fairfield Osborn, 

President. 



HEALTH AS A NATIONAL DUTY 

War is no longer a conflict of armies but a struggle be- 
tween nations. Behind the gallant bat- n „ 
talions in the field there must be other , ... . J^ 

battalions in the munition factories and on _ T J t « . . 
. . . , j. „ National Cnsis 

the farms whose devotion is equally essen- 
tial to national victory. Success demands the coordinated 
individual efficiency of the whole people; and individual 
efficiency rests upon health. 

As the United States enters upon a great war for liberty, 
for justice and for humanity, there arises in all of us a new 
sense of common responsibility, a new determination to 
reach the highest level of effectiveness. There is no place 
any more for carelessness, for meddling, for self-indulgence. 
There is no place for preventable disease. 

Health is to-day, as never before, a national duty — 
health not merely in the sense of freedom „ . , - 
from acute sickness, but in the sense of full Vff * . 
abounding vigor and vitality and power. 
The maintenance of such vigor and vitality depends on 
simple principles of hygiene and sanitation. It has been 
truly said that "within natural limitations, a community 
can determine its own death rate." It is equally true that 
"within natural limitations, an individual can determine his 
own physical efficiency." 

It is in the belief that thousands of men and women in 
training camps and in munition factories, on farms and in 
homes, are determined in this hour of trial to give their best 
to their country that this Handbook of Health and Efficiency 
has been prepared by the American Museum of Natural 
History and dedicated to an awakened and a reborn America. 

5 



FUEL FOR THE LIVING MACHINE 

The food is the fuel which runs our living machine, just 
p , p . as truly as coal is fuel for an engine. Ex- 
periments in physiological laboratories have 
shown that in a man, as in any other well-made machine, 
you get out an amount of work and heat that corresponds 
directly to the amount of fuel put in. 

Our first food need, then, is for a sufficient supply of 
energy. Food energy is measured in calories, one calorie 
being the amount of heat energy necessary to raise the 
temperature of one kilogram (about two pints) of water 
one degree on the centigrade thermometer. Three large 
lumps of sugar, one large banana, one very large egg, one 
chop, two thin slices of bread, two apples, one pat of butter, 
two-thirds of a glass of milk — each of these food portions 
contains about 100 calories. The average adult needs about 
2,500 calories a day if leading a sedentary life, 3,000 calories 
if engaged in active physical work. 

The individual soldier has his dietary needs cared for by 
those in authority. For the civil population and for the 
nation as a whole, however, the question of the food supply 
is a vital one in war time, and particularly at the present 
moment when the food supplies of Europe are exhausted and 
the whole allied world depends on America to preserve it 
from starvation. 

The attainment of proper national dietary standards de- 
_ . « pends partly on the available food supply 

Q 1 . f and partly on the intelligent selection and 

TV t use °^ f°°d s - The cost °^ 100 calories in 

different forms varies enormously; and by 

learning to make an intelligent selection every individual 

purchaser and every individual householder can help in the 

great task of food conservation. 

The following table, from "The Fundamental Basis of Nu- 
trition/ ' by Graham Lusk, shows the cost of 1,000 calories in 

6 



the form of various staple foods. The actual prices would 
be higher now than in 1913, but the figures are significant 
of more or less constant relative differences. The economy 
in such foods as cornmeal, wheat flour, beans and pork as 
compared with mutton, beef and codfish is worthy of special 
note. 

Cost in Cents of 1,000 Calories 

(Lusk) 

Glucose 1% Butter 10 

Cornmeal 2 Milk 10 

Wheat flour 2 l / 2 Smoked ham 10% 

Oatmeal 2y 5 Cheese 11^ 

Cane sugar 3% Loin pork 12% 

Dried beans 4 Mutton (leg) 16% 

Salt pork (fat) 4^ Salt cod 19^ 

Rice 5 Sirloin beef 24 

Wheat bread h\i Turkey 40 

Oleomargarin iy 2 Codfish steak (fresh) . . .42 

Potatoes iy 2 

The supply of a sufficient calorie allowance is, of course, 

only a part of the problem. The body not _> , , .... 

i + f - + t a u / i Body-building 

only gets energy from its food but also „ . 

builds up out of the foods its own substance 
which is constantly being consumed as a result of the life 
process. Muscle and brain and all the other tissues of the 
body are wasting away minute by minute and second by 
second, and the waste must be made good from the sub- 
stances in the food. Some of the elements in living tissue 
are present in almost all food substances and are sure to be 
supplied in sufficient amounts in any diet which will furnish 
2,500-3,000 calories of energy. Other building stones of the 
body are found only in certain foodstuffs. 

The most important of these building stones are found in 
the nitrogen-containing foodstuffs known as proteins, of which 

7 



white of egg and lean meat are examples. So important are 
these substances that many authorities have divided foods 
into two main groups. 

(1) Body-builders and repairers. (Protein, chiefly con- 
tained in meat, eggs, milk, peas, beans, kernels, grain, etc.) 

(2) Energy-producers, yielding heat and work. (Fats, 
and oils [hydrocarbons] with sugar and starch [carbohy- 
drates].) 

A definite proportion of protein food (10-15 per cent.) is 
an absolute essential of the diet, and people who fail to get 
a sufficient amount of such food quickly show the result in 
diminished vigor. Pellagra, a serious disease which occurs 
particularly among the poor population of our southern 
states, is closely connected with a diet poor in protein, and 
can be cured by the substitution of one rich in meat, eggs and 
milk. 

The table below, showing the classification of certain com- 
mon foodstuffs according to their richness in proteins and 
fats, is taken from the excellent handbook on "How to Live/' 
by Prof. Irving Fisher and Dr. E. L. Fisk. Foods low in 
both proteins and fats are composed chiefly of carbohy- 
drates (sugar and starches). 



Common Foods Classified 
Poor in Fat Rich in Fat 





White of eggs 




Very high 


Codfish 




in 


Lean beef 




Protein 


Chicken 
Veal 






Shellfish 


Most fish 


High in 


Skim milk 


Most meats 


Protein 


Lentils 


Most fowl 




Peas 


Whole egg 




Beans 


Cheese 





Poor in Fat 


Rich in Fat 


Very Rich 
in Fat 


Moderate 


Most vegetables 


Peanuts 


Fat me; 


or 


Bread 


Milk 


Yolk of eggs 


Deficient 


Potatoes 


Cream soups 


Most nuts 


in 


Fruits 


Most pies 


Cream 


Protein 


Sugar 


Doughnuts 


Butter 



Mineral salts, such as lime, iron, etc., are also essential to 
the body and there are peculiar substances T f 

called vitamins present in certain foods, v . 
such as fruits, unpolished rice, etc., which . 
are necessary for its normal development. 
The disease beri-beri among the Philippine scouts was due 
to the lack of such substances in a diet made up largely of 
polished rice, and was cured by a change in diet. As wide 
a variety of foods as possible should be included in the diet, 
and fads as to the avoidance of certain foodstuffs frowned 
upon. A certain proportion of hard, bulky and indigestible 
foods, such as crusts, fibrous vegetables and nuts, is essen- 
tial to the proper working of the bowels. Ample protein, 
salts and vitamins will be secured by the normal instincts 
if unhampered by economic limitations, so that the whole 
question comes down to one of costs. Professor Lusk esti- 
mates that the average cost of a group of staple articles has 
increased from 11 cents in 1916 to 18 cents in 1917 for an 
amount that would supply 2,500 calories. To help meet 
the problem of this increased cost of living he has prepared 
the following low-cost meatless dietary of high caloric value, 
designed for a family of five persons, the father at work 
and the mother doing household work. Potatoes, with 
their valuable alkaline salts, had to be excluded from the 
diet because of their prohibitive price. The cost amounted 
to SI. 16 daily for 14,400 calories, or eight cents per thousand 
calories, which is not a high price: 







Low-Cost Meatless Dietary of High Efficiency Value 

for a Family of Five Persons, Father at Work 

and Mother doing Household Work 

Essentials. — Do not buy meat until you have bought 
three quarts of milk a day. Milk contains valuable tissue- 
building food, valuable salts and invaluable vitamins which 
help toward sound health. 

If you buy bread remember that day-old bread is much 
cheaper than freshly baked bread and is just as good a food. 

The menus may be arranged as follows: 

BREAKFAST 

Cornmeal mush, fried (-fmilk for children and corn syrup for 
adults), or oatmeal, or hominy, or farina, or buckwheat 
cakes. 

Bread (or toast). 

Oleomargarin. 

Coffee (adults). 

Stewed prunes. 

Orange juice for baby. 

LUNCHEON OR SUPPER 

Pork and beans (bean soup for young children), or creamed 

dried beef on toast. 
Bread. 

Oleomargarin. 

Tea with milk and sugar, for adults. 
Milk for youngest children. 
Cereal, coffee or cocoa for older children. 
Sliced bananas with sugar, or stewed dried peaches. (The 

bananas may be boiled in their skins.) 

DINNER 

Lentil soup (or potato, or bean, or pea soup). 
Boiled rice (or spaghetti, or macaroni with cheese, or 
baked split peas with bacon). 

10 



Tomato catsup. 

Bread. 

Oleomargarin. 

Tea for adults. 

Milk for youngest child. 

Dried-apple pie with cheese, for adults. 

Dried-apple sauce for others. 

The Approximate Cost per Day and the Nutritive 

Values in Calories Appear Below 

Cost in 
Amount Calories Cents 

Coffee 23^3 ounces 3 

Tea l /2 ounce 2 

Milk 3 quarts 1,800 27 

Bread 2 pounds 2,500 9 

Cereal Y 2 pound 800 4 

Oleomargarin % pound 2,500 19 

Corn syrup 3^ pound 650 2 

Sugar J4 pound 450 2 

Rice or macaroni 1 pound 1,600 8 

Dry navy beans 10 ounces 1,000 7 

Fat pork 6J/2 ounces 1,000 6 

Dry fruit (prunes) 1 pound 325 12 

Flour, lard, etc., for pie or 

other extras 1,800 15 

14,425 Tl6 

As cheaper meats, pork sausages, braised chuck rib of 
beef, salt cod or herring may be added if finances allow. 

The amount and hence the cost of food available for the 

poor depend directly on the amount wasted _. , 

by the well-to-do; and it is the duty of _ . , 

. Rule for 
every American to give serious attention F 

to this question. A diet containing a sur- _ . 

plus of meat, fish and eggs is not only 

wasteful but positively harmful, since proteins in excess 

11 



decompose in the intestines and poison the body. An ex- 
cellent general rule in this connection has been suggested 
by Prof. H. C. Sherman, who advises that the average 
family should spend as much for fruits, vegetables and milk 
as for meat, fish and eggs, and as much for vegetables and 
fruits as for milk and eggs. 

Wastage in purchasing and preparation of foods is another 

ox xt. -rrr important cause of dietary deficiency. The 

Stop the Waste f . . . f J , 

,i , following suggestions indicate some of the 

special ways in which the housewife can 

economize. 

Go to the store yourself and select the food, with a view 
to quality and cost. Be sure you get full weight and take 
home for soup or stew all bones and trimmings. 

Buy the cheaper cuts of meat. They are in many cases 
more nourishing than the more costly ones, and can be made 
tender by proper cooking and seasoning. The cheaper cuts 
of meats cost only one-half as much as the round and sirloin. 

Buy in quantity if possible. 

Use fish instead of meat as much as possible. 

Milk, cheese and beans are cheaper than meat and con- 
tain all necessary nutrients. 

Use a fireless cooker, which saves time, fuel and food value. 

Buy fruits and vegetables only when in season. 

Buy foods in bulk, not in packages. 

Omit luxuries and foods of low-energy value. 

Save left-overs. 

PURE FOODS AND CLEAN FOODS 

In war time we should welcome the introduction of cheap 

food substitutes or the marketing of second- 

A grade foods if they are really valuable and 

" if they are sold as such. Cold-storage 

products are usually not as palatable as 

fresh meats; but cold storage has vastly increased the food 

12 



resources of the world by conserving the excess of one season 

and one locality for use at other times and places. Skim 

milk is a highly valuable food material which should be sold 

freely if properly labeled. There are butter substitutes on 

the market which are as valuable for food as real butter 

and cost but half as much. 

The purity in foods is mainly a question p, •♦«■ h 

of honesty. Clean food, on the other hand, ~. .. 

u i +• i f \ uu Cleanliness 

is a vital essential of health. 

Polluted water in the past has been a common cause of 

disease both in the camp and in civil life. n - 

All surface water supplies, lakes and streams _. „ . , — T , 

.. ,. . n x. , t Polluted Water 

are liable to pollution from sewers or from 

material washed in from the banks, and wells and springs 
may be polluted through crevices in the soil. No water 
should ever be drunk if there is any uncertainty as to its 
quality. The water for troops in the field should be purified 
by filtration or disinfection, and it is one of the first duties 
of the soldier to avoid the use of any unauthorized supplies. 
Water of doubtful quality may be made safe by boiling or 
bj' the addition of chloride of lime. Dissolve a teaspoonful 
of chloride of lime in four pints of water and add one teaspoon- 
ful of this solution to a gallon of the water to be purified 
(one tablespoonful to four gallons, ten tablespoonfuls 
to a barrel). The water should stand for half an hour 
before use. 

Milk is another food which often carries the germs of 
disease, germs of tuberculosis from the cow, n f 

or germs of typhoid fever, sore throat, M ..^ 
diphtheria, etc., from human beings who 
have handled it. Milk should always be pasteurized or 
heated to 140 Q -145 C F. for 20 to 30 minutes before it is used, 
and on no account should uncooked cow's milk be given to 
young children. 

The best way to pasteurize milk in the home is to set the 
bottles in a deep pan of water on the stove, put a milk 

13 



thermometer into the water, heat to about 145° F. or 
Pj. a little over, and then set the pan on 

p . the back of the stove, moving it back and 

M .„ forth now and then to keep the tempera- 

ture, for half an hour, as near 145° as 
possible, say between 140° and 145°. If no milk thermometer 
is at hand it will be almost as well to heat the pan till 
the water boils and then let it stand on the back of the 
stove for half an hour, although this may give the milk a 
slight cooked taste. 

Foods of all sorts should be carefully protected from dust 

Oth ^ f an( * ^ es ' wn * cn ma y carr y disease germs, 

- f and from unnecessary handling. It is im- 

~, - portant that foods should not be handled 

by those who are "coming down" with any 
communicable disease; and foods to be eaten raw should be 
purchased only from careful and responsible dealers. The 
greatest care should be taken to avoid tainted meats and to 
keep perishable foods from spoiling. 



EXERCISE AND REST 

The heart, the lungs, the blood vessels, the bowels de- 
generate if they are not given their proper 
Value of work to do, and on the other hand they 

Exercise suffer if too heavy a burden is placed upon 

them. 

The muscles make up more than one-half the total weight 
of the human body, and their proper use is essential, not 
only for their own growth but on account of the inter- 
relation between the health of the muscles and that of the 
rest of the organs. Vigorous physical exercise not only de- 
velops the muscles themselves, it stimulates the heart and 
the blood vessels, it deepens the breathing, it keeps up the 
tone of the digestive system, it frees the tissues from the 
accumulation of harmful waste products. 

14 



The physique of the recruit is systematically developed 

by setting-up exercises, marching, rifle and . . , M 

\ & . . ' ?.' Avoidance of 

sabre exercises, applied gymnastics, swim- _ . 

ming and athletic games. It is overstrain 

which the soldier must avoid, and " soldier's heart" has been 

a common complaint in Europe during the present war. 

Exercises should be varied so as not to overtax any one 

group of muscles and they should never be carried to the 

point of exhaustion. Breathlessness is a valuable danger 

signal of overload of the heart. 

It is not hard work that kills. It is prolonged strain at 
dull tasks without variety, on the one hand, p , 

worry and excitement on the other. With __ . 

a proper variety of work it is marvellous 
what the human mind and hand can accomplish, but they 
cannot endure too long a pull without interruption. The 
operatives in the Zeiss Optical Works at Jena actually did 
more work in an eight-hour day than in one of nine hours. 
They could keep fresh and vigorous for the shorter period, 
while they began the nine-hour day in poor condition be- 
cause imperfectly rested from the day before. 

The studies made in the English munition factories dur- 
ing the present war have shown clearly that a limitation of 
hours of labor may often lead to such an increase in pro- 
duction; and this is a lesson we must bear in mind in this 
country in the present crisis. 

The first rule of the hygiene of rest, then, is to avoid so 
far as possible overstrain due to prolonged w - 

work of a similar kind. People vary a p ti 

good deal in their rest needs. Some men 
are rested by a change of work, some by active play and 
some by complete rest. Nothing, however, can take the 
place of necessary sleep, and the average individual needs 
about eight hours of sleep out of the twenty-four. No one 
can work hard all day and play half the night. Nervous- 
ness and irritability are danger signals. They mean that 

15 



the strength is being overtaxed and that some change in 
habits should be made. 

Cultivation of mental poise is a great help in conserving 
vital force. Worry is as bad as monotony and a fit of anger 
poisons the whole system and is more exhausting than a 
hard day's work. 

POSTURE AND RESPIRATION 

Standing still properly is one good form of exercise. 
p Posture depends on the muscles which con- 

v f trol the position of different parts of this 

. framework. With the same equipment of 

bones, one body may be stoop-shouldered 
and slouching and another may be erect and well-knit. 
One of the most immediate good results of military training 
is correct posture, which involves the exercise of all the 
hundreds of muscles which help to hold the body well. 

The backbone, as we have seen, is meant to be slightly 

^ m r « j curved, so as to give elasticity. In people 
Evils of Bad , ' , ., & , , ; . ,. *7u* 
p who do not sit or stand straight, these 

curves become greatly exaggerated, leading 

to round shoulders and a drooping head. Such bad posture 

is not only ungraceful but unhealthy. If the back and 

shoulders and abdominal wall are not held properly the 

lungs do not get sufficient aeration and the internal organs 

are crowded together and their blood supply hampered. 

Many and grave disorders are traced to faulty posture and 

are cured by improving it. 

When standing correctly, the head, body and legs should 

_ be poised one above the other so that a 

line dropped from the front of the ear falls 

within the forward half of the foot. "This 

is the position of the long-distance walker, the mountain 

climber, the best all-round athletes; it is the position of 

command and authority, and is found predominant in the 

16 



great leaders of commerce and public life. On the other 
hand, collapsed positions are characteristic of both physical 
and mental weakness. They constitute a distinct aspect 
of weakness and illness, from the tuberculosis patient to 
the feeble-minded." * 

In sitting, the body should be bent only at knees and 
hips, and the head, neck, and trunk should be kept in one 
straight line. 

Another important element in hygiene is the exercise of 
the organs of breathing. In ordinary breath- _ 

ing only about ten per cent, of the lung R . . 

contents is changed at each breath, and the 
remoter air sacs of the lungs which are not properly exer- 
cised are peculiarly liable to disease. The high mortality 
from tuberculosis among clerks, bookkeepers, telegraphers 
and other indoor workers whose tasks require or invite a 
stooping posture are examples of such harmful effects. 
"A hundred deep breaths a day" is one physician's recipe 
for tuberculosis, according to Fisher and Fisk. Deep 
breathing should be slow and not forced. 

FRESH AIR 

Variations in the chemical composition of the air are of 

little practical moment, except for the pres- „„ „ « A . 
r r j j j Why Bad Air 

ence of poisonous fumes and dust under T tt c i 

special industrial conditions. Even in the 
worst ventilated room the proportions of carbon dioxid and 
oxygen never change sufficiently to produce harmful physi- 
ological effects. The discomfort and injury to health that 
come from living in badly ventilated rooms are due not 
primarily to any chemical changes but to the rise in tem- 
perature that obtains under such conditions. 

This does not mean that fresh air is unimportant, but 
quite the contrary. A badly ventilated room is generally 
* Jessie H. Bancroft, in The Teaching of Hygiene. 
17 



an overheated room. In such a room the blood vessels 
■pft f * °f the skin are dilated, the body tempera- 

~ . . ture rises, the pulse increases, the blood 

pressure falls. The brain and inner organs 
are robbed of blood. One feels dull and listless and disin- 
clined to exertion. The New York State Commission on 
ventilation showed that when there was a powerful incentive 
exertion was possible for short periods at high temperatures, 
but that under ordinary conditions 6 per cent, more work 
was done at 68° than at 75° and 15 per cent, more than at 
86°. Prof. Ellsworth Huntington, from exhaustive studies 
of the effect of season and climate upon physical and mental 
work, finds a mean outdoor temperature of 60°-64° most 
favorable for efficiency, summer and winter both showing a 
marked falling off as compared with fall and spring. It 
cannot be doubted that the excessive temperatures main- 
tained in many factories (often combined with high humid- 
ities, which accentuate the effect by checking evaporation 
of perspiration) militate very seriously against industrial 
efficiency. In military life the important influence of climate 
upon bodily vigor should be borne constantly in mind in 
the selection of training camps. 

The avoidance of gross overheating (temperatures above 
v , f .. 68°) is not the only factor to be considered. 

M The body must be protected against the 

debilitating effect of heat on the one hand 
and against the shock of excessive chilling on the other. 
Within reasonable limits, however, variations in tempera- 
ture, and particularly movement of the air, are important 
factors in promoting health. The body owes its marvellous 
power of maintaining its own temperature constant through 
a wide range of outside temperatures to the reaction of the 
skin blood vessels, which contract to keep the blood out of 
the skin when it is cold and expand and bring the blood to 
the surface when a more rapid heat loss is desired. The 
tiny muscles in the walls of these blood vessels must be ex- 

18 



erased like any other muscles if they are to be kept in good 
condition. In a person who lives habitually in an even 
high temperature the blood vessels do not respond readily 
to sudden change. In such people, the mucous membranes 
of the nose are constantly congested (filled with blood and 
lymph) as the blood vessels dilate to keep the body at the 
proper temperature. As a consequence, these membranes, 
instead of shrinking and drying promptly as they should 
when they come in contact with cold outer air, lose their 
quickness of response and stay moist and swollen even after 
the blood vessels themselves have contracted; this makes 
them an excellent breeding place for bacteria. People who 
have been weakened in this way are very sensitive to the 
cold air and are easily subject to chills. Benjamin Franklin 
once said, "People who live in the forest, in open barns, or 
with open windows, do not catch cold, and the disease called 
a cold is generally caused by impure air, lack of exercise, 
or from overeating." Science has amply confirmed these 
observations of our great natural philosopher. 

Fresh air, then, means air that is not too hot, or too cold, 
or too even in temperature, — air that is w « „ , 
pleasantly cool and in moderate motion. .. T 
If the thermometer reaches 70° (except in the 
case of elderly people, who may require a higher tempera- 
ture) it is a sign that the window should be opened. It is 
particularly important to have plenty of fresh air in the 
sleeping room and windows should be kept well opened at 
night even in cold weather. 

HYGIENE OF CLOTHING AND BATHING 

The clothing should protect against extremes of cold, and 
this is particularly necessary after exercise n ... - 
when the skin blood vessels are dilated and /£ f| , . 
the body bathed in perspiration. Woolen 
clothes may be desirable under such conditions because 

19 



wool being porous is a poor conductor of heat and also be- 
cause it takes up moisture readily and so absorbs and holds 
the perspiration. 

Cotton, and particularly linen, are rapid conductors of 
_ .- , T heat and do not absorb moisture, so that 

"R ri tV ^ e Y are niore suitable for warm weather. 

It is quite as undesirable to wear clothes 
that are too warm as to expose the body to undue chill. If 
the skin cannot get rid of its heat fast enough as a result 
of too heavy clothing the dull and sleepy feeling associated 
with "bad air" results. The habit of wearing too many 
clothes weakens the power of the system to respond quickly 
to changes in temperature, and renders one susceptible to 
colds. Most people wear too heavy underclothing in winter. 
Cotton or linen underwear is generally better than woolen; 
and up to the age of fifty or even sixty years it is wiser to 
wear underclothing of the same weight both winter and 
summer, relying on an overcoat for warmth when out of 
doors and not exercising. 

The first object of bathing is to wash off the dirt and soot 
w - which soil the body and to remove the waste 

r ih "R fh* materials deposited on the skin by per- 

spiration. Warm or tepid water is most 
effective for cleaning the hands or body. Bathing in warm 
water increases the size of the blood vessels in the skin and 
draws the blood away from the brain, making one feel com- 
fortably sleepy. This is the reason why a warm bath is 
usually taken at bedtime. After every hot bath cold 
water should be applied to the entire body. A cold bath, 
on the other hand, contracts the skin blood vessels and 
drives the blood to the internal organs and the brain, mak- 
ing one feel alert and keen. Cold bathing is a powerful 
tonic to the skin, since it trains these blood vessels to re- 
spond quickly to changes in temperature. People who take 
cold baths regularly are likely to be hardy and little subject 
to colds. 

20 



In the matter of bathing, however, we must again re- 
member that the body should be stimulated . . . . 
by cold water, but not chilled too severely. _, 
A cold bath should be followed by a re- 
action ; that is, the surface blood vessels should enlarge again, 
so that the skin becomes warm and glowing. Brisk rubbing 
with a rough towel helps to secure this reaction. If no re- 
action follows, or if one feels tired after bathing, the bath was 
too cold or too prolonged, or the body is not strong enough 
to endure the shock. In such cases cold baths may do 
serious harm. 

No bath of any kind should be taken within an hour after 
eating. The blood is needed in the intestines for the process 
of digestion, and it is harmful to disturb the circulation, as 
any bath must do at such a time. 

The cleanliness of underclothing is of specially vital im- 
portance to the soldier. The suppuration _ , 
of wounds is frequently due to germs _, 
coming from dirty clothing, and the terrible 
disease " trench-foot," w T hich has afflicted the French troops 
in the present war, has been shown to be due to neglect in 
this regard. Molds from damp and dirty socks get into cuts 
and cracks in the foot, stop up blood and lymph vessels, 
and gangrene follows in the tissues thus deprived of the 
protective action of the body fluids. 

Shoes of proper shape and material are also primary mili- 
tary essentials. Colonel Keefer says, "No _. „ . . 
one article of the soldier's clothing plays so _. 
large a part in his efficiency as the shoe.'' 

As the result of an exhaustive study made by a special 
army board created to study this subject, the problem of 
army shoes has been satisfactorily solved. The civilian, 
however, still often suffers from improper footgear. The 
deformity known as flat foot, often accompanied by pains 
reaching far up the back, may be caused by the resulting 
strains. A hygienic shoe should be everywhere as wide 

21 



as the sole of the foot, and wide enough in front to permit the 
toes to move freely. The inner edge of the shoe should be 
straight, so that a line drawn back from the middle of the 
great toe touches the heel. The heels should be low and 
broad. The sole and uppers should be flexible, so that the 
foot may be bent freely at the point where the toes join the 
instep. A high shoe should not be so tightly laced at the 
top as to interfere with circulation. A porous shoe, like one 
made of russet leather, is much better than an enamel or 
patent-leather shoe, because it allows the escape of moisture 
and prevents overheating of the foot. 

CARE OF THE TEETH AND BOWELS 

Many obscure maladies of the joints, the heart and the 
kidneys are traced to bacterial infections arising from de- 
cayed teeth, and the care of these strong but delicate struc- 
tures is a primary essential of personal hygiene. 

The enamel is the natural protection of the teeth, and it 

T , r f is very important that it should not be in- 

, t +h jured by cracking hard nuts with the teeth 

or picking the teeth with hard objects which 

might splinter them. 

On the other hand, thprough chewing of the food, and 
particularly of fairly hard foods like crusty bread, helps to 
polish the surfaces of the teeth and to prevent deposits on 
them. The coarse food which savage people eat helps to 
keep their teeth in good condition, but since civilized man 
eats few hard foods, especial care is necessary to prevent 
tooth decay and keep the mouth healthy. 

The most important help in keeping the teeth in good 
Th T +h condition is, of course, the toothbrush. It 

. - - has been said that in an army the soldier's 

toothbrush should be inspected every morn- 
ing as systematically as his gun. The teeth 
should be brushed regularly night and morning at least. 

22 



I 



It is well to brush them after each meal, because the sooner 
deposits of food are removed, the better. Once a day a good 
tooth powder may be used to aid in cleaning the teeth. For 
soldiers in the field, where no tooth powder is available, wood 
ashes or wood charcoal has been recommended. 

The toothbrush should not be too large, and the bristles 
should be of medium hardness and so shaped that they will 
get between the teeth. Both sides and the top of the teeth 
should be thoroughly brushed. It is much better to brush 
down or up from the gums to the cutting edge than side- 
ways across the teeth, because when the brush passes side- 
ways the bristles do not get in between the teeth. The most 
effective method is to place the bristles of the brush firmly 
against the teeth, apply pressure as if trying to force the 
bristles between the teeth, and then give the brush a rotary 
or scrubbing motion. Care should be taken to go over 
both the back and the front of the cutting teeth in both 
jaws, as well as the flat crowns of the grinding teeth. The 
gums above and below the teeth and the surface of the 
tongue should also be cleaned. 

When the brushing is finished, lukewarm water should 

be taken into the mouth and forced between ^ A ., £ xf _ 

, , , , i-i Details of the 

and around the teeth several times by — M . — .- . 

. ., r , , , , J Tooth Toilet 

means of the lips, cheeks, and tongue. 

This is as important as the proper use of the toothbrush 

itself. The tooth toilet should take from three to five 

minutes. 

Even the best use of the toothbrush will not always keep 
the spaces between the teeth entirely clean. If food par- 
ticles collect in these spaces, a bit of dental floss may be 
passed up and down between the teeth, care being taken not 
to injure the delicate gums. 

With all precautions tooth decay is likely to begin in 
places; and the teeth should be regularly examined by a 
competent dentist twice a year to detect such troubles in 
time. 

23 



Another common cause of obscure ailments, headache, 

TT a -j dullness and feeling of oppression is decom- 

How to Avoid ... , , , & *T ■ , . ■ .. 

r . . position of food wastes in the intestines. 

If the bowels are not emptied regularly, 
bacteria form poisonous products of decay, which are ab- 
sorbed along with the food and produce far-reaching 
harmful effects. 

It is important to form the habit of cleaning out the in- 
testines regularly at least once a day and perhaps oftener, 
so as to keep the intestinal tube clean. If this does not 
happen naturally, the remedy should be found, not in medi- 
cines, but in drinking plenty of water and eating more fruit, 
green vegetables, and coarse foods, or in more exercise, sleep 
and fresh air. 

Too frequent loose movements of the bowels (diarrhea) 
_. . are often due to the growth of special kinds of 

harmful microbes in the digestive tract. The 
best remedy is cut down the food, particularly meats and 
eggs, and to take a dose of castor oil or some other medicine 
which will help the body to get rid of both microbes and 
poisons. If the trouble continues, a doctor should be 
consulted. 



AVOIDANCE OF DRUGS AND STIMULANTS 

Among the influences which work to deprive the body 
ai 1, i °f ^s maximum efficiency, none is more 

. n important than certain dangerous drugs, 

among which alcohol is the chief offender. 
Alcohol, like many other drugs, acts chiefly on the nervous 
system; it does not serve to make any part of the nervous 
system work more readily, but numbs or puts to sleep certain 
parts of it. It acts first of all on the inhibitions, with the 
result that some of the nerve actions which would ordinarily 
be inhibited or held in check are allowed to go on more freely. 
This seems like a stimulation or increase of power, but it is 

24 



really only a breakdown of the system of control. The situ- 
ation is somewhat similar to the case of a runaway horse. 
The horse is no stronger, but is much more dangerous, 
when it is running away than when it is held firmly by the 
reins in the hands of a skilled driver. 

A long series of experiments, of which the most recent 
have been carried out by Prof. F. G. Bene- .. , . « 
diet, in the Carnegie Nutrition Laboratory, Fffi . 
have made it abundantly clear that even 
very moderate doses of alcohol tend seriously to interfere 
with the working of the nervous machinery of the body and 
to make its reactions slow and clumsy. Of eleven different 
tests of efficiency made by Professor Benedict, all but two 
showed a decrease in quickness or accuracy of from 3 to 46 per 
cent, in the persons who had taken alcohol. The relation of 
the use of alcoholic liquors to industrial accidents is well rec- 
ognized; and the attitude of public service corporations and 
other large employers of labor toward alcohol offers eloquent 
testimony to its harmful influence. No one who has ever 
been a steady user of alcohol is accepted as a member of an 
arctic expedition, and alcoholic drinks are never used by 
those engaged in these enterprises. Such persons have been 
found by experience to be lacking both in efficiency and in 
the ability to endure the necessary hardships. 

Xor are the results of the use of alcoholic liquors limited 
to a temporary interference with mental and A1 , 1 
physical powers. Exhaustive studies of the , , 

death rate among abstainers and non-ab- n , p 
stainers conducted by English and American 
life insurance companies have yielded most significant results. 
One such recent investigation made by forty-three American 
life insurance companies showed that the death rate of those 
who used alcohol steadily and freely was 86 per cent, above 
the normal, while the rate among steady moderate drinkers 
(persons taking the equivalent of two glasses of beer or 
one glass of whiskey a day) was 18 per cent, above the normal. 

25 



It is evident that alcohol does a great deal of harm to 
certain individuals and a certain amount of harm to all who 
use it habitually. No man who wants to do anything diffi- 
cult, and to do it well, uses alcohol beforehand. No sur- 
geon about to perform a difficult operation would dream of 
taking a drink. No athlete would think of drinking before 
running a race. When a person wants to be at his best, to 
have his nerves and muscles and his whole body working 
most smoothly and effectively, he does not use a drug. 

So it is with nations. The evil effects of alcoholic drinks 
upon national efficiency, and the wastefulness involved, were 
strikingly recognized in the European War. The Russian 
government stopped the sale of vodka (the Russian strong 
drink), and the governments of France and England passed 
laws to restrict drinking. As soon as the European nations 
wanted to be at their best, to meet a great crisis, they laid 
aside the burden of alcohol. 

Now that the United States has entered the world con- 
flict the policy of "down glasses till the war is over," 
should be the slogan of every man determined to give his 
country his best service in an hour of crisis. 

It is important to remember that both alcohol and many 

„,, ^ . other harmful and often habit-forming 

The Patent , .. , , , . , . 

■** j- • t- -i drugs are often taken unknowingly in van- 
Medicme Evil & , . , . j- • a * 

ous kinds of patent medicines, borne 01 

the commonest and most widely advertised "tonics" and 
"spring medicines" owe any effect they have to the fact 
that they are composed largely of whiskey. Remedies sup- 
posed to cure catarrh, tuberculosis, and other diseases often 
contain opiates that may lead to a drug habit. Medicines 
advertised to soothe babies usually contain morphine or 
opium, and headache cures frequently contain deadly 
poisons, such as acetanilid. The use of such preparations, 
except on the order of a physician, is most unwise. Patent 
medicines and their misleading advertisements do immeasur- 
able harm by arousing a false sense of confidence and de- 

26 



laying the medical or surgical care, prompt use of which is 
essential in such diseases as cancer and tuberculosis. The 
well person has no need of drugs of any kind, and if one is 
ill enough to need drugs, he is ill enough to benefit by medical 
advice. 

HYGIENE OF ADULT LIFE 

Statistics show that at ages over 45 the death rate in the 
United States is apparently increasing and _, _^ . 
not decreasing, as is the case at earlier age p . 

periods. The increase is manifested almost _, -J fi 

wholly in the degenerative diseases of the 
heart and blood vessels and kidneys, and in cancer. Most 
of the degenerative diseases cannot be cured in the sense 
that diseases of early life are cured. Old age prevails in 
time. The important fact is that in too many cases old 
age comes on prematurely and without the victim suspecting 
its insidious onset. 

The premature onset of old age, when not due to specific 
congenital defects, is usually the result of _ f 

unhygienic living and particularly excesses p 

of various kinds. Under the unnatural con- , . 

ditions of modern life too many of us suffer 
from too little air, too little exercise, too much work and 
too much food. 

The degenerative diseases of adult life are gradual in 

their onset and could generally be checked v t , 

if the enemy were detected in time. When 

disease of the heart or arteries or kidneys . .. 

, u c ,, .. animation to 

or any other organ first sets in, the ordinary _^ _ . 

mm ii* i i i .Detect Disease 

rules of personal hygiene must be supple- . T . 

mented by special rules of daily living 
which take into account the particular defect. Even can- 
cer, one of the most deadly of the diseases of adult life, can 
be curod in a large proportion of cases by a surgical operation 

27 



if the condition is recognized early in the disease, while if 
treatment is delayed, there will be little hope. 

The only way in which these physical defects can be de- 
tected early enough to check their course is through a com- 
plete examination of the whole body by a competent physi- 
cian. It is the conviction of public health authorities that 
every person over forty-five should consult a physician at least 
once a year, for a complete examination of the whole body, 
to learn in time of the beginnings of disease and the precautions 
necessary to prevent it from extending. Such a course would, 
it is conservatively estimated, add five years to the average 
life of persons between forty-five and fifty years of age. 



MAN AND THE MICROBE 



Good and Bad 
Microbes 



There are many different kinds of microbes (or little living 
things, which is the meaning of the word), 
some of them classified by the biologist as 
animals and some as plants. Most microbes 
are harmless and some are actively beneficial to man, as, for 
example, the bacteria which ripen cream and make vinegar 
and those which fix the nitrogen of the air and make it avail- 
able for the food of higher plants. A few of the microbes, 
however, are parasites which live in the tissues or on the 
surface of the human body as a mold grows in jelly. As the 
mold forms chemical products which give the jelly a musty 
taste, so the microbes form chemical substances called toxins, 
which poison the body and produce the symptoms of disease. 
Disease germs are normally propagated only by transfer 
from one human being (or animal) to an- 
other. They may survive for a time out- 
side the body, but with rare exceptions they 
do not multiply under such conditions, but 
gradually and progressively perish. In an experiment by the 
English bacteriologist Houston, of 470,000 typhoid germs 
placed in ordinary tap water, only 480 were alive after one 

28 



Where Disease 
Germs Come 
From 



week, 31 after two weeks, 5 after three weeks, and none after 
four weeks. The danger against which we must guard is the 
rather direct transfer of infectious material from one person 
to another (or in a few instances from one of the higher 
animals, such as the cow, to man). 

The source of disease germs is then the human (or in a few 
cases, the animal) body. An important „. ~ 

part in the spread of communicable disease . f 
is played by early cases (not yet displaying . 

any characteristic symptoms of illness) and 
by "carriers," persons who have recovered from their illness 
or may never have themselves suffered from a particular dis- 
ease at all, and yet are cultivating in their bodies and spread- 
ing to others the germs which are capable of causing the 
malady in question. An outbreak of over three hundred 
cases of typhoid in New York City was caused by a milkman, 
a typhoid carrier, who had had typhoid in Michigan forty- 
six years before and had been cultivating the germs in his 
body ever since. One or two out of a hundred well persons 
in a given community may be cultivating the germ of diph- 
theria in their noses or throats, and one or two out of a 
thousand may be cultivating the germ of typhoid fever in 
gall bladder or intestines. In such diseases as pneumonia 
and epidemic cerebro-spinal meningitis, the proportion of well 
carriers may be much higher, and infant paralysis appears to 
be chiefly spread in this manner. 

Bacteria are solid particles not easily detached from moist 
surfaces. Quietly expired air is germ-free, w n . 
and disease microbes are not transmitted by r 
the atmosphere except where there is gross Q , 
local pollution by the spray thrown out in 
coughing or sneezing or by clouds of infected dust. Cloth- 
ing, books, toys, or other objects handled by the infected 
person play a much smaller part in the spread of disease 
than was thought a few decades ago. There is no absolute 
sharp line to be drawn between objects of this sort, which are 

29 



dangerous, and those which are not, since the dying out of 
disease germs outside the body is a gradual one. We know, 
however, that the danger varies inversely with the time 
which elapses, and that the legends of disease caused by 
toys, locks of hair, etc., put away for months and years, are 
almost certainly apocryphal. 

There are three principal vehicles which commonly serve 
to effect a rather direct transfer of infectious material from 
one person to another, and which between them account for 
99 per cent, of all cases of communicable disease. These are 
articles of food and drink, flies and other insects, and more 
or less direct personal contact— food, flies, and fingers. 

DISPOSAL OF WASTES 

The germs of disease leave the infected person or the 

n f carrier, in most instances, in the body dis- 

_» , _. charges. The care of sputum and the fine 

Body Dis- fe , , l \ . . . 

. spray thrown out in coughing or sneezing is 

essential in the control of such nose and 
throat diseases as tuberculosis, diphtheria, measles, whoop- 
ing cough, scarlet fever, septic sore throat, and the like; 
while in the control of the bowel diseases, typhoid fever, 
cholera, hookworm disease, and dysentery, the care of intes- 
tinal and bladder discharges is of primary importance. 

In army camps and in all unsewered districts, particularly 

_ . . , . in warm climates, the proper care of excre- 

yp . ment, so that the germs it contains may not 

be carried by flies or in other ways to food, 

is a first essential of sanitation. 

Typhoid fever earned the name, "the scourge of armies," 
on account of the epidemics which occurred up to the pres- 
ent century whenever large bodies of men were brought 
together without adequate precautions in regard to the dis- 
posal of bodily wastes. In our war with Spain, we had 
20,738 cases of typhoid with 1,580 deaths among 108,000 
men in a period of less than four months, nine-tenths of all 

30 



deaths among the troops encamped in the United States 
being due to this cause. 

In the disposal of excrement it is essential to avoid 
pollution of water supplies, and above all r 

the exposure of the wastes in such a manner ^ /? . 

that infection may be carried by flies or in 
other ways to food. In fixed garrisons satisfactoiy methods 
of disposal will usually be provided. For use in camp good 
portable incinerators have been devised; but when these 
are not available, sink or latrine trenches may be dug to 
receive the excreta, in such a position as not to menace any 
source of water supply. In fly season the trenches should 
be provided with seats with the lids and the open space be- 
neath the seats boxed in or covered to the ground with mus- 
lin or sacking. When it is impossible to prepare pit covers, 
crude oil, kerosene or chloride of lime well distributed over 
the sides and bottom will help to keep flies away. 

Indiscriminate soil pollution is a military offense which 
may be of serious magnitude, since an individual in perfectly 
normal health may be a typhoid carrier and through care- 
lessness may infect scores of his fellows. For the same 
reason the habit of washing the hands after resort to the 
toilet is of the greatest importance. 

In civil life, where sewers are not available, the provision 
of tightly built fly-proof outside toilets is _. . - 

of vital sanitary importance. The screen- tt h m 
ing of such closets in Jacksonville, Fla., w 

and elsewhere has been followed by phenom- 
enal decreases in the typhoid death rate. For thickly 
settled communities the installation of a sewerage system 
of course offers the ideal solution of the difficulty from the 
standpoint of the individual householder. The sewage 
collected by such a system may be so treated as to be purified 
to any desired degree by screening, sedimentation, filtration 
or disinfection before it is discharged into adjacent water- 
courses. 

31 



INSECTS AND DISEASE 

Insects were in the past a far more important factor in 

p. . the spread of disease than is the case today. 

~. , ~. Bubonic plague, which destroyed a quarter 

Olden Times , ,, , .- r t^ • , L -L- , i, 

of the population of Europe in the Middle 

Ages, is primarily a disease of the rat, spread from rat to rat, 
and from rat to man by the bite of the flea. The dreaded 
typhus fever, which once decimated jails and camps, is 
spread by the bite of the body louse. With improvements 
in habits of personal cleanliness these pestilences have dis- 
appeared from civilized countries. Plague broke out in 
1894, ravaged India, and found its way to ports all over 
the known world, but nowhere outside of Asia could it gain 
a foothold. Typhus was almost forgotten until the con- 
fusion and ruin of the European War permitted its appear- 
ance on the Eastern battle front. It is controlled by de- 
stroying lice through rigid measures of disinfection of the 
bodies and clothing of those who have been exposed to 
infection. 

The most important insect carriers of disease today, out- 
T , side of certain regions in Africa, are the fly 

V'Mh V] an( * ^ e mosc l u ^o. The common house fly 

or filth fly is only an accidental carrier of 
such disease germs as it may happen to pick up on its feet 
or body; but in warm climates, where excreta are improperly 
disposed of, it is an important factor in the spread of typhoid 
fever, and studies in New York City and Richmond, Va., 
have shown that it may play a considerable role in distribut- 
ing the germs of infant diarrhea. The first essential in con- 
trolling the fly is to do away with its breeding places b}^ 
proper care of stable manure, in which it lays its eggs by 
preference, and by the elimination of other decaying rub- 
bish. Manure should be stored in a closed dark bin with 
an impervious floor and removed once a week. The tight 
floor and complete removal are essential, since the fly mag- 

32 



got burrows down into the ground or out into the outer drier 

portions of the manure to go into its resting or pupa stage, 

before it hatches out as an adult fly. Fly maggots in 

manure may be destroyed by the use of borax or hellebore. 

Adult flies may be trapped or poisoned. The traps most 

commonly used consist of a wire cone in a • «« T * 

box or cage largely of wire, with bait under _/ _ . 

., . % 6 J . ' , ~ Fly Poisons 

the large lower opening of the cone. On 

leaving their food the flies go upward toward the light, 
through the small opening, and into the cage, in which they 
perish. For fly poisons the U. S. Public Health Service 
recommends formaldehyde or sodium salicylate. For house- 
hold use these solutions may be prepared by the addition of 
three teaspoonfuls of either the 40 per cent, solution of 
formaldehyde found on the market or the powdered sodium 
salicylate to a pint of water. Nearly fill a glass tumbler 
with the solution, place over this a piece of blotting paper 
cut to a circular form and somewhat larger in diameter than 
the tumbler, and over this invert a saucer. Invert the 
whole device and insert a match or toothpick under the 
edge of the tumbler, to allow access of air. The blotting 
paper will remain in the proper moist condition until the 
entire contents of the tumbler have been used and the 
strength of the formaldehyde solution will be maintained. 
A little sugar sprinkled upon the paper will increase the 
attractiveness of the poison for the flies. 

The conquest of mosquito-borne disease is one of the most 
brilliant triumphs of sanitation. The fact Th r 
that yellow fever, the curse of tropical f y 
America, was transmitted by the bite of _, 
the Mdes mosquito was demonstrated by 
Major Walter Reed and three other surgeons of the U. S. 
Army in 1901, by experiments on themselves and other 
volunteers, Jesse W. Lazear, one of the intrepid investi- 
gators, giving his life for the cause. As a result of this dis- 
covery the pestilence which had caused 750 deaths a year in 

33 



the City of Havana alone was wiped out in a few months, 
the building of the Panama Canal was made possible, and 
tropical America was rendered habitable for the white race. 
Malaria, our principal insect-borne disease, is held re- 
ly- . sponsible for an annual money loss of 

^Malaria $ 100 > 000 > 000 in the United States alone. 
It is transmitted by the bite of the Anopheles 
mosquito, which breeds in pools of stagnant water and woody 
sluggish streams. The adult mosquito of this type can be 
distinguished from the common or Culex mosquito by the 
fact that its wings are spotted and by its posture when 
lighted. Its body stands out in a straight line at an angle 
to the surface on which it rests, while the body of the com- 
mon mosquito stands in a humpbacked position, with the 
posterior part of its body roughly parallel to the wall or 
ceiling. 

The control of malaria depends on the elimination of 
breeding places by drainage of swamps, by cutting out and 
clearing ditches, streams and pools, and by the elimination 
of small receptacles of stagnant water. Mosquito larvae, 
or "wigglers," may be destroyed by the use of oil or poison- 
ous larvicides or by stocking ponds with fish, which feed upon 
them. Adult mosquitoes should be kept out of houses, and 
particularly excluded from malaria patients by screening, 
and in seriously infected regions, quinine should be system- 
atically employed as a prophylactic. 

SPREAD OF DISEASE BY CONTACT 

While the diseases carried by food and by insects have in 
r , large measure been brought under control, 

_. the diseases which are chiefly spread by 

contact, particularly such diseases as diph- 
theria, measles, scarlet fever and whooping cough, which are 
disseminated by the discharges from the nose and throat, 
have been much less successfully controlled. The methods 

34 



by which infection finds its way from one mouth to another 
are almost without number. The common drinking cup 
and the direct discharge of mouth spray in coughing or 
sneezing furnish two obvious modes of infection. A hun- 
dred times a day fingers and other things that are not bac- 
teriologically clean go to the mouth or nose, and to one who 
considers the possibilities the wonder is, not that we contract 
diseases, but rather that we so often fail to do so. 

The only reliable defense against contact disease is the 
cultivation of habits of personal cleanliness that will keep 
everything but food and the toothbrush away from the 
mouth, and that will make the thorough washing of the hands 
before handling food an absolute and inevitable routine. 

In all communicable diseases, but particularly in those 

which are spread by contact, it is important T . . f 

to surround all known infected persons with _ . ,, 

, „ Communicable 

special precautions, so as to reduce as tar _. 

as possible the danger of the spread of 

disease germs from them. For this reason the reporting of 

communicable diseases to the health authorities is required 

by law, and boards of health maintain special laboratories 

to assist in the early diagnosis of suspicious cases of disease. 

When the infected person is found he must be isolated or 

cared for under such conditions that family and friends will 

not be endangered; and if this cannot be done at home, he 

must be removed to an isolation hospital. 

In isolation emphasis is laid particularly upon limiting 

direct contact with the patient to the nurse or person in 

immediate charge, upon the prompt disinfection of body 

discharges and clothing, bedding, etc., soiled with discharges, 

and upon the disinfection of objects which leave the sick 

room, and particularly of the hands of the attendant. If 

such precautions are not conscientiously observed during the 

course of the disease, fumigation at its close will be of little 

use, since susceptible persons in the house will already have 

been infected. If isolation has been thorough, terminal fumi- 

35 



gation is unnecessary, since there will be no gross soiling of 
the sick room with discharges, and occasional germs coughed 
out onto the floor or wall will soon die out and disappear. 

Each communicable disease has its own definite period of 
TT T <;* Xc duration, and experience teaches that a cer- 
P 1 <*h 1H * a * n num ^ er °f days or wee ks must pass be- 
"R T 1 t H ^ ore ^ * s sa ^ e ^ or *^ e P a ^^ en ^ ^° m ingle with 
other people. The periods of isolation for 
the more common communicable diseases are shown in the 
following table. In each case, of course, the patient should 
be isolated until he has entirely recovered from the disease, 
and running of the nose and ears has ceased. In diphtheria 
the only safe rule is to wait until tests made by a bacteriolo- 
gist show that the nose and throat are free from diphtheria 
germs. 

Isolation Periods of Common Communicable Diseases 

_ . Isolation Period from Time 

of Beginning of Attack 

Chickenpox 12 days 

German measles 8 days 

Measles 10 days 

Mumps 2 weeks 

Scarlet fever 30 days 

Whooping cough 8 weeks, or until one week 

after last whoop 

The fact that many diseases are particularly catching just 
_ 4 when they are beginning makes it very im- 

8 portant to watch for the onset of disease 

: ** and to start isolation as soon as possible. 

Measles, for instance, begins like an ordi- 
nary cold in the head, with sneezing and running nose and 
eyes. It has been shown by the investigations of Anderson 
that there is far more danger of spreading the germs of 
measles at this time than there is later, when a rash has 
appeared and the patient has been put to bed. 

36 



Children should never be sent to school and should not 
play with other children when they have any of the signs 
which may mean an attack of communicable disease, par- 
ticularly if there is reason to think they may have been 
exposed to infection. 

The principal signs of the beginning of an attack of com- 
municable disease are the following: 

Coughing, Watery eyes, 

Sneezing, Headache, 

Running nose, Vomiting, 

Sore throat, Diarrhea, 

Feverishness, Swelling or pain^back 
Rash or spots of any kind, of or under the ears. 
Weak, tired feeling, 



In each particular disease a certain time must elapse 
tween the day when a person first gets the 
rm into his body and the day when the 
actual symptoms of disease appear. This is 



between the day when a person first gets the T . .. 

germ into his body and the day when the p . , . 



called the period of incubation. During this ^. 

.Diseases 
time the germs are growing in the body until 

there are enough of them to make the person feel sick. The 
incubation period varies with different diseases, from a few 
days to several weeks. The periods for the commoner dis- 
eases are shown in the table below. 

Disease Incubation Period 

Chickenpox 11-22 days 

German measles 11-22 days 

Measles 8-15 days 

Mumps 15-22 days 

Scarlet fever 7 days 

Whooping cough 14 days 

Those who have been exposed to any of the communicable 
diseases should be kept under observation, and if possible 

37 



isolated from others until the period of incubation has passed 
without any signs of the disease appearing. In the case of 
chickenpox, German measles, measles, mumps or whooping 
cough, this is not necessary if the person has had the disease 
before, and is, therefore, immune. In diphtheria the incu- 
bation period is short (from one to five days), but carrier 
cases are so common that all those who have been exposed to 
diphtheria should have their throats examined and a sample 
taken from the throat for bacteriological examination. 

Everyone takes typhoid and scarlet fever seriously, but 
T f measles and whooping cough are often re- 

iur i j garded as unimportant and negligible in- 

-^ . fections. This is by no means the case. 

r u Measles is an important cause of in- 

validism in the army. " In the Union Army 
during the Civil War, there were 76,000 cases with more than 
5,000 deaths. Among the Confederates whole brigades were 
temporarily disbanded on this account in the early part of 
the war." Among the civil population measles is in most 
cities the cause of more deaths than either typhoid or scarlet 
fever, while whooping cough stands very close to it. Above 
all it should be remembered it is to young babies that these 
maladies are most deadly. Measles and whooping cough 
are more than five times as fatal in infants under one year 
of age as in children over five. Every possible effort should 
therefore be made to protect infants from contact with those 
who have any symptoms of what may prove an infectious 
disease. 

IMMUNITY AND ITS CONTROL 

Every attack of communicable disease is a struggle be- 
v . 1 tween the invading microbes and the body, 

p . for as soon as foreign germs enter, the sol- 

dier cells of the blood attack the invaders 
while the tissues of the body begin to produce chemical sub- 

38 



stances which tend to destroy the germs or neutralize their 
poisons. The degree of this natural vital resistance varies 
widely. Disease germs, like other enemies, are more likely 
to attack weak people than strong ones, though some dis- 
eases, like measles and smallpox, affect all alike. 

Besides this sort of general vital resistance, a person who 
lias recovered from an attack of some spe- T . 

cific communicable disease enjoys a special . . , ,~ 
A , .. i • Against Specific 

immunity against the particular germ m _?: 

question as a result of the struggle through 
which it has passed. In a number of diseases it is now pos- 
sible to produce at will a state of immunity by the introduc- 
tion into the body of weakened or killed cultures of the germ 
which have lost the power to produce active disease, but 
are still able to stimulate the tissues of the body, so that they 
can defend themselves against a later attack of living and 
virulent microbes. 

This principle w r as applied over a century ago in the case 
of smallpox by Edward Jenner, an English „ .. 

physician. It has been said that this dis- TT . x . 

Vaccination, 
covery of vaccination by Jenner was the 

greatest single practical benefit ever bestowed by one man 
upon the human race. As soon as vaccination was generally 
introduced, the dreaded epidemics of smallpox ceased, and 
this disease now exists only as far as vaccination is neglected. 
During the eight years before the American Army entered 
Havana, there were 3,132 deaths from smallpox in the city; 
during the next eight years, when vaccination was enforced, 
there were seven. 

Vaccination has conquered smallpox so successfully that 
people have almost forgotten what a terrible disease it was, 
and some of them have grown careless about vaccination. 
Others object to being vaccinated for fear some infection 
may get into the wound. All vaccine used in the United 
States is now tested as to its purity by the National Gov- 
ernment, and there is no danger from its use, provided that 

39 



the place where the vaccine is rubbed into the arm or leg 
is kept clean and free from dirt germs. The protective 
effect of vaccination wears off after a time. Every child 
should, therefore, be vaccinated when about a year old, and 
again at about the seventh year. 

The most brilliant practical application of the principle 
Anti-Tvnhoid °^ vaccme th era Pv> since the time of Jenner, 
Vaccination ^ aS ^ een ^ e P re P arat i° n °f the vaccine 
now used for the prevention of typhoid fever. 
Its adoption in the United States Army has been attended 
with brilliant results, as indicated by the table below. 

v v • f Cases of Typhoid Typhoid Deaths 

x ear v accinaoion -r» , i-» ■ 

Number Rate P er Numhpr Rate P er 
lNumoer 1QQ0 lNumoer 1000 

1907 None 237 3.79 19 .30 

1908 None 239 3.20 24 .31 

1909 Voluntary 282 3 .35 22 .26 

1910 Voluntary 198 2 .43 14 .17 

1911 Voluntary 70 .85 8 .10 

1912 Compulsory 27 .31 4 .04 

1913 Compulsory 3 .03 .00 

Mixed vaccines which will protect against typhoid fever 
v . . and the two distinct forms of a similar 

. .... , disease, paratyphoid fever, have been used 

. . with striking success in the European armies 

during the present war. The number of 
cases of typhoid fever among British troops in France up 
to November 1, 1916, was 1,684, of paratyphoid cases, 2,534, 
and of indefinite related fevers, 353, a total of 4,571. In the 
South African War nearly 60,000 cases of typhoid fever alone 
were admitted into hospital, and there were 8,227 deaths. 

Armies in the past have been an important agent in spread- 
ing typhoid and other infections through the regions where 
they operated and in the homes to which they returned. 
Today the success of typhoid vaccination in our military 
establishments points the way to the elimination of this 

40 



disease in civil life. Every man and woman under 45 

should make use of this simple and efficient safeguard. 

Another method of controlling immunity is by the use of 

antitoxins, or antitoxic sera, as they are _,, n - 

often called, of which diphtheria antitoxin . ... . 
. , . . Antitoxic Sera 

is the best example. 

Diphtheria antitoxin was introduced into the United States 
by the New York City Department of Health in 1894, and 
it has reduced the death rate from diphtheria in that city 
from 155 deaths for every hundred thousand of the popula- 
tion, to 24. The antitoxin is of comparatively little value 
when the attack has gone on for a long while and the body 
has become severely poisoned, but if it is used as soon as the 
disease begins, it is a practically certain cure. 

Antitoxic sera are also used in the treatment of tetanus, 
meningitis and more recently in certain forms of pneumonia. 

From a military standpoint some of the most important 
applications of the principles of vaccine and r tr 1 f 

serum therapy are those which have been w « 

worked out in connection with the treat- t f ti 

ment of wound infections. The surgeon in 
his operating room relies on antiseptic and aseptic methods 
to keep out the germs of suppuration. Wounds received in 
battle are generally already infected and the destruction of 
germ life is impossible without serious injury to the tissues 
themselves. The military surgeon must therefore rely 
largely on the stimulation of the defensive machinery of the 
body (except in the case of tetanus, for which a specific and 
powerful antitoxin is at his disposal). The newer solutions 
used in the treatment of wounds, such as Dakin's chloramine, 
are specially adapted to check bacterial growth without 
harming the soldier cells of the blood; and the use of a strong 
salt solution for the treatment of an infected wound pro- 
duces an increased flow of lymph from the tissues into the 
wound, thus relieving the inflamed tissues of congestion and 
setting up a flow of fluid from within outwards, which tends 

41 



to wash away bacteria. Both the lymph and the strong 
salt solution are unfavorable to the growth of bacteria. So 
far as the white corpuscles are concerned, strong saline solu- 
tions are unfavorable to their vitality; but when the wound 
has become healthier, it is usual to decrease the strength of 
the salt solution until its saturation has reached that of a 
fluid of the same specific gravity as the blood. In a fluid 
of this degree of concentration the body cells can live and 
act freely. 

TUBERCULOSIS 

Tuberculosis, a disease which causes about one-third of 

Thf» C t a ^ ^ e deaths which occur between the 

—~ . p- ages of 18 and 45, and kills each year about 

le ague 15Q0Q0 people in the United states, is 

caused by a bacterium which may grow in a great many 
different parts of the body, although it is most likely to be 
found in the lungs, causing tuberculosis of the lungs, or 
consumption. The germ does not grow all through the 
lungs in this disease, but here and there at special points, 
where there form hard little knots or tubercles, from which 
the disease is named. 

Tuberculosis of the bones is not uncommon among children, 
and a great many of the lame people we see on the streets 
are crippled from this cause. 

The primary cause of tuberculosis is a germ discharged in 
T - r f the spray and sputum coughed out by con- 

T , 1 . sumptives, and infection comes in most 
cases from getting these human discharges 
into the mouth. Sometimes the germ is inhaled in dust, 
but it is more frequently transferred from one person to 
another by rather direct contact. 

A great many cattle suffer from tuberculosis, and children 
may become infected by drinking the milk of tuberculous 
cows. 

42 



To prevent the spread of tuberculosis it is necessary first 

of all to destroy the germs discharged TT ~ 

t *u tu c *• & ,HowtoPre- 

from the mouths ot consumptives; and ... 

, . ... F ,j vent the Spread 

second, to pasteurize the milk ot all cows . _ . . . 
. ; . i r ■<• n of Tuberculosis 

not certamlv known to be tree trom the T - .. 
.. ' Infection 

disease. 

The careless consumptive is a great danger to his family 
and associates, but one who is always careful to destroy his 
sputum and to avoid coughing out mouth spray into the air 
need not be a menace to the health and life of others. The 
consumptive should always cough into a cloth or handker- 
chief, or a paper napkin, which can be burned, and all sputum 
should be received in paper cups and burned at the end of the 
day. If handkerchiefs are used, they should not be put into a 
laundrj' bag or basket with other soiled linen, but should be 
boiled for twenty minutes in a strong soapsuds solution. 

Tuberculosis is a disease in which vital resistance plays a 

specially important part. The germ is un- v . - p . 

fortunately very common; in fact, almost 

,. ., , , . . « ,., tance agamst 

every individual, sooner or later, is slightly „, , , . 
. . \ , ... .. ' toJ Tuberculosis 

intected with it. 

This does not mean that every man has tuberculosis, in 
the sense of suffering from actual disease. The human body 
has a wonderful power of defending itself against this in- 
vader, and a few germs entering a healthy body are quickly 
overcome. It is when a great many germs are taken in, and 
particularly when the strength is reduced by attacks of other 
diseases, or when resistance is lowered by intemperate habits, 
by living and working in overheated rooms, by eating insuf- 
ficient food, or by breathing sharp dust particles, that the 
invisible enemy overcomes the defenses of the body. France 
has today some 500,000 cases of tuberculosis to care for 
because of the deadly effects of the strain of trench life 
upon soldiers who, in a time of crisis, had to be sent to 
the front whether they were in full physical health or 
not. 

43 



People who have recovered from tuberculosis, and those in 

-. , whose family there has been a case, should 

„, , . . be specially on guard against allowing their 
Tuberculosis , T . / ~ , . . ? 

vital resistance to become weakened. Among 

the most important causes of tuberculosis are the unsanitary 
conditions of factory life. An overheated, un ventilated 
workshop is certain to lower vital resistance and make the 
worker an easy prey to the tuberculosis germ, particularly if 
he is weakened by long hours of labor. An especially dan- 
gerous thing about some industries is the fact that the air of 
the workshops is full of fine particles of mineral or metallic 
dust. These dust particles are inhaled and injure the deli- 
cate tissues of the lung, so that tuberculosis germs find it 
easy to grow there. The workers in some of these industries 
— granite workers and grinders, for instance — are two or 
three times as likely to contract tuberculosis as are people 
who work at less dangerous trades. 

In all such places there should be special pipes with exhaust 
fans to draw off the dust from the air. Where this cannot be 
done, the worker should wear a respirator over his mouth, to 
keep out the dust particles. 

Just as the tuberculosis germ fails to gain a real foothold 

T r . in the body of a thoroughly healthy person, 

_ , , . so by proper hygienic treatment it can be 
Tuberculosis , , A .,, , ., , 

conquered even alter it has begun its work. 

There are no medicines, in the ordinary sense, that will 
cure tuberculosis. All so-called " Consumption Cures" are 
frauds which take the money of their victims and do them 
immeasurable harm by wasting precious time. The cure for 
tuberculosis is hygienic living under the advice of a compe- 
tent physician, properly directed rest and exercise, plenty of 
fresh air, and a sufficient amount of wholesome food. If 
such treatment is taken early in the disease, tuberculosis can 
generally be cured. 

The main thing is to begin the treatment of tuberculosis as 
soon as possible. The time to put out a fire, or to control 

44 



a disease, is before it gets well under way. When tuberculosis 

has Kone far, it cannot usually be checked, T r 

.. , .. . , , , ., , Importance of 

but if the disease is attacked at its beginning, _, r . 

there is everv reason to be hopeful. Among _ y 

* . , , - Ireatment 

the common danger signals are loss 01 

weight, loss of appetite, prolonged "cold" with cough and 
spitting — the expectorations sometimes blood-tinged — fre- 
quent hoarseness, afternoon fever, chills, nightsweats, easy 
tiring, and pains in the chest. One of the earliest symptoms 
of pulmonary tuberculosis is a sense of weakness and loss of 
energy, both of body and mind, not infrequently out of all 
proportion to the extent of the disease. If any of these 
symptoms are present, the patient should go to a physician 
and have his lungs examined. 



RACIAL HEALTH 

Success in the struggle for existence involves 

Individual efficiency 

Perpetuation of the Race 

Both personal health and success in leaving progeny are 
threatened by the grave communicable T , M 
maladies which are known as the venereal f v . 

diseases. Lack of self-control endangers ~. 
one's life ; it threatens the life of the wife; 
it endangers the life of the mother; it imperils the life and 
the sanity of the child. From the medical standpoint it 
is vitally important that these diseases should be more 
fully controlled by public health authorities, that facilities 
for laboratory diagnosis should be furnished, and that pro- 
vision should be made for dispensary and hospital treat- 
ment. Concealment, delay in securing treatment, and resort 
to advertising quacks and charlatans are in large measure 
responsible for the extent of the damage wrought by these 
infections. 

45 



Around all the camps of England and France the great- 

T , „ f est enemy of the soldier is the diseased 

xi. o u- prostitute. Some of the finest British and 

the Soldier , . , . , , , 

, _ M colonial regiments have been seriously 

and Sailor «. , , ™, ^ ... t . 

affected, ine British government is 

now taking stern measures to protect its soldiers by 
the establishment of health zones, and the keeping of 
the men within certain bounds. In view of the special 
temptations which will surround our new army in this 
country and on the continent, the most earnest efforts 
should be made to control the surroundings of encamp- 
ments in this regard. 

Lieutenant-Colonel Frank R. Keefer, in his text-book on 
n . . - "Military Hygiene and Sanitation," says: 

M .J. " Venereal infections are responsible for an 

. ,. J. enormous amount of sickness in the army — 

Authorities .. ,, ,, , 

vastly more than any other cause — and 

constitute the most important health problem with which 

we have to deal." In the "Manual of Military Hygiene," by 

Colonel Valery Havard, the author points out that on 

account of the importance of this question, " soldiers should 

be taught all knowledge deemed necessary and useful on 

the subject. For instance, that sexual intercourse is not 

necessary for the attainment of the best physical and mental 

health, and that a strong, manly character is developed only 

by self-control and continence. They should have a proper 

appreciation of the prevalence and gravity of venereal 

diseases. 

"Many men expose themselves thoughtlessly, with the 

impression that, at the worst, a few days in hospital will 

suffice to get rid of the consequences. This is foolish 

and dangerous ignorance which officers, especially medical 

officers, should endeavor to dispel by a few plain talks, 

demonstrating to them the many complications and sequels 

of gonorrhea as well as the ravages of syphilis, which affect 

not only the incontinent, but, through matrimony, many 

46 






innocent women and children. Let them know that, in 
the opinion of gynecologists, a majority of the hazardous 
surgical operations performed upon married women are 
made necessary in consequence of gonorrheal infection 
by the husband; and another terrifying fact, that 
syphilis, so far as absolutely known, is not only directly 
transmitted from father to children, but the sole disease 
thus transmitted, as it were, a special curse upon the 
human race." 

More recent studies have shown that the proportion of 
prostitutes afflicted with venereal disease is far higher than 
has been assumed by earlier writers. Dr. Walker in an in- 
vestigation in Baltimore found over 90 per cent, of a group 
of prostitutes suffering from syphilis alone. 

The good soldier owes to his country today his full meas- 
ure of strength and vigor. He owes to his country of the 
future a full measure of strength and vitality to be handed 
on to coming generations. Both may be fatally jeopardized 
by a moment of weak self-indulgence. 

ACCIDENTS AND FIRST AID 

Slight cuts and scratches should be washed free from dirt, 
then carefully dried and painted with a r + H 

little tincture of iodine. More serious w - 

wounds should be dressed temporarily, until 
the doctor can attend to them, by covering them with sur- 
geons' gauze fastened on with a bandage. A deep wound, 
particularly if produced by a rusty nail or other dirty object, 
should always receive prompt medical attention; so should 
even the slightest scratch, if, after a few days, it is red, hot 
or painful. Any wound will heal without much pain or 
redness if there are no germs in it. Remember that germs 
get into a wound, not from the air, but from dirty things 
that touch it. A scratch or cut should never be touched 
with anything but sterilized surgeons' gauze. In connec- 

47 



tion with automobile accidents, it is well to remember that 
gasoline is a good disinfectant. 

If the blood comes from a wound in jets or spurts, an 
artery is bleeding, and the result may be serious if the flow is 
not checked. Fortunately, at most parts of the body the 
arteries are deeply buried in the flesh. A severed artery 
calls for prompt action. Put firm pressure close to the bleed- 
ing part, between the wound and the heart. In case the 
wound is in the arm or the leg, the pressure is best applied 
by tying a knot in the center of a folded handkerchief, and 
laying this knot over the artery. Tie it loosely around the 
limb, but with a good knot. Place a stick under the bandage 
and twist it round and round until the bandage is tight 
enough to stop the bleeding. 

The pain and swelling of an ordinary bruise will be much 

_» . . less if something cold is placed on the bruise 

Bruises and . , , , . & ., , . ^ , T . 

_ . at once to drive the blood away. Ice in a 

cloth may be used for this purpose, or simply 
a cloth wrung out in cold water. 

If a joint has been sprained (which means that the liga- 
ments that hold the bones together have been strained or 
torn), the same treatment with cold cloths is very useful, 
and should be kept up at intervals for twelve hours. In 
old and enfeebled patients, hot wet cloths are better. The 
injured part should be placed as high as possible, so as to 
keep the blood out of it. 

If a bone is broken, medical care is, of course, necessary. 
. While waiting for the doctor, the only thing 

to do is to keep the broken limb in as com- 
fortable a position as possible. Above all, 
do not let the limb bend at the place where the bone is 
broken, because that gets the splinters of bone out of place, 
and may drive them through the skin and lead to an infected 
wound. If you find it necessary to lift a broken limb, put 
one hand on each side of the break and lift it with both 
hands at the same time. 

48 



A person who has become faint and dizzy from the direct 
ect of strong sunlight shining on the 
ad should be placed in a seated position 
in the shade. His clothing should be loos- 



effect of strong sunlight shining on the . - 

i-juuui j • a j u- Sunstroke and 

head should be placed in a seated position 



ened, and cold water poured on his head, or 

his body rubbed with bits of ice. Cool drinks should be 

given, if possible. 

Heat prostration due to excessive heat acting on the whole 
body, and not to the direct sun's rays, should be treated 
somewhat differently. The patient should be laid flat on 
his back in a cool place, his clothing loosened, and his hands 
and feet rubbed, to restore the circulation. The face and 
body should be bathed in warm water and warm drinks 
should be given. 

If the clothing catches fire, there is only one thing to do, 

and it must be done quickly: smother the R 

flame. Fire needs plenty of oxygen, and ~. A1 _. 

- u wif- • i Clothmg and 

if a person whose clothing is on fire is _, - 

. , ; , i , , ■ Treatment of 

quickly and closely wrapped in a coat, _. 

shawl, blanket, or rug, the fire will go out. 

It is important to remember to wrap the cloth from above 

down. If the wrapping is done from below, the flames 

may be driven up and inhaled into the lungs with very 

serious results. If your clothing catches fire when you 

are alone, do not run for help, but lie down flat and roll 

over and over on the floor or on the ground, to smother the 

flames. 

In the case of a slight burn which only reddens the skin 

without forming a blister, the pain will be lessened if the air 

is kept from the burned place. A paste of ordinary baking 

soda and water applied to the burn will do this, or carbolized 

vaseline, or any grease, like lard, may be used instead. The 

burn should then be covered by tying a piece of cloth or 

bandage around it. If there is extensive blistering, the 

application of soda or vaseline may do harm; and severe 

burns should be treated like open wounds. 

49 



If ears, nose, or fingers are frost-bitten, the affected part 
„ - . should be rubbed with snow or very cold 

water until the blood has come back and 
the flesh begins to sting and burn. On no account should 
the person go into a warm room until this has been done, and 
until the frozen part has become gradually warm by rubbing. 
Even after the circulation has come back, the patient should 
become warm only gradually. 

When a person has been under the water or in some suffo- 
n . - eating gas for a long time, the breathing 

~ ~ . stops, and the patient becomes unconscious. 

If breathing can somehow be started again, 
recovery may follow. The starting of the breathing move- 
ments in a person who has ceased to make them for himself 
is called artificial respiration. 

Artificial respiration should be begun by laying the patient 
face downward upon the ground. The feet should be raised 
to drain out any excess water. Stretch the arms of the 
patient straight above his head and let them rest on the 
ground in that position. Turn his head a little to one side, 
so that the air will not be impeded in entering the nose and 
mouth. Next stand astride of the patient, with your body 
directly over his hips and facing his head. Put your hands 
on each side of his back, below the shoulder blades. Your 
hands now rest upon the patient's lower ribs. The fingers 
are spread out, pointed toward the head and away from the 
spine. 

Swing your body forward, keeping your arms straight and 
allowing your weight to rest on the patient's back; then 
swing back, taking all your weight off the patient. Do this 
fourteen or sixteen times per minute. This imitates the 
motions of breathing. When you put your weight on the 
patient, you press his chest together and force the air from 
the lungs; when you release the pressure, the chest springs 
back into place, and the lungs expand and draw air into 
them. 

50 



Recovery may be very slow; keep up your work for at least 
two hours. 

While this process is going on, some one should remove the 
patient's clothing. If necessary, he should be dried with a 
towel and then covered with a blanket. This work must 
not interfere with the operator who is causing artificial 
respiration. Compel bystanders to stand back. The patient 
needs every bit of air he can get. 

When the patient begins to breathe, — but not before, — he 
should have his legs and arms rubbed toward the body. 
This should be done without removing the blanket. The 
patient will not breathe well all at once, and it will be neces- 
sary to help him at first by continuing the artificial respira- 
tion every little while. Of course, if he stops breathing at 
any time, the artificial respiration must be renewed. 

After he is breathing well, put him to bed. Surround him 
with hot water-bottles and cover him up well. As soon as 
he can swallow, give him some hot coffee. Open the win- 
dows wide, and allow him to sleep quietly. 

Cases of electric shock (from contact with live wires, for 
example) and cases of gas poisoning require the same treat- 
ment — artificial respiration. 

If some poisonous drug has been taken, the first thing to 

do is usually to get it out of the body again _. . 

• i i ui u • •*• Poisons 

as quickly as possible by causing vomiting. 

This may be done by running the finger down the throat, by 

drinking a large quantity of warm water, or by taking some 

substance which will cause vomiting, called an emetic. A 

teaspoonful of mustard or salt in a glass of lukewarm water 

will serve as an emetic. Promptness is more important than 

an exact dose. After the emetic has been taken, large 

quantities of warm water should be drunk, to dilute the poison 

that remains. 



51 



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