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Health on the Farm: A Manual of Rural Sanitation and Hygiene

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Title: Health on the Farm: A Manual of Rural Sanitation and Hygiene

Author: H. F. Harris


        
Release date: September 28, 2008 [eBook #26718]

Language: English

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THE YOUNG FARMER'S PRACTICAL LIBRARY

EDITED BY ERNEST INGERSOLL




HEALTH ON THE FARM

BY

H. F. HARRIS




The Young Farmer's Practical Library

EDITED BY ERNEST INGERSOLL


Cloth 16mo Illustrated 75 cents _net_ each.

=From Kitchen to Garret.= By VIRGINIA TERHUNE VAN DE WATER.

=Neighborhood Entertainments.= By RENEE B. STERN, of the Congressional
Library.

=Home Water-works.= By CARLETON J. LYNDE, Professor of Physics in
Macdonald College, Quebec.

=Animal Competitors.= By ERNEST INGERSOLL.

=Health on the Farm.= By DR. H. F. HARRIS, Secretary, Georgia State Board
of Health.

=Co-operation Among Farmers.= By JOHN LEE COULTER.

=Roads, Paths and Bridges.= By L. W. PAGE, Chief of the Office of Public
Roads, U. S. Department of Agriculture.

=Farm Management.= By C. W. PUGSLEY, Professor of Agronomy and Farm
Management in the University of Nebraska.

=Electricity on the Farm.= By FREDERICK M. CONLEE.

=The Farm Mechanic.= By L. W. CHASE, Professor of Farm Mechanics in the
University of Nebraska.

=The Satisfactions of Country Life.= By DR. JAMES W. ROBERTSON, Principal
of Macdonald College, Quebec.




             HEALTH ON THE FARM

   A MANUAL OF RURAL SANITATION AND HYGIENE


                     BY
                H. F. HARRIS
 SECRETARY OF THE GEORGIA STATE BOARD OF HEALTH

                 =New York=
          STURGIS & WALTON COMPANY
                    1911
            _All rights reserved_


               Copyright 1911
        By STURGIS & WALTON COMPANY

  Set up and electrotyped. Published July, 1911




INTRODUCTION

BY THE GENERAL EDITOR


This is the day of the small book. There is much to be done. Time is
short. Information is earnestly desired, but it is wanted in compact
form, confined directly to the subject in view, authenticated by real
knowledge, and, withal, gracefully delivered. It is to fulfill these
conditions that the present series has been projected--to lend real
assistance to those who are looking about for new tools and fresh ideas.

It is addressed especially to the man and woman at a distance from the
libraries, exhibitions, and daily notes of progress, which are the main
advantage, to a studious mind, of living in or near a large city. The
editor has had in view, especially, the farmer and villager who is
striving to make the life of himself and his family broader and brighter,
as well as to increase his bank account; and it is therefore in the
humane, rather than in a commercial direction, that the Library has been
planned.

The average American little needs advice on the conduct of his farm or
business; or, if he thinks he does, a large supply of such help in
farming and trading as books and periodicals can give, is available to
him. But many a man who is well to do and knows how to continue to make
money, is ignorant how to spend it in a way to bring to himself, and
confer upon his wife and children, those conveniences, comforts and
niceties which alone make money worth acquiring and life worth living. He
hardly realizes that they are within his reach.

For suggestion and guidance in this direction there is a real call, to
which this series is an answer. It proposes to tell its readers how they
can make work easier, health more secure, and the home more enjoyable and
tenacious of the whole family. No evil in American rural life is so great
as the tendency of the young people to leave the farm and the village.
The only way to overcome this evil is to make rural life less hard and
sordid; more comfortable and attractive. It is to the solving of that
problem that these books are addressed. Their central idea is to show how
country life may be made richer in interest, broader in its activities
and its outlook, and sweeter to the taste.

To this end men and women who have given each a lifetime of study and
thought to his or her specialty, will contribute to the Library, and it
is safe to promise that each volume will join with its eminently
practical information a still more valuable stimulation of thought.

ERNEST INGERSOLL.




                  TABLE OF CONTENTS


  CHAPTER                                          PAGE

     I IMPORTANCE OF OUR SUBJECT                      3
    II CARE OF THE PERSON                            12
   III SANITATION IN AND ABOUT THE HOUSE             35
    IV HYGIENE OF INFANCY AND CHILDHOOD              63
     V PROPER EATING--THE SECRET OF GOOD HEALTH      92
    VI BREAD AND ITS RELATIONS                      104
   VII MEATS, SUGARS AND MILK                       117
  VIII FOOD-VALUE OF VEGETABLES                     130
    IX DANGER IN FRUITS AND PICKLES                 144
     X DRINKS--PROPER AND HARMFUL                   148
    XI IMPORTANCE OF GOOD COOKING                   164
   XII SEVEN AVOIDABLE DISEASES                     171
  XIII HYGIENE OF THE SICK ROOM                     217
   XIV EMERGENCIES AND ACCIDENTS                    223
    XV WHAT TO DO WHEN POISONED                     251
       APPENDIX                                     273




HEALTH ON THE FARM

CHAPTER I

IMPORTANCE OF OUR SUBJECT


Notwithstanding the extraordinary advances in a material way that have
been accomplished in this country within the last few decades, it is a
significant and most alarming fact that progress in hygienic matters has
lagged far behind. Why this is, it would be very difficult to say,--for
the reason that the causes are perhaps many. Chief among these, probably,
is the fact that our progress along industrial lines has occupied the
entire time of the majority of our best intellects, and it is also in no
small degree the consequence of a fatalism that regards disease as a
direct visitation of providence and therefore a thing which man may not
avoid. Another cause in some instances is the pride of our people in
their homes and respective localities, which causes them to repel with
indignation the suggestion that any special measures are necessary in
order to conserve the public health where they reside. Ignorant as the
average man is of the causes that produce sickness and the means by which
this result is accomplished, he is naturally not in a position to form a
correct judgment concerning such matters, and as a consequence, sees no
reasons for taking the precautions that are necessary in order to ward
off disease. This ignorance, it must be confessed with sorrow, is in a
measure the fault of the medical profession, which has not in the vast
majority of instances lived up to its ideals in this connection. Petty
and unworthy rivalry has played an extremely important part in this
failure of medical men to do their duty in this particular--none of the
physicians of a community being, as a rule, willing that others should
instruct the public, however vital this might be for the general good. As
a consequence, that class of vultures known as medical quacks has
furnished to the laity by far the greater proportion of their
instruction on hygienic subjects, with the result that the average man
has a greater misconception and less real knowledge of such matters than
of anything else in which he is vitally interested.

Another, and very curious explanation for our general disregard of the
laws of health is that our strong belief in ourselves impels us to think
that however much others may suffer from things generally regarded as
unhygienic, we, ourselves, will be immune. This belief is fostered by the
fact that in early life there often seems no end to our capacity to
endure, and we find ourselves constantly defying without apparent harm,
what we are told by others is directly contrary to all rules of proper
living. But it is unfortunately true also that the reserve force and
great power of resistance that enables us to do these things begins to
wane towards the end of the third decade of life, and we, therefore, find
ourselves sooner or later breaking down after we have become thoroughly
convinced that we were made of iron, and that while other people might
not be able to do as we were, it could not possibly result in evil in our
own cases.

What a pity it is that the young will not learn from the experience of
those who have gone before them! Could they only do so, how much
suffering and woe could be avoided in this world. Unfortunately, however,
there are few men so constituted that they are willing to be guided by
the experience of those who have preceded them, and there is but a faint
possibility, therefore, that any good can be accomplished by warning the
coming generation of the troubles in store for them should they not heed
the advice of those who have suffered before them. Notwithstanding this,
the writer feels that these words of warning should be spoken to the
young, since they, alas, are the only ones to be benefited by such
advice.

_As you value your happiness materially, and as you desire a healthy old
age and a long life, inform yourselves as to the few simple laws that
govern human existence, and attempt so far as lies in your power to
follow them. If you do not do this, disaster will follow as surely as the
night follows the day._

_Apathy of the Public as to Hygiene._--As a partial consequence,
probably, of all the reasons mentioned, along with others, there exists
in the popular mind a curious apathy concerning hygienic matters--an
apathy so great that it is scarcely possible to get the average man to
discuss, much less to put in practice the all-important laws that govern
health. As a result of the work of the various State boards of health and
of the Public Health and Marine Hospital Service, this condition of
affairs happily shows some signs of abatement, and we certainly have
reasons to believe that the future promises great things along these
lines. No sign of this change is more significant than the awakening of
the press of the country to the vast importance of instructing the public
in health matters, and their changed attitude toward the charlatans and
quacks who live by promising the impossible. Largely subsidized by the
infamous vendors of patent medicine, our newspapers and magazines still
lend their columns to these human vampires who prey pre-eminently on the
ignorance and credulity of the hopelessly-diseased poor; but within
recent years some of our foremost journals show signs of an awakening of
conscience, and a very few have even gone so far as to exclude
advertisements of this character altogether.

It has been said, certainly with more or less truth, that we are
creatures of our surroundings, but whether we accept this in its broadest
sense or not, there can be no question that our well being is most
intimately connected with those things with which we come into every day
contact. _Nothing is more important for us to recognize than that our
diseases are contracted from neighboring subjects just in proportion as
we are closely associated with them._ From our fellowmen we contract, as
everyone knows, a large number of diseases, either by direct contact or
by means of the air that surrounds us. From the earth we get hook-worms
and other animal parasites, either by coming directly in contact with it
or through eating uncooked fruits and vegetables. From water we get
typhoid fever, dysentery, cholera, and many other parasitic diseases.
From our food we likewise contract dangerous maladies such as tapeworms
from uncooked meats and fish and the deadly trichina from raw hog meat.
With decomposed breads we take the poisons that produce pellagra,
kak-ke, ergotism and acrodinia. From uncooked fruits and vegetables we
get dysentery, typhoid fever, cholera, and parasitic diseases. Spoiled
beans give us the deadly lathyrismus. From decomposed meat and fish we
get ptomaine poisoning. Mosquitoes convey to us malaria, yellow fever and
a parasite known as the filaria. The dreaded sleeping-sickness of Africa
comes through the bites of a small fly; the bedbug is believed to be the
means of conveying a frightful disease known as kala-azar, and the
house-fly often brings to us the germs that produce typhoid fever,
dysentery, and probably other diseases as well.

The bubonic plague, which is one of the most frightful diseases known, is
conveyed to man by the rat and mouse.[1] Hydrophobia is usually
contracted from the bite of the dog, and it is a well-known fact that
this animal often harbors a minute tapeworm, a single egg of which, when
swallowed by the human being, is often followed by death. Both dogs and
cats probably convey diphtheria, and both unquestionably often have
within their intestinal tracts tapeworms that occasionally infect
children. With the exception of the rare disease known as glanders, the
horse is not believed to be directly responsible for any of the maladies
from which the human being suffers, but it is well established that fully
95 per cent. of house-flies hatch in the manure of these animals, and
they, therefore, become indirectly responsible for some of the most
serious diseases affecting the human being. It is thus seen that almost
every object with which man comes in intimate contact is capable of
conveying to him the poison of one or more diseases. If it were possible
for us to separate ourselves completely from everything with which we are
ordinarily associated there can be no question that the span of human
life would be greatly increased, and that death from bacterial and
parasitic diseases generally would no longer occur. All this is said not
with the object of startling the reader, but to warn him of the dangers
that surround him on every hand, and to urge a recognition of that which
can so materially prolong his life. Fortunately these sources of
infection may be almost entirely done away with by a few simple rules of
life, and the health and longevity of mankind must necessarily be
directly proportionate to the care with which we observe them.

It is now in order to discuss in detail the subject of personal hygiene.


FOOTNOTE:

[1] See the volume in this Library, _Animal Competitors_, by ERNEST
INGERSOLL, for the agency of rats and mice in the introduction and
dissemination of plague and other diseases; and the means of destroying
these pests of the farm.




CHAPTER II

CARE OF THE PERSON


It is happily the case that in America the importance of personal
cleanliness is more thoroughly understood, and is more generally
practiced than any of the other important hygienic procedures. While it
is true that there are many--particularly those of foreign extraction,
and who live for the most part in the larger cities--to whom an
occasional bath appeals only as a painful necessity, a very large
percentage of those born in this country bathe regularly. It should be
thoroughly understood that a daily bath is essential, not only from the
standpoint of cleanliness, but from the fact that this practice is in the
highest degree conducive to health. It should never be forgotten that by
cleanliness infectious materials are removed from the surface of the
body, and at the same time the skin is put into a condition to eliminate
from the system those waste products which it is its special function to
remove. The close relationship of the proper activity of the skin to
health is perhaps not generally sufficiently appreciated--for it is true
that the body cannot remain normal when the secretory power of its glands
is impaired, and that even death quickly follows when they cease to
functionate altogether.

_Advice as to Bathing._--Much difference of opinion exists as to the
proper temperature of the water for bathing, some holding that it should
be quite cold, while others are equally positive that it should be warm.
Unfortunately it is impossible to give fixed rules concerning this
somewhat important matter, for there is every reason to believe that it
should be determined in each individual case according to circumstances,
and that, therefore, both may be right. Some persons unquestionably do
better with one, and some with the other. It has been established clearly
that the cold bath is highly stimulating, and where not too prolonged,
and when followed by vigorous rubbing, is undoubtedly healthful for a
large number of people. The cold bath is often used by physicians in the
treatment of diseases of low vitality. Many persons however, are
unpleasantly affected by bathing in water of a temperature much below
that of the body; particularly is this true of women, and the like may be
said of thin and nervous persons of the other sex. It is claimed by the
advocates of the cold bath that those who practice this procedure daily
are practically immune from colds, but this, certainly, is not always
true; on the contrary the writer has seen instances where the cold bath
has unquestionably led to chronic nasal catarrh, with increased tendency
to inflammatory conditions of the air passages. It is also the case that
baths of this description tend in some persons to prevent a normal
accumulation of fat beneath the skin, and keep individuals of this kind
unnaturally lean.

The warm bath is perhaps, on the whole, more popular than the cold, since
it is preferred usually by children and women, and is practiced by a
considerable proportion of adult males. It is unquestionably somewhat
enervating, and at best fails entirely to give the agreeable stimulation
experienced by those who take a cold plunge. It is, however, to be
preferred in those instances where cold water produces disagreeable
effects, and if the bath be not too long continued it is followed by no
ill results. Persons who become lean under cold baths not uncommonly take
on flesh when they begin to use warm ones. It is unquestionably true that
the latter is to be preferred in hot climates.

The sea bath is invigorating not only from the water being cool, but as a
consequence of the pleasurable excitement with which it is attended. Its
greatest disadvantage lies in the fact that there is a tendency to overdo
it, many persons remaining in the water for hours. Ten or fifteen minutes
is as long as the average person should indulge in sea-bathing, and it is
a question if even those who are young and vigorous should remain in the
water longer than half an hour.

Bathing of any kind should be indulged in before meals, the best time
being before breakfast in the morning.

_Care of the Teeth._--Nothing in connection with the subject of personal
hygiene is of more importance than keeping the teeth properly cleansed.
The fact is not generally appreciated that sound teeth stand in a most
intimate relationship with good health, and that disastrous consequences
are sure to follow sooner or later where these most important structures
are neglected.

While it is true that in a person of vigorous health one or two decayed
teeth do not, as a rule, occasion obvious trouble at once, ill effects
are sure sooner or later to be felt. For one thing, a person without good
teeth cannot chew his food well. Those who begin by neglecting what at
first are slight defects in the teeth seem to acquire in the course of
time a sort of habit of doing this, and ultimately disregard and fail to
have corrected the more serious diseases of the dental structures.
Nothing is more common than for the practicing physician to find patients
with one or more teeth partially gone, or, even worse, with only the
exposed roots remaining.

Where cavities exist, food is constantly forced into them, and undergoing
decomposition, the breath of their owner becomes foul, and portions of
decayed food mixed with multitudes of bacteria are constantly swallowed;
sooner or later there inevitably follows under such circumstances
catarrhal conditions of the stomach, which reaches a point in some
individuals where the health is seriously threatened. Not only do bad
teeth produce trouble in the way just mentioned, but there is every
reason to believe that germs that produce disease--particularly those
that cause consumption--not uncommonly find their way to the interior of
the body through the resulting cavities.

It is the duty of everyone to properly cleanse the teeth at least once
daily--to do so after each meal would be even still better. This should
be done with a moderately soft brush, with which it is unnecessary to use
tooth-powders or lotions--though many prefer to do so. Where something of
the kind is desired, ordinary lime-water is perhaps as satisfactory as
anything else; peroxide of hydrogen, diluted eight or ten times with
water, to which a pinch or two of ordinary cooking soda has been added,
undoubtedly aids the cleansing process, and has the advantage that it
leaves a pleasant after-taste in the mouth. In brushing the teeth care
should be taken that every part of the tooth receives attention, it being
not sufficient, as is so often done, merely to brush the front. It should
be the practice of everyone to have the teeth looked over at least once a
year by a good dentist, as even where cleansing is diligently performed
decay frequently sets in on their inner sides.

The utmost care should be taken of the permanent teeth especially, and as
long as it is possible to prevent it no one should be allowed to pull
them. There can be no doubt that life is shortened by the early loss of
the permanent teeth in most, if not in all, cases--not to count loss in
health and happiness that follows their absence.

_Clothing,--Material and Color._--Clothing will be considered in this
article only as regards its function of properly protecting the body,
which it does by preventing the escape of heat, thus keeping the body
warm, or, under other circumstances, by keeping out excessive heat or
cold.

Materials of which clothing is made differ very greatly in their ability
to accomplish the object just mentioned, some being comparatively poor
conductors of heat and hence fulfill the desired function admirably,
while others, for opposite reasons, are of comparatively little value for
this purpose. In general it may be said that structures of animal origin,
such as wool and silk, are much poorer heat conductors than those
obtained from the vegetable world, and as a consequence the former are
justly held in much higher esteem as material for clothing than the
latter. It should not be forgotten, however, that the protective value of
a fabric also depends upon the manner in which it is woven, since those
that are loosely constructed are much warmer, other things being equal,
than those that are put together more closely; this depends upon the fact
that in the former there are innumerable small cavities between the
fibers in which air is contained, and as this substance is a very poor
conductor of heat, it follows that a garment made loosely and containing
many such chambers is warmer than where the number is less. It may well
be the case that a fabric constructed of a material which is a poor
conductor of heat and closely woven may be actually cooler than another
composed of a substance which is a much better conductor of heat but of a
loose texture.

The efficiency of different materials of which clothing is made also
depends upon their capacity to absorb water. This may be done in two
ways: the water may simply collect between the fibers, in which case it
may be in a large measure removed by wringing, or it may be actually
absorbed into the substance composing the fabric, and, as a consequence,
the latter, even though containing much moisture, do not appear damp.
Fabrics made from vegetable materials, as cotton or linen, have little
power of actually absorbing water, and hence they become wet on the
slightest addition of moisture, while on the other hand those of animal
origin have the capacity of absorbing water, and appear dry even after
the addition of this substance in considerable amounts. A person,
therefore, dressed in cotton fabrics will find after active perspiration
has begun that his clothing quickly becomes moist, while if he have on
woolen garments this will not occur. It is particularly noteworthy that
water is gradually removed by evaporation from animal fabrics, which
causes a general cooling without producing a chill; it is therefore
readily understood that woolen clothing is much to be preferred where
active exercise is being taken.

Color is also of some importance in determining the value of a fabric for
protecting the body from the sun's heat. Within recent times we have
learned a great deal respecting the wonderful penetrating power of the
invisible light rays, and we have every reason to believe that these
modify to a very considerable degree every process going on within the
body. The violet and ultra-violet rays are those that unquestionably
exert most influence, and it has been suggested that they may be broken
up and rendered innocuous by covering the body with materials having a
reddish-yellow color. It is not necessary to put these materials on the
outside where they would be conspicuous, but they may be used as lining
for hats and clothing; and there are good reasons to believe that if
their use were generally adopted suffering and actual loss of life from
overheating would be greatly reduced, particularly in warm countries.

_Work and Rest._--Very slowly the people of our country are beginning to
realize that it is quite as necessary to rest as to work, though
unfortunately in some quarters a strenuous life is urged as being only
secondary in importance to possessing a big family; that there is an
intimate association between the two there can be no doubt, since the
latter beyond peradventure would entail the former. It has ever been the
habit and misfortune of sages now and then to desert the field of their
own peculiar activities and to make incursions into unknown
regions--generally giving advice with a dogmatism and finality
proportionate to their ignorance of the subject under discussion.

As a matter of fact the average American works entirely too much, and
while he sometimes accumulates an immense fortune with astounding
rapidity, to his sorrow he often learns later that he has likewise
acquired a damaged heart, premature thickening of his blood-vessels or
nervous dyspepsia with all of its attendant evils. Descended as we are in
a large measure from the most vigorous and adventurous Europeans of the
last few centuries, and coming into possession of a new world where
everything was to be done, this tendency to overwork is most
natural,--and for this reason is all the more to be combated. That we
have been able so successfully to carry the burden for several
generations is indeed remarkable, but there are not wanting numerous
indications that the strain is beginning to tell. If we do not call a
halt, and devote more time to rest and agreeable pastimes, disastrous
consequences are sure to follow, and we will become in the course of time
a race of neurasthenics and degenerates. Attention should likewise be
directed to the fact that men do not develop to the highest point of
mentality who devote their entire time to work, as leisure is absolutely
essential for thought and the development of all that is best in man.

Let us then cast aside the shallow and ignorant preachments of those who
do not understand the subject, and devote a reasonable time to the
reading of good books, to thought, to the cultivation of the arts and
sciences, and to pleasurable pastimes. In these particulars we are far
behind Europe, and we shall never take our place as an intellectual
people until we radically change our method of life. A nation must dream
before becoming great. Let it not be understood from the foregoing that
the writer would in the slightest degree minimize the necessity for a
reasonable amount of work, for he thoroughly appreciates that without
labor neither the individual nor the nation itself could remain sound--it
is only urged that excessive work is quite as much to be feared as none
at all.

_Health and Labor._--As to the number of hours that should be devoted to
labor no rule can be laid down. It all depends on the age, physical and
mental vigor of the individual, and likewise, to a considerable degree,
on the character of the work. Occupations requiring intense mental or
physical strain can only be kept up for short periods of continuous
application, while, on the other hand, quite naturally, those of a less
strenuous nature would permit longer hours. The young man, in pride of
perfect bodily and mental vigor, too often assumes, because he has been
able in the past to do pretty much anything that pleased him without
ill-effect, that he can continue to do the same through life. No greater
mistake could be made.

Anything that has a tendency to undermine the health, repeated
sufficiently often, will ultimately cause a complete breakdown. How often
do we see the strength and beauty of early manhood blighted and turned to
premature old age and death as a consequence of disregarding the warnings
that have just been given! How frequently do we observe young men
rejoicing in the emancipation from home and school and spurred on by the
fatal delusion that while others might suffer they will not, becoming in
the end the victim of that arch enemy of early manhood, consumption!
Every practicing doctor has seen this, not once, but hundreds of times,
and in the vast majority of instances he can say with truth that the
frightful result is a consequence of overwork--too often associated with
nocturnal dissipation. The man who works during the day, and devotes his
nights to alcohol and gay company when he should be sleeping, will
assuredly, sooner or later--and usually sooner--suffer the inevitable
consequences.

To those who live sedentary lives, active out-door exercise is very
essential, but inasmuch as this little volume is being written for those
who live a saner and more healthful existence, it is not deemed necessary
to discuss here this phase of the subject.

_Value of Sleep._--Closely connected with the subject just discussed is
sleep. Here also we have no rules, or laws, from which we can clearly
determine the amount required in individual cases. Overwise philosophers
have asserted that seven hours for a man, eight hours for a woman, and
nine hours for a fool, was the allotted time for sleep. As a matter of
fact, the necessity for repose varies greatly in different individuals,
some of them requiring less while others demand more. It is a safe rule
to follow that every man should sleep as long as he naturally desires,
for nature is a much better mentor than any man could be--however
learned. The majority of men require at least eight hours of sleep for
the day and night, and this should be secured if possible at such a time
as will permit it to be undisturbed; hence it is that man usually prefers
to sleep at night, and, all things considered, it is probably the time
best suited for his repose. We read many marvelous stories of certain
great men who required little or no sleep. Within recent years the press
has frequently contained articles recounting the extraordinary fact that
a certain prominent inventor of this country lived daily on a mere
spoonful or so of food, and only slept a few hours now and then when
there was nothing else particularly to do. Such stories should be
accepted only on absolute proof, as, irrespective of their utter
improbability, one may observe that they are generally insisted upon in
and out of season with a pertinacity that would indicate that they were
conceived and are scattered abroad with the sole idea of impressing the
general public with what a marvelous and unusual person the individual in
question is. There can be no reasonable doubt that they are merely
evidences of childish vanity and puerile mendacity, and are only referred
to here for the reason that young persons, ignorant of the laws of
health, might attempt to emulate them, with results that could be but
disastrous. _Nothing so preserves youth, health, and good looks as a
sufficient amount of sleep, and it is pre-eminently the secret of long
life._

Reference will be made in the chapter on the Hygiene of Infancy to the
necessity of children sleeping as much as is possible. It will do no harm
to say again here that nothing is so essential for the proper development
of the body as sleep, _and that it is absolutely a crime to awaken a
child except under circumstances of absolute necessity._

_Precautions in Respect to Eating._--A sufficient amount of sleep, and a
proper quantity of digestible and nutritious food, thoroughly cooked and
carefully masticated, are the things which above all others are most
important for the maintenance of health. In the chapter on Foods, the
nutritive values and digestibility of the various articles eaten by man
will be discussed with sufficient thoroughness to instruct the reader as
to a wholesome dietary; it is, therefore, not necessary here to go into
the matter fully, but the subject is so important that a few general
remarks will not be out of place.

Eating should never, so far as is possible, be hurried. Nothing is more
important for the proper digestion of food than its thorough
mastication, and this can only be accomplished when sufficient time is
allowed for eating. It is not necessary that this be done to the extreme
advocated by some, but it is certainly of the highest importance that the
food be so thoroughly chewed that it is reduced to fine particles, and
that it should be so soaked in saliva that it may be swallowed without
the aid of liquids of any kind.

It is also desirable that food should not be taken while the individual
is tired, so that it is a good plan where this condition exists for one
to lie down for a short time before eating.

Regularity in eating is likewise of importance, it being best to take the
meals at stated periods; the consumption of food at irregular hours often
leads to indigestion and is a practice which should not be indulged in.

It is highly desirable to have food served under agreeable circumstances,
digestion being accomplished in a much more satisfactory manner if
pleasant conversation be indulged in during the meal, and if the food be
of an appetizing character. Nothing is of more importance in connection
with this subject than to have the food properly prepared. Not only is
thorough cooking important from the standpoint of making foods
digestible, but as is shown in another part of this volume, grave and
sometimes fatal diseases are contracted by a neglect of this important
procedure.

Fruits, contrary to what is generally thought, contain but little
nourishment, and severely tax the digestive powers of those who have a
tendency to dyspepsia. When eaten at all, they should be perfectly ripe
and fresh, and should always be taken after meals rather than before.

_Drinks,--Coffee, Tea, Milk, etc._--Much misconception exists, among
people generally, and even among the medical profession, concerning the
proper amount of water that should be drunk. While this substance is
unquestionably the most wholesome of all drinks, there exists no
necessity for taking it in great quantities at times when the system does
not call for it. It would perhaps be a good rule for all to form the
habit of drinking little while eating, the reason for which will be
explained hereafter.

Coffee is exceedingly popular both on account of its delicious odor and
taste when properly made, and for the reason that it is highly
stimulating. While it is borne by young and vigorous persons of either
sex with apparent impunity, there frequently comes a time in life when it
can no longer be drunk without ill effects. As a general rule, dyspeptics
do not bear it well.

Tea, if properly prepared, is a most palatable beverage, and one that is
generally better borne than coffee. It is more wholesome when taken
without lemon juice, and like coffee it is less disposed to produce
trouble if largely diluted with milk, or if taken without cream or sugar.

Cocoa and chocolate are often used as substitutes for tea or coffee, and
where they agree with the individual are perhaps as wholesome as either.
Both, however, contain considerable quantities of fat, and as they are
frequently prepared with cream, or very rich milk, they are not as a rule
well borne.

While milk might be considered as being almost as much a food as a drink
still the fact that it is fluid, and that it contains a very large
percentage of water, causes it to be regarded as a beverage. When taken
slowly--and this precaution is particularly necessary where it is fresh
and sweet--milk is a drink that should be regarded as being on a par with
water. It contains no injurious substances, but sour milk should, as a
rule, be avoided by dyspeptics.

The cardinal principle in taking beverages of any kind at mealtime is
that they should be drunk alone after the food has been swallowed, as
when they are taken with the purpose of softening the latter, mastication
is seriously interfered with and the proper soaking of the food in the
saliva prevented.

_Alcoholic Beverages._--Alcoholic drinks are so fully discussed in a
latter part of this book that here it may merely be stated that they
cannot be regarded as having food-value to any degree, and so far as the
matter is at present understood, appear to be entirely superfluous, and
even positively injurious. If taken at all, they should be consumed in
extreme moderation, after meals rather than before. The young especially
should be particularly warned against the use of all beverages of this
class.

_A Word on "Soft Drinks."_--Mention should also be made of those drinks
commonly sold at soda-fountains. The vast majority of them may be taken
occasionally without any appreciable ill effects, but the habitual use of
beverages containing considerable quantities of syrup is not entirely
wholesome. Particularly is this true where the drink contains stimulating
drugs, such as do some of those most advertised. Some of them are, if no
worse, the equivalent of a strong cup of coffee, and should, therefore,
no more be taken every hour or two during the day than a cup of the
substance just mentioned. If their use is persisted in, it is sure to be
followed by indigestion, and in many instances nervous disorders of even
a serious character. The reader should also be warned against the use of
drinks containing medicine for the relief of pain--particularly those
that are advertised as remedies for headache. Practically without
exception, all such drinks contain coal-tar preparations that greatly
depress the heart, and have in a number of instances been followed by
death. Drugs of this character should be taken with the utmost
circumspection, and only on the prescription of a competent physician.

_Tobacco._--Tobacco, of all nerve sedatives, is the most universally
used. In moderation it could not be said that it is followed by any
apparent ill effects in the majority of people, but if used in excess
oftentimes sets up serious disturbances. It is peculiarly injurious to
boys, and should never be indulged in until manhood is reached. Some
persons seem to possess a natural immunity to the ill effects of
nicotine, and appear to be able throughout their lives to chew or smoke
tobacco in any amount without harmful results; such instances are,
however, rare--its excessive use being usually followed by symptoms that
may be of a serious nature. Of the two methods of use perhaps smoking is
less open to objection, though it is unquestionably true that chewing is
not so apt to cause disturbances of the heart. Smoking affects the
stomach, but not to the extent that chewing does.




CHAPTER III

SANITATION IN AND ABOUT THE HOUSE


The bearing of intelligently located houses of proper construction on
health is not so generally understood, even by physicians, as the facts
warrant, and, of course, is even less well recognized by the non-medical
public. It is true that some attention has been given to the matter of
_location_, but even in this connection there prevails a woful ignorance
among all classes as to just how the diseases are transmitted that are
most influenced in this way. As a result of recent advances in medicine
it has been clearly shown that at least some of the diseases that are
most influenced by locality may be easily avoided, and as a consequence
we find that the views of the modern sanitarians have necessarily
undergone a certain amount of change in this direction. On the other hand
recognition of the necessity of hygienic _construction_ has not been
sufficiently accentuated,--since it is possible by proper attention to
the details of building to do away entirely with at least two of the
diseases that have heretofore been the principal drawbacks to life in all
tropical and sub-tropical countries. Much importance likewise attaches to
houses being thoroughly ventilated, and to their being sufficiently roomy
to properly accommodate their inmates. The following table shows the
striking relationship that mortality bears to over-crowding:--

  RELATION OF DEATH-RATE TO DENSITY OF POPULATION.

  City.              Mean number      Average death-rate
                   of inhabitants   per 1,000 inhabitants.
                   to each house.
  London                  8                24
  Berlin                 32                25
  Paris                  35                28
  St. Petersburg         52                41
  Vienna                 55                47

Many other statistics could be quoted, but all follow the general trend
of those just given.

_Choice of Site._--In our rural districts the inhabitants have a wide
latitude in the matter of the selection of the location for their
houses, and it is usually the case that our people are sufficiently
intelligent to make the best use of their opportunities in this
direction. It may, however, be mentioned that it is generally considered
that building-sites in the neighborhood of cemeteries are not favorable
locations, nor should houses be erected in the vicinity of a
manufacturing plant that gives off injurious gases, or obnoxious
materials of other kinds. Inasmuch as we now know that malaria is
transmitted by a certain mosquito, and that by properly screening the
house their attacks may be avoided, the necessity no longer exists for
avoiding the vicinity of lakes and rivers as building-sites; such
localities being as a rule pleasant and often picturesque, they would
naturally under ordinary circumstances be selected, and there now remains
no reason why this may not be done,--provided that the house is so
constructed that mosquitoes can be effectually prevented from gaining
entrance.

Of much importance is the selection of a locality where good and pure
water can be easily procured, as otherwise disastrous consequences are
sure to follow.

The soil should be of a light and porous character, easily permeable by
water, and free from the decomposing remains of excretions of man or
animals. There is much reason for the belief also that the level of the
ground-water plays a somewhat important part in the salubrity of any
given locality, and it is generally considered that this should be at
least ten feet below the surface. It is generally thought, and probably
with truth, that those sites are most healthful which have their location
on a basis of granite, or other rock-foundation; in such localities there
is usually a considerable slope of the general surface of the ground,
with the result that water rapidly runs off after rains, and consequently
stagnant pools, which might serve as a breeding place for mosquitoes and
bacteria, do not form. Soils through which water easily permeates are
likewise, as a rule, healthy, though this depends in a measure upon
whether or not they contain a very considerable proportion of vegetable
matter. Clay foundations are healthful where there is a considerable
slope to the surface of the ground, but where this does not exist the
soil is damp, owing to its impermeability, and often has stagnant pools
upon its surface. Marls and alluvial soils are not regarded as being
wholesome, but it is not unlikely that their bad reputation is largely
due to the fact that they generally exist in the neighborhood of rivers
and other considerable bodies of water where mosquitoes are numerous.
There are no reasons going to show that cultivated lands are
unhealthy--even where they receive yearly abundant additions of manure.
Where it is necessary to build in damp localities the site should be
thoroughly drained, and the space upon which the house is constructed
should be carefully covered with some impermeable cement.

_Building Materials._--Of all building materials, the one most commonly
employed in America is wood. This arises from the fact that in the past
we have had unlimited quantities of timber from which lumber could be
procured at a price so reasonable that no other material could ordinarily
be considered. That the wooden house has some advantages cannot be
denied; its walls rapidly cool following the torrid days that so commonly
occur during the summer in almost all portions of the United States, and
it is usually well ventilated as a result of the numerous fissures
naturally existing in its structure.

Next to wood, bricks are most commonly used for building purposes, and
have many advantages, among which are their handsome effect, their
stability, and their being poor conductors of heat; the last mentioned is
of considerable importance, since it keeps both heat and frost from
rapidly permeating the interior, and as a consequence houses constructed
of this material are cooler in summer and warmer in winter.

Other materials occasionally used are concrete, granite, marble, and
sandstone, any of which, on account of their durable character and the
beauty that they lend to structures made from them, may be selected for
building purposes, but inasmuch as they are rarely used in rural
districts, a detailed consideration of their peculiar advantages for
building purposes is not deemed here necessary.

The internal wall-coating of houses deserves more consideration than is
commonly accorded it, since the dyes used for coloring wall-paper and
curtains in some instances contain noxious materials. Chief among those
that are dangerous are the bright green pigments which commonly contain
arsenic as their principal constituent; where these or other poisonous
substances are employed in interior decorations the air, wherever the
room is kept closed, may become more or less impregnated with poisonous
gases, and serious consequences to the inmates may ensue.

_Screening Indispensable to Health._--Nothing is more important in
connection with house construction than having every opening thoroughly
screened. We have learned that both malaria and yellow fever are
transmitted always by certain kinds of mosquitoes, and it therefore,
becomes a matter of the greatest importance to effectually prevent the
entrance of these insects. It cannot be too strongly insisted upon that
we absolutely know that the statement just made is correct, and that
avoiding the diseases referred to becomes as a consequence entirely a
matter of preventing the entrance of mosquitoes into houses.

[Illustration: Fig. 1. ANOPHELES. (Malarial Mosquito.)]

[Illustration: Fig. 2. CULEX. (Common Mosquito.)]

The _Anopheles_ mosquito, which is the one that transmits malaria, often
exists in localities where the more common varieties do not occur, and on
account of the habits of this insect their presence is liable to be
overlooked. They seldom attempt to bite during the day, and it is only
rarely the case that they try to do so at night in a well lighted
room;--particularly where movement of any kind is going on. During the
day this mosquito remains perfectly quiet in the dark corners of the
house, and is very fond of resting on cobwebs, presenting, when doing so,
an appearance strikingly similar to that of fragments of leaves, soot or
of other natural objects that are frequently found suspended on such
structures. On account of these peculiarities and for the further reason
that the insect bites mainly just following daybreak, when the victim is
profoundly unconscious in sleep, its presence often remains undetected,
and as a consequence we occasionally hear from those who do not take the
trouble to inform themselves that malaria exists in this or that locality
where mosquitoes do not occur.

The yellow-fever mosquito bites for the most part during the day, but
will do so at any time when there is light. In districts where this
disease occurs it is quite as important to prevent its entrance as that
of the malarial mosquito. Not only does screening prevent malaria and
yellow fever, but it keeps out flies and other insects that
unquestionably bring with them the germs of other diseases.

There now remains no doubt that several affections, notably typhoid fever
and dysentery, are frequently communicated by means of the common
house-fly, which spends its time alternately on the fecal material around
privies or in other filth, and in our kitchens and dining-rooms; it is
one of the most astounding evidences of the power of habit, in the face
of common sense and ordinary decency, that we have not long ago taken
active steps to rid ourselves of its disgusting presence. Fortunately in
screens we have a perfect barrier to the entrance of flies, and no house
can be considered complete without being thoroughly equipped with these
all-necessary appliances.

It is scarcely possible to overestimate the economy that results from the
use of screens; among the various means employed for conserving the
public health they take first rank, and undoubtedly insure those who live
in houses to which they have been added an immunity against the costly
effects of disease that could scarcely be computed. A house would be more
habitable without chairs, beds, or tables than screens, since in the
absence of the former we may be healthy, though somewhat uncomfortable,
but without the latter serious disorders are pretty certain, sooner or
later, to make their appearance.

It is of considerable importance to use a screen the mesh of which is
sufficiently fine. Where mosquitoes exist, the screen should be of such
fineness that at least sixteen, or better eighteen meshes be in each inch
of the gauze. Where it is absolutely certain that mosquitoes are not to
be feared, the spaces may be somewhat larger--but always of such size as
will prevent the entrance of the smallest fly.

_Air-space Required._--It is of much importance from a hygienic
standpoint that the rooms of dwellings should be sufficiently large. The
height should never be less than eight feet, and the living-room should
be made as large as circumstances will permit. Bed-chambers should
contain at least 1,000 cubic feet of air space for each adult, with
somewhat less for children, though it should never be forgotten that the
more the better; this means that each person should have the equivalent
of a room which is at least 10 x 12 x 9 feet.

_Heating._--Americans are extravagant in the matter of heating to a
degree that astonishes the average foreigner, and it is by no means sure
that we do not go to unhygienic extremes in this direction. It is not,
perhaps, true that the excessive heat itself could be considered as
especially hurtful, but it is too often the case that the conditions
required to secure the degree of heat preferred by us are incompatible
with proper ventilation, and hence are to be condemned. It is generally
considered that the temperature of living-rooms should be somewhere about
70 deg.F.; for many persons this is lower than would be entirely comfortable,
and as a consequence our houses in the winter are frequently kept nearer
80 deg.F. than the figure just given. The reader should be urged to see to it
that, at whatever temperature his habitation is kept, a sufficient amount
of ventilation be secured.

There are many different methods of heating, the most satisfactory of
which are by means of hot water or steam; a modified form of the latter
is the so-called vapor method, which in recent years has proven extremely
satisfactory. Hot air, supplied by a furnace is also extensively used,
and for the reason that by this method fresh air from the outside is
constantly brought into the house, it is theoretically to be commended;
practically, however, a considerable difficulty is experienced in
securing an equable distribution of this heat throughout the various
parts of the house, and as a consequence it has not achieved the
popularity that it would otherwise have done.

Inasmuch as the installation of plants for heating by the methods just
referred to entails quite an expense, and for the further reason that
they require coal for satisfactory operating, they have not been employed
in the rural districts of America to any considerable extent. The farmer,
for the most part, depends on the old open fireplace where wood is
plentiful and the weather does not become excessively cold, while in
those portions of the country where the temperatures in winter go very
low, the stove is generally employed. Of the two methods, the former is
much the more hygienic where it can be used successfully, but over a
greater portion of the United States this cannot be done owing to the
cold winter climate.

The principal objection to the stove lies in the fact that the heat that
comes from it is very dry, and that where its walls have to be heated
excessively, unpleasant odors are apt to be generated; the former is
usually and ought always to be obviated by keeping upon the stove a
vessel of water, the vapors from which moisten the atmosphere, and the
latter by having the stove of such size that it will not require
excessive heating in order to warm the room in which it is placed.
Wherever possible the open fireplace is to be preferred to the stove for
the reason that it very thoroughly ventilates the room.

_Ventilation._--In order that the health of the inmates may be conserved
proper ventilation of all habitations is essential. However cold the
weather may be, an abundance of fresh air should be allowed to enter all
parts of the house. In the average wooden dwelling there are so many
cracks that good ventilation is generally secured without opening doors
or windows, but where the construction does not permit this, openings for
the entrance of air should be left in the most convenient and suitable
places. Windows may be slightly raised and draughts prevented by proper
screening, or what is even better, rooms should be so constructed that
they have openings at the top and at the bottom to allow free
ventilation. Openings towards the upper portion of rooms are especially
important in hot weather, as the warm air rises to the ceiling and
escapes only very slowly where such exits do not exist. Lowering windows
from the top aids materially in allowing the hot air to escape, but this
is not altogether so satisfactory as having openings higher up on the
walls, or in the ceiling.

_Disposal of Sewage._--No problem that confronts the dweller in the rural
district is of greater importance than the proper disposal of sewage. It
is unfortunately impossible in most instances for the farmer to have in
his house a system of water-works, and, therefore, all dish-waters and
slops are thrown into the yard, and a privy is used instead of a modern
water-closet. Where the lay of the land is such that water readily runs
off, or the soil is of a character that permits rapid absorption,
throwing slops on the ground around the house may not constitute a danger
to the inmates, but nothing is more certain than that the old fashioned
privy is a dire menace to the health of all those in its vicinity.

Not only are infectious materials brought into houses by flies, from
fecal matter and other excretions, but they are carried away by the
rains and sometimes contaminate sources of water-supply. It is
furthermore extremely probable that bacteria in particles of dust from
dried fecal material may be carried by the winds from privies into wells
and houses, and as a consequence diseases may be spread; of perhaps still
more importance--and certainly of far greater moment all over the
southern portions of the country--is the fact that hook-worm disease and
other infections caused by animal parasites are transmitted from man to
man as the result of our adherence to the old fashioned privy.

As will be explained in the chapter devoted to the common communicable
diseases, the eggs of the hook-worm pass from the intestine along with
the feces of those who are victims of this parasite and reaching the
ground, hatch out in the course of a few days minute hook-worm embryos,
which crawl away and permeate the soil in the vicinity; later collecting
in little pools that form after rains, or in dew-drops during the night,
they attach themselves to the skin of barefooted children who come in
contact with such collections of water, and boring into the body
ultimately, through a circuitous route, reach the intestines. Here they
undergo further development, and in a short time become mature
hook-worms, which in their turn lay eggs, and the life cycle begins over
again. It is thus seen that a child having hook-worm disease becomes a
menace, on account of the privy, to its brothers and sisters, and of
course quite commonly receives back into its own body, worms that had
previously escaped as eggs.

In the same way eggs of the two common tapeworms pass out with the feces,
and the offal containing them being eaten by hogs in the one case, or
being scattered in the vicinity and taken in with grass by cows in the
other, have their shells dissolved off as soon as they reach the stomachs
of these animals, and there are liberated small embryos that bore through
the walls of the stomach and later find their way into the muscular
tissues of these beasts, and there lie dormant until eaten by man with
imperfectly cooked meat; after being swallowed, the embryo parasite
passes to the intestine and soon becomes a fully developed tapeworm.

Particular reference at this point should be directed to the evil
effects, which are even still greater than those that come from the
privy, of permitting children and hired helpers to scatter their feces
indiscriminately in corners of the yard, the apple-orchard, or in the
horse-lot; under such circumstances, where hook-worm disease is once
introduced, the soil in the course of a short time becomes thoroughly
permeated with the embryos of this worm, and, as a consequence, all of
the children who play in the infected area barefooted, as is customary in
the country, are sooner or later infected with these parasites. It is
thus seen that soil-pollution from fecal material is a most dangerous
thing, and, particularly in the southern portion of the United States,
deserves the most earnest consideration of everyone. We should see to it
that our children only evacuate their bowels in properly constructed
closets; and it is the duty of the head of every family to provide such a
place for the accommodation of those who are dependent on him.

_Proper Construction of Out-door Privies._--The most practical and
generally satisfactory device heretofore invented for the disposal of
the sewage of communities unprovided with water-works is what is known as
the Rochdale, or dry-closet, system. By this system a privy, at a
distance from the dwelling, is constructed in the ordinary manner, with
the exception that instead of being open at the back it is tightly
closed. In the space beneath the seat receptacles are placed for
receiving the urine and feces. These may consist of pails of wood or
better of galvanized iron; or a single box occupying the whole space. If
wooden receptacles are used, they should be thoroughly coated on the
inside with tar, to prevent both leakage and the soaking of the liquids
into the wood. One such structure, which the writer knows has been wholly
satisfactory has a brick foundation with walls two feet high around the
front and sides, within which rests a shallow tarred box. It ensures
perfect cleanliness.

In any case this space under the seat is tightly closed, being guarded by
doors that open outward, through which the pails or box may be introduced
and removed for emptying.

Each privy contains a box in which is placed either wood ashes or dry
powdered earth, with a small shovel by which a sufficient quantity of the
dust to cover the deposit is thrown into the pail after each evacuation.
It is remarkable how completely this shovelful of earth or ashes destroys
all disagreeable smell. The privy should be provided with at least two
opposite windows, both of which should be thoroughly screened. The
entrance should have a door that is closed with a spring, so that it
cannot be carelessly or accidentally left open when vacant. At intervals
the pails containing the feces are removed, and the contents are carried
to a distance and buried.

Another plan that is quite satisfactory where iron pails are used, is to
place a quantity of water in the vessels for receiving the feces, and
then to pour in a small quantity of kerosene; the latter substance forms
a layer over the water that keeps out flies, and does away largely with
the disagreeable odors that are likely to emanate.

If any contagious disease exists among those who use such a closet, the
fecal material should be carefully sterilized before being removed, as
by means of corrosive sublimate, carbolic acid, chlorinated lime, or any
one of the many commercial disinfectants containing crysylic acid, all of
which may be obtained at any drug store. If carbolic acid or other liquid
antiseptics be used the amount by volume should be equal to about five
per cent. of the material to be treated; the proportion of corrosive
sublimate should be at least 1 to 1,000 where this disinfectant is used.
Along with whatever antiseptic is chosen, water should be added in
sufficient quantity to permit the whole to be rendered semi-fluid, and
the mixture should then be thoroughly stirred, and the chemical left to
act for some hours before emptying the receptacle. By far the most
satisfactory method of sterilizing infected material, however, is by
boiling, since disease-germs are killed by such a temperature in a few
moments. Where iron receptacles are used, therefore, the simplest method
is to set them upon an open fire in the yard for a little while.

A privy constructed after the manner just described possesses some
advantages even over the regulation water-closets that are used in
cities, since they are cheaper in original cost, require less repairs,
and are uninjured by a freezing temperature. The amount of care required
to keep them in proper condition is not excessive, and they are so
infinitely superior from a hygienic standpoint to the old-time privy that
no sort of comparison is possible.

It should always be remembered that the principal advantages of this
closet are that where it is used we are able to collect all of the
evacuations, which may then be properly deodorized with soil or ashes,
and that it may then be finally disposed of in such a way that it cannot
be reached by hogs or other animals; of very great importance also is the
screening of the closet, since only in this way is it possible to prevent
flies from gaining entrance to the fecal material in the receiving pails.

_Water supply._[2]--In the location of houses and schools an eye should
always be had to selecting a site where it is possible to obtain good,
pure water. To those fortunate dwellers in the mountainous regions of our
country this is usually a matter of little difficulty, since it is always
possible to find a location in the neighborhood of which the purest
spring water may be obtained. In less favored regions the well becomes
the main reliance, while cisterns are used in some portions of our
country, in which water is collected during the rainy seasons of the
year. Of the two, the former is undoubtedly to be preferred, provided a
pump be used instead of the old fashioned bucket. The writer is strongly
of the opinion that a very large proportion of the contamination to which
sources of water-supply are subject comes from the bucket being drunk
from or handled by persons with contagious diseases, or from germs being
blown into the well with dust, or carried in by means of insects and
small animals. It is inconceivable that any appreciable amount of
contamination from the surface can reach the underground streams that
supply wells in localities that are thinly populated, though it is
unquestionably true that a well might be infected as a result of the
entrance of surface-water where its top is not properly protected. On the
other hand we have in an open well or cistern every facility afforded for
the entrance of bacteria.

It is unquestionably of the utmost importance that wells be carefully
covered over, and every precaution should be taken to prevent
surface-water leaking into them around their edges. In order to comply
with these conditions a pump is essential, since it is the only means by
which water can be brought to the surface without exposing the contents
of the well to contamination. It is likewise of the first importance to
have the walls of the well curbed to a sufficient depth to prevent the
possibility of seepage from the surface. It is, of course, also quite
necessary that the well be of sufficient depth--the lower we go the more
likely are we to secure a perfectly pure water. In regions where the
water rises to within eight or ten feet, or less, of the surface, the
possibility of the well being contaminated during the rainy season by
seepage is considerably increased, and the waters of such wells should be
used only after analyses have shown that they are pure; where this cannot
be done, the water should be boiled before being drunk. Of course, the
possibilities of contamination are greatly increased if the locality be
thickly inhabited.

As has been before remarked, cisterns are more liable to contamination
from the air than are wells, chiefly owing to the fact that they are
supplied by water that is conducted into them by gutters from the tops of
houses. There is no question that during the dry seasons dust containing
many kinds of bacteria is deposited all over the tops of houses and
remains there until washed away by the rains. While it is true that the
sunlight quickly kills most germs that produce disease a certain number
of them would inevitably escape, and having gained entrance to a
cistern, would be likely to multiply and later cause trouble. It is thus
seen that however pure the rain-water may originally have been--and it is
among the purest of all waters--it is likely to become contaminated in
the process of collection, and may ultimately in this way become the
source of disease. Where any doubt exists as to the purity of such water
it should be boiled before use.

Surface-streams also occasionally supply drinking-water in rural
districts, and while the use of such waters may not always be attended by
danger, their contamination by disease-producing germs is much more to be
feared than when they are derived from wells or springs; where streams
arise from and keep their course through uninhabited districts the
probabilities are strong that their waters are pure and fit for use, but
where they run through cultivated fields, and particularly where they
pass in the neighborhood of houses, their waters should never be looked
upon as being drinkable,--except after being boiled or properly filtered.
Inasmuch as adequate filtration is exceedingly difficult to carry out,
and requires a somewhat extensive and costly plant, this is, as a rule,
not feasible for the dweller in country districts, and boiling,
therefore, remains the only satisfactory method of rendering the water
fit for use where doubt exists as to its purity.

_Location of Pens and Stables for Animals._--Animals should always be
housed at some little distance from the dwelling. While it is true that
man does not often contract directly diseases from hogs, sheep, horses
and cattle, there are some maladies of a most serious character that come
to us in this way, and we should, therefore, always guard against their
occurrence by removing ourselves as far as is possible from sources of
possible infection. The matter also has an aesthetic side, as odors of a
disagreeable character may prove very annoying where animals are kept too
close to the house. It is likewise of importance that stables should be,
if possible, on lower ground than the dwelling, since during rains
materials from their dung may be washed around and under the house, and
may possibly gain access to the well.

Every care should be taken to keep hog-pens and stables clean, since
otherwise very foul smells are engendered that oftentimes find their way
to neighboring houses. There is also a suspicion that some of the germs
that produce disease find the conditions suitable for their stables
and pig-sties.

In this connection it might be well to warn those unacquainted with the
subject against the _all too common practice_ of close association with
dogs, since it is well established that in addition to hydrophobia they
may transmit, while apparently in perfect health, maladies of a deadly
character to the human being. It cannot be too often emphasized that the
less intimate our association with the lower animals is, the greater the
likelihood of our escaping many serious diseases.


FOOTNOTE:

[2] This subject is fully treated in another volume of this Library,
entitled _Home Water-works_, written by PROF. CARLETON J. LYNDE. It
shows where water should be sought, and how it may be supplied under
perfectly safe conditions to the household, with descriptions of
machinery, estimates of expense, etc. This thoroughly practical book
meets a widely recognized need for information, and is written by a
specialist. Thousands of men living in rural parts of the United States
and Canada, out of reach of a public water-system, have equipped their
homes with water-supply conveniences equal to any found in the cities.
Thousands more who could well afford to do so and who could do so
advantageously, have not done so for various reasons--because the idea
has not occurred to them, or because they did not know how to go about
it, or because they mistakenly thought the expense too great. To all
such this book should prove of the greatest practical help.




CHAPTER IV

HYGIENE OF INFANCY AND CHILDHOOD


No characteristic of the Caucasian mind is more marked, and none more
universally affects his actions than a constant, gnawing suspicion that
the things going on around him are not being done in the proper way, and
consequently an irrepressible desire to experiment, and if possible, to
change everything. Such a spirit is unquestionably the basis of what we
call progress, and, in so far as it conduces to the health and happiness
of mankind, is entitled to our most hearty commendation. On the other
hand, it cannot be denied that too often we endeavor to bring about
changes with but an imperfect understanding of the basic principles at
issue, and naturally, under such circumstances, our efforts are crowned
with anything but success. In other words, an enlightened investigation
of the whys and wherefores of any existing state of affairs may and
often does, lead to improvement, while, on the other hand, ignorant
meddling is likely to be followed by disastrous consequences.

Nowhere do we see the bad results of false conceptions more marked than
in our treatment of infants and children.

     Particularly do young infants suffer in this way, as they are
     pounced upon as soon as they enter the world by every old "granny"
     and negro "mammy" in the neighborhood, and plied with abominable
     concoctions that would be productive of homicide if we were to
     attempt forcibly to administer them to grown men, and whose only
     effect on the defenseless little sufferer is to cause colic and
     indigestion. Many times has the writer seen a wee, tiny little
     mortal, who was too young and weak to even protest, bundled up with
     a mountain of flannels in the hottest weather of July and August.
     True to the superstition that the warmer we kept an infant the
     better, too frequently we see them confined to hot stuffy rooms
     when they should be out in the sunshine, or under the trees.
     Instead of being allowed to gain health and strength in the
     forests, which are the schoolhouses of nature, the miserable little
     wretch is later sent to a public school as soon as he or she can be
     trusted to go alone on the streets, and the tiny victim too
     frequently contracts diphtheria, scarlet fever, whooping-cough,
     measles, or some other disease as a reward of merit. Truly we see
     to it that the helpless innocents early realize the truth of the
     melancholy and hopeless biblical lament that "man's days here are
     few and full of trouble."

We should rear our children with as little interference as possible,
allowing them the utmost freedom compatible with their safety, and
permitting them to do those things that nature and instinct demand. Above
all let them sleep as much and as long as they will, insist that they
live in the open air, and encourage them in every possible way to perfect
their physical education by those active amusements that they
instinctively prefer. After they have established a sound and rugged
constitution ample time will be left for them to develop mentally.

_Feeding of Nursing Infants._--The most important thing in connection
with the feeding of infants is to always remember that nature has
provided in their mother's milk, when sufficiently abundant and normal in
quality, everything in the way of food and drink that they require.
During the three days that usually intervene between birth and the coming
of the milk in the mother's breast, infants may be given from time to
time small quantities of pure water, but under no circumstances should
anything else be allowed. During this period the child may be put to the
breast four or five times in the twenty-four hours, for, while it gets
but little in the way of nourishment, there is even at this time a watery
fluid secreted in the breast that goes far towards supplying everything
that the infant needs for the time being.

A child should never nurse longer than twenty minutes at one time. It is
likewise of importance that the time of nursing be strictly regulated.

Particularly during the first year it is of the utmost importance to
watch with an intelligent eye the growth and development of the child.
Where the milk agrees with it it has a good color and gains regularly in
weight; it cries but little, and is good natured, and thoroughly
contented. Should it, on the other hand, lose weight, appear fretful and
listless, and sleep badly, there is something wrong, and the mother
should at once have her milk examined by a competent physician.

In case the mother does not give sufficient nourishment there is no
objection to partially feeding the infant on modified cow's milk--the
method of the preparation of which will be considered later on.

Where colic occurs it generally means that the infant is getting a diet
too rich in albuminous foods, which should be corrected by advising the
mother to take an abundance of out-door exercise, and to avoid all causes
of worry so far as is possible.

Vomiting freely is a very common occurrence in small children, and is
usually the result of too much food being taken at a time. It also
occurs, particularly some time after feeding, as a result of indigestion,
which is frequently the consequence of the milk being too rich in fats.
Wherever an infant shows signs of trouble it is well to advise the mother
to use a diet less rich in meats, and to caution her against over-eating.

Children should be weaned at the end of their first year. This had best
be brought about gradually, by, in the beginning, feeding the child once
daily, and then gradually increasing the frequency, at the same time
proportionately leaving off the nursing. Where children are not thriving,
it is often a good practice to wean earlier, in which case modified cow's
milk, taken from a bottle, must be substituted.

_Artificial Feeding._--While it is true that children often thrive for a
time on the various baby-foods with which the market is so abundantly
supplied, it is, nevertheless, the case that where fed in this way they
are very apt to develop rickets or scurvy, and not uncommonly show
evidences of bad nutrition in loss of weight and strength, becoming
peevish and fretful, and sleeping badly.

Much better than any of the artificial foods is properly modified cow's
milk, which, with care, may be prepared in such a manner as to take the
place of mother's milk in the vast majority of instances. In order,
however, that this be successfully carried out, much care and attention
is necessary.

     At this point it is well to stress the fact that the mother's milk
     differs from that of the cow in some quite important particulars,
     and it is only by intelligently taking these differences into
     consideration that it is possible for us to prepare an artificial
     food that will be satisfactory. Principal among these differences
     are that cow's milk contains three times as much albuminous
     material as that of the human being, and that it is less rich by
     about half in milk-sugar; furthermore, the former is acid in
     reaction, while the latter is neutral, or faintly alkaline. It will
     be seen, then, that in order to prepare a modified cow's milk that
     will approximate that of the human being it is necessary to dilute
     it with water sufficiently to cause the albumin to approach in
     proportion that of mother's milk, and at the same time some alkali
     must be added to neutralize the excessive acidity. Modified milk
     prepared, however, from the whole cow's milk, would contain much
     less fat than is desirable, so that we must use in making it the
     upper third of the whole milk after it has been allowed to remain
     undisturbed for a number of hours; in other words, in making
     modified cow's milk we use a large proportion of the cream, with a
     less amount of the other constituents.

     The following table for calculating the proper proportion of milk
     to be used at the various periods of the infant's life may be
     recommended, as it gives quite as satisfactory results as those
     that are more elaborate; it also gives the frequency of feeding and
     the proper amounts that should be used. The table was devised by
     Dr. C. E. Boynton, of Atlanta, Georgia.

                   Fat      Quantity         No. of
                percentage  ounces at     feedings in    Intervals
                 desired.   feeding.       24 hours.      by day.

     Premature     1.00      1/4 to 3/4      12-18      1 to 1-1/2 hrs.
     1-4  day      1.00    1     to 1-1/2      6-10     2 to 4   "
     5-7    "      1.50    1     to 2         10        2        "
     2-   week     2.00    2     to 2-1/2     10        2        "
     3-     "      2.50    2     to 2-1/2     10        2        "
     4-8    "      3.00    2-1/2 to 4          9        2-1/2    "
     2-   month    3.00    3     to 5          8        2-1/2    "
     4-     "      3.50    3     to 5-1/2      7        3        "
     5-     "      3.50    4     to 6          7        3        "
     6-10 month    4.00    5     to 8          6        3        "
     11-  month    4.00    6     to 9          5        4        "
     12-    "      4.00    7     to 9          5        4        "
     13-    "      4.00    7     to 10         5        4        "

     In making calculations from this table it is assumed that the milk
     from the upper third of the bottle, after it has been allowed to
     sit for at least four hours, contains 10% of fat, and this is
     therefore called 10% milk. The calculation is made as follows:--10%
     milk is to the fat percentage desired, as the amount which we wish
     to make up is to X. For example, if we wish to prepare twenty
     ounces of milk for an infant two months old, we will note by
     referring to the table that 3% is the amount of fat that is
     desirable for a milk for a child of this age, and the formula will
     be constructed as follows:--

       10:3::20:X.   X = 60/10.   X = 6.

     Six ounces is then the amount of 10% milk that must be used for
     making twenty ounces of modified milk,--this being mixed with one
     ounce of lime-water and thirteen ounces of boiled water. It should
     never be forgotten that while milk modified by the foregoing
     formula is suitable for most children, it is by no means always
     satisfactory, and we may, therefore, be compelled to do a
     considerable amount of experimenting in some cases before arriving
     at the correct formula.

     Suppose the infant is twelve months old, we would get according to
     the rules just stated the following equation:--

       10:4::20:X.   X = 80/10.   X = 8.

     Eight ounces would then be the amount of milk required for
     preparing twenty ounces of modified milk for an infant of this age.

     In preparing modified milk according to the formulas just given, it
     must be remembered that in all instances only that portion is to be
     used which collects in the upper third of a bottle of milk that has
     been allowed to sit undisturbed in a refrigerator for at least four
     hours. The lime-water is for the purpose of correcting the acidity
     of the milk.

     It is of much importance to select the milk from a healthy cow in
     all instances where it is to be fed to infants, and where possible,
     it should be examined by a competent laboratory man in order to
     determine if it answers the proper requirements. The writer has
     often seen milk from apparently healthy cows, which seemed in every
     way good, that showed on microscopic examination pus cells and a
     harmful germ (streptococcus).

     It is not desirable to have a milk for this purpose that is too
     rich in fats, and for this reason a cow of the ordinary mixed breed
     is more satisfactory than the blooded Jerseys or Alderneys.

     Not only is it essential to get the proper kind of milk, but the
     utmost care is necessary in handling it. It should, of course, be
     as free as possible from every source of contamination, and should
     be strained thoroughly as soon as milked. It should then be
     bottled, and chilled at once by being placed in cold water, and
     after being properly sealed, should be placed in a refrigerator at
     a temperature of about 50 deg.F., where it should remain undisturbed
     for four hours before the top portion is skimmed off for making the
     modified milk.

     After the modified milk has been prepared it should be returned to
     the refrigerator, where it should be kept until required for
     feeding. It is best not to use milk that has been in the
     refrigerator longer than twenty-four hours, or at most forty-eight
     hours, and then only if kept at a proper temperature. The modified
     milk should be poured directly from the receptacle in which it is
     kept into the feeding-bottle, and the latter should then be placed
     in warm water until its content is milk-warm, at which time it is
     ready to be given to the child.

It is highly necessary in feeding infants by the bottle to remember that
cleanliness in everything connected with the process only makes success
possible, and in no particular does this apply with greater force than in
connection with the proper care of the bottle and nipple. In every case
immediately after use they should both be put in water, which should then
be brought to a boiling temperature, and both should then be kept in a
saturated solution of boric acid. The nipple, after being placed on the
bottle, should not come in contact with anything but the infant's mouth.
Bottles that have no neck are much to be preferred to others, as they can
be readily cleansed. There is on the market at the present time a bottle
called the "Hygeia," which possesses the necessary qualifications in a
perfectly satisfactory way.

When children who have nursed at the mother's breast reach the age of
weaning it is of importance to remember that they cannot eat without
digestive disturbances the modified cow's milk of a strength that would
otherwise correspond to their age; they should invariably under such
circumstances begin with a milk prepared by the formula used for a child
several months younger, after which the proportion of milk may be
gradually increased until it is used in a pure state.

During very warm weather it is well to reduce the amount of fat by using
the whole milk instead of the top portions, as heretofore described. The
same precaution should be followed where children have acute diseases,
and the total quantity taken should be less than under ordinary
circumstances. Where infants have acute indigestion, accompanied by
vomiting and diarrhoea, all milk should be for the time withheld,--boiled
water being substituted; some hours later barley water may be given, but
no milk for at least twenty-four hours. Where children have loss of
appetite, it is well to give less cream, and the intervals between food
should be increased.

_Sterilized (Pasteurized) Milk._--During epidemics of dysentery,
diarrhoea, typhoid fever, scarlet fever, and diphtheria, as well as in
those instances where it is suspected that the cow is not healthy, or
where the milk has to be kept for considerable periods of time, it is
well to sterilize it by heating. The most effective method of
accomplishing this is by boiling the milk for an hour or so, but
inasmuch as it is believed to be then not quite so wholesome as when less
heat is employed, a process known as _pasteurization_ is frequently used;
this consists in heating the milk for thirty minutes to from 155 deg. to
160 deg.F.,--such temperatures killing all of the ordinary germs, but not
altering the milk so completely as when it is boiled.

_Peptonized Milk._--It now and then happens that children fail to thrive
where all of the precautions heretofore referred to have been strictly
adhered to, and under such circumstances good results are frequently
secured by subjecting the milk to a process known as _peptonization_.
This consists in the addition of a digestive ferment, obtained from the
pancreas of lower animals, together with ordinary cooking-soda. In
carrying out the process the milk, whether whole or modified, is placed
in a clean bottle, and the peptonizing powder added after having been
rubbed up with a teaspoonful of milk. The container is then placed in a
pitcher of water at a temperature of 110 deg.F., which is about as warm as
the hand can bear comfortably, and is here left for from ten to twenty
minutes if only partial peptonization is desired, or for a couple of
hours should it be wished to complete the process. The peptonized milk
may be prepared at each feeding, or the whole amount for the day may be
made at one time in the morning; in the latter case, where it is desired
to have the milk only partially peptonized, the ferment should be
destroyed by boiling after it has been allowed to act for from ten to
twenty minutes.

_Feeding after the First Year._--As the infant is weaned other food
should be gradually added; this should still consist largely of milk, to
which some time later may be added gruels prepared from well-cooked oats
or barley, beef-juice, or the white of an egg slightly cooked. The
various broths may also be allowed. Children relish very much all
fruit-juices, and they may be given in moderation without harm, and even
with benefit in many cases. As the child grows older, the various cereals
should form a greater and greater proportion of its diet, but due care
should be exercised in always seeing to it that they are thoroughly
cooked; in order to be digestible for children such substances should be
cooked at least three or four hours before eaten.

_General Hygiene of Infant Life._--In order for children to be healthy,
the greatest regularity is necessary in their habits. They should arise
at a certain hour in the morning and go to bed at a fixed time at night.
Their clothing should be loose, and not too tight fitting, and should at
all times correspond to the state of the weather. Nothing is more common,
and nothing produces irritability, loss of sleep, and even serious
general disturbances in infants, more frequently than too much clothing.
It is generally customary to use from the time of birth and during the
period of infancy a flannel band around the child's abdomen. Just how
this acts is not clear, but there seems good reason for the belief that
in some unexplained way the practice has the effect of warding off
intestinal disturbances, and is, therefore, to be recommended.

Napkins should be changed when soiled, and then should be immediately
placed in water, in which they should remain until washed out; under no
circumstances should they be left lying around the nursery.

When the weather permits, the child should be kept as much out-of-doors
as is possible. For the first few days of the infant's life, particularly
if the weather be cool, it should, of course, be kept indoors, but even
then free access of air should be allowed. There is no objection whatever
to the infant sleeping out-of-doors--in fact, where this is feasible, it
generally shows improvement as soon as the practice is commenced. When
out-of-doors, it is of course necessary to see that the sun does not
shine directly into the infant's face, and wetting should, of course, be
avoided; also the hood of the carriage should be arranged to prevent
strong winds from blowing on the child.

The nursery should be well aired, a window being left up at night except
during severe weather.

_Sleep._--Nothing is more important for the proper development of a child
than for it to have an abundance of sleep. During the first few months of
its life it sleeps practically all of the time--the period becoming
gradually lessened as it grows older. Infants should be suffered to sleep
just as much as is possible, it being not only unjustifiable but
absolutely criminal to interfere with them in this particular in the
slightest degree. Not only is it necessary that infants have all the
sleep that they desire, but it is true throughout childhood, a fact to
which many foolish parents seem utterly oblivious. How often do we see a
child scarcely more than an infant aroused in the morning and sent off to
school, and how frequently do we hear misguided parents boast of their
inflexible rules in enforcing such evil practices. Truly man comes hard
by the knowledge that nature is much wiser than he, and the vast majority
never learn the fact at all.

As soon as the child is able to crawl, it should be placed on a clean
quilt or blanket on the floor, and allowed to move about to its heart's
content. When it is able to walk, allow it to run about and play to its
full capacity--as in such exercises consists the great school of its
physical being, the school upon which will depend its strength and
health in after life. Allow the child to keep up his play as long as he
has any inclination to do so, and never be so foolish as to confine him
in the house when he wishes to be out under the blue heavens, for here
only will it be possible for him or her to develop into a real man or
woman. Allow this to go on until the child of its own accord comes and
asks to be taught other things, for not until then is its outside
education nearing completion, and not until then is it possible for him
to take interest in and learn things connected with books. No boy should
ever be sent to school before he is twelve or fourteen years of age;
girls, on account of their maturing earlier, may begin a couple of years
sooner.

The whole science and art of properly raising children consists in
feeding them good clean food in proper amounts, in never allowing them to
be awakened, and in permitting them to play in the open air to their
hearts' content.

_Teething._--Teething is a subject which has at all times interested both
doctor and layman, and in its supposed relation to all kinds of
disorders of infancy has undoubtedly exercised an influence over the
popular imagination out of all proportion to its real importance. Too
often it has happened that this perfectly normal, and usually by no means
serious, process, has been held responsible for grave diseases in
children--diseases which in reality were the consequence of neglect
and mismanagement in the far more serious matters of food, sleep,
out-of-door exercises, and general hygiene. It cannot, however, be
denied--particularly in respect to nervous children--that teething
appears occasionally to induce unpleasant disturbances, such as
fretfulness, broken sleep, digestive disorders, and occasionally fever;
as a rule such symptoms persist only for a few days, if the infant be
properly looked after. The treatment should consist in lancing the gums
should they become much swollen, and the withholding of the usual amount
of food, particularly where intestinal disturbances occur. The ages at
which the teeth usually come are as follows:

  2  Middle Lower Teeth                5 to  9 months.
  4  Upper Front Teeth                 8 to 12 months.
     Remaining Lower Front Teeth      12 to 18 months.
  4  Front Jaw Teeth                  12 to 18 months.
     Stomach Teeth (Canine)           18 to 24 months.
     Eye Teeth (Canine)               18 to 24 months.
  4  Back Jaw Teeth                   24 to 30 months.

_Bowel Diseases._--Digestive disturbances, accompanied by diarrhoea, are
the bane of infancy, and are responsible for a very large part of the
frightful mortality among babies. The subject, therefore, is one of
tremendous importance, but is so complicated that the limits of this
little volume will only permit its being touched upon.

As already mentioned, indigestion accompanied by looseness of the bowels
may be and often is the result of milk being used from diseased cows, or
it may be the consequence of such carelessness in handling it that
disease-producing bacteria are later allowed to contaminate it. It should
also never be forgotten that where children are eating artificially
prepared food improper mixing of the different components may result in
serious disturbances, and we should, therefore, exercise the utmost care
always in seeing to it that the food is prepared strictly according to
the table which has already been given--not forgetting that in a certain
number of instances we can go by no rule, and will have to experiment
until we ascertain the proper proportion of the ingredients.

After a diarrhoea begins we should at once reduce the quantity of fat in
the milk that is being given to the infant, and if the trouble be at all
severe it is best to take it off of all food for twenty-four hours, and
substitute boiled water or barley-water. As soon as the trouble is
checked we may then begin to feed cautiously with largely diluted milk,
and, gradually increasing its strength, in the course of a few days
return to the food that was being given before the disturbance occurred.
A dose of calomel or castor oil in the beginning of diarrhoeal troubles
often has a very salutary effect; the parent should not hesitate to
administer this if a doctor is not at hand.

In warm climates during the time of teething children very commonly
develop chronic diarrhoeal conditions which often end fatally; wherever
possible the parent should under such circumstances at once remove the
little sufferer to a colder climate where recovery is generally rapid and
complete. Even the most careful nursing under the most competent
physician is often fruitless in combating disorders of this character as
long as the infant remains in a warm climate.

_Colic._--Colic is always due to indigestion, and is the result of the
food undergoing fermentative changes, with the production of gases. This
goes on even under normal conditions to a certain extent, but when it is
excessive the intestines become greatly distended, and pain of a severe
or even agonizing character is produced.

In the treatment of this condition warm applications should be made to
the abdomen, and as quickly as possible an enema (injection), consisting
of a few ounces of warm solution of salt water should be given; the salt
should be in the proportion of a level teaspoonful to the quart of water.
Parents will find the little ear syringe, which may be purchased at any
drug store, a most satisfactory instrument for giving enemas to infants,
as they do not hold too much, and being soft, are incapable of tearing
the delicate tissues of the child. It is of the utmost importance to
remember that the salt solution should be tepid, yet not sufficiently hot
to scald the infant. As the water when given in this way is expelled very
quickly the enemas may be repeated any number of times desired.

Where these measures fail, a physician should be sent for at once, but in
the meantime if it be evident that the infant is suffering very much, a
small dose of paregoric may be given; it should not however be forgotten
that opiates are exceedingly hurtful to nervous children, and that
soothing syrups and other mixtures containing drugs of this class should
be avoided.

_Constipation._--Constipation among very young children generally passes
off as the food becomes richer, but should it occur at a later time, the
trouble may be more difficult to remedy. Of first importance is having
the bowels of the infant move at a certain time each day, which may be
quickly accomplished in many little children by placing them upon a small
chamber daily at a given hour; usually the baby very quickly learns what
this procedure means, and in this way a regular habit is established
which is of the utmost value to the child throughout its infancy, and
every effort, therefore, should be made to bring it about as quickly as
possible.

The addition of malted milk or Mellin's Food may also have the effect of
diminishing constipation;--the result being brought about by the maltose
contained in these preparations. The same thing may be accomplished by
substituting for a part of the milk sugar in the baby's food a similar
quantity of maltose. Milk of magnesia may be used in preparing the baby's
food in the place of lime-water, with the result oftentimes of relieving
a tendency to constipation.

_Croup._--By croup is meant a spasmodic condition which usually affects
children at night, and is in no way to be confounded with that really
dangerous disease, membranous croup, or diphtheria, to which so many
children fall victims.

Spasmodic croup is a condition which has as its basis digestive
disturbances, and is almost always relieved as soon as the stomach is
emptied. Vomiting may be brought about by making the child swallow a
small quantity of mustard stirred up in water, or by the use of ipecac.
Such severe and extremely unpleasant remedies are rarely necessary,
however, since the disease may be in almost all instances at once
relieved by placing around the victim's throat a cloth wrung out of cold
water, which may itself be covered by a dry bandage to prevent the bed
from getting wet. Children will usually go to sleep in a few minutes
after the cold cloth is applied, and suffer no ill consequences as a
result of its remaining around their throats throughout the night. Where
the croup is very severe the little sufferer's feet may be placed in hot
water, in addition to the cold cloth around the neck--the combination
practically always resulting in the rapid relief of the unpleasant
symptoms.

Great care should be exercised in the diet of children who are subject to
croup, as by intelligent supervision the tendency to this very annoying
trouble may be in a short time entirely overcome.

_Nervousness._--Children of neurotic parents, particularly where they are
reared in cities, are exceedingly prone to nervousness in one form or
another. The condition is undoubtedly often due to heredity, but may be
induced in otherwise healthy children by unhygienic surroundings and
improper food. Infants exhibiting symptoms that indicate trouble of this
kind should not be played with, and every care should be exercised to so
direct their lives that the trouble may be gradually overcome. In all
cases where nervousness persists an intelligent physician should be
consulted.

_Vaccination._--The only safe method that we possess of preventing
small-pox is by means of vaccination. Its great value has been so
thoroughly tested that the writer does not deem it necessary to go into a
discussion as to its merits. A child should be vaccinated in at least
three places during its early infancy,--there being no danger in doing
the operation immediately after birth. Persons ignorant of aseptic
surgery should not do this operation, but should always call in the
services of some person prepared to do the work in a cleanly manner.
Either the leg or the arm may be selected; and children should be
revaccinated whenever small-pox breaks out in the community.

_Kissing Babies to be Avoided._--Kissing infants in the mouth is a very
bad practice, as in this way disease may be quite innocently conveyed to
them. The public should be taught to understand that it is not
infrequently the case that bacteria may be present in the mouths of
individuals who are quite immune to their ill effects, and who are,
therefore, perfectly well, but who may, by conveying them to others,
particularly children, induce in them serious disease. When caressed in
this way at all children should be kissed upon their necks or feet, and
never in their mouths or on their hands.

_Juvenile Contagious Diseases._--Children are peculiarly prone to a class
of highly contagious diseases, the exact nature of which is not yet
understood, and we possess therefore little knowledge as to the proper
means of preventing their spread. Practically all that is known about
them is that they are conveyed by contact, or even by the air,
particularly where a child suffering from one of them is placed in a
confined place with another who is susceptible; these diseases likewise
may be carried by means of clothing and other articles that have been in
close contact with a child suffering with any of them. The lesson of
importance to be learned, therefore, is that if we wish our children to
escape maladies of this class we should not permit their indiscriminate
association with others. As these diseases cease to be a serious menace
after children have passed through their earlier years it does not at a
later time matter so much as to whether they are exposed to them or not.
As a general thing children develop these affections in from ten to
fifteen days after having been exposed, though one of the most severe of
them, scarlet fever, may make its appearance as early as twenty-four
hours after it is contracted. These diseases are usually ushered in by a
severe headache, pains in the head, back, and limbs, high fever, and
oftentimes a chill. As soon as a child develops such symptoms the advice
of a competent medical man should be at once sought, and the little
sufferer should be at once completely isolated.

In concluding, the writer would particularly exhort parents to obey to
the letter the instructions of their physicians, and never under any
circumstances to dose their helpless off-spring with patent or
proprietary medicines, which contain no man knows what, and which
unquestionably are often highly injurious, especially to children.




CHAPTER V

PROPER EATING--THE SECRET OF GOOD HEALTH


Very slowly the world is awakening to the fact that no agencies play such
an important part in the preservation of health as the consumption of
reasonable quantities of well-cooked and properly selected food, and the
habitual taking of wholesome drinks. On all sides the observant medical
man sees constant and reckless disregard of the simplest and most
fundamental laws governing this subject. Nothing is more common than to
hear of men in the prime of life being seized with what is called a
"nervous breakdown,"--which generally means a digestive breakdown--to be
followed by an era of misery for the unfortunate subject and his scarcely
happier family. Nervous and irritable, the slightest inconveniences are
magnified into terrible calamities, he constantly fears death, and his
sleepless nights become a saturnalia of gloomy thoughts and abject
fears.

Of course, not everyone guilty of dietetic sins goes through such sad
experiences, for the naturally strong frequently escape the consequences
of their rashness, particularly where they live in the rural districts
and take plenty of out-door exercise. Let not such, however, flatter
themselves that their disregard of hygienic laws will go unpunished.
After indiscretions in eating they will all, at one time or another, have
acute indigestion with diarrhoea; and how often does the previously well
and hearty man after indiscretion in eating wake up with a dull headache,
furred tongue, foul breath, and a general feeling of sluggishness and
mental depression?

Is it his liver? Our unscientific medical ancestors--at a loss to account
for the state of affairs in any other way--answered in the affirmative,
and, believing it was produced by a collection of bile in the liver,
called the condition "biliousness." How absurd modern science has shown
this assumption to be! We now know that the liver is rarely diseased,
and that it furnishes its secretion, called bile, for the purpose of
aiding digestion rather than hindering it, and that this substance is
rarely, if ever, produced in excess. It is undigested, putrefying food in
the intestinal tract that produces the trouble. Under such circumstances
one usually takes a dose of calomel, which, being perhaps the most
satisfactory and perfect purgative that we possess, relieves the
condition promptly by getting rid of the offending material; but the drug
does not act on the liver.

Unfortunately ill results of quite a different and a much more serious
character often follow in the wake of dietetic errors; in those who have
a tendency to consumption, particularly where they overwork, this dread
disease frequently makes its appearance as a consequence of bad eating
and drinking. Many, if not all, of the degenerative diseases that appear
in the latter half of life are produced in this way, and nothing is more
certain than that the peace, happiness and longevity of mankind could be
incalculably increased by the simple observance of what is known
concerning proper eating and drinking.

We will now consider the very important subject of the quantity and
character of foods which should be taken in health, with suggestions as
to those most suitable for dyspeptics.

_Over-eating too Prevalent._--The majority of us take much more food than
is necessary, with the result that we suffer from indigestion.

When we consume more than a reasonable amount of food habitually serious
digestive disturbances are sure to result,--to be often followed at a
later time by tuberculosis, morbid alterations in the blood-vessels,
Bright's disease, and other serious maladies of a chronic nature.
Professor Chittenden, who is America's greatest physiological chemist,
has demonstrated that in all probability previous workers along these
lines have been excessive in their estimates as to the amount of food
required. He showed that a man could live for a period of nine months on
a daily ration which contained about one-third of the usual amount of
proteids generally thought to be necessary, and at the same time the fats
and carbohydrates were reduced to such a degree that the total number of
heat units, or calories, liberated from the food scarcely exceeded in
number one-half of the standard requirements. He also experimented on
thirteen volunteers from the hospital corps of the United States Army, to
whom he daily fed rations of only 2,000 calories, and, notwithstanding
that they engaged in physical work, all were found to be in better
condition at the end of six months than they were at the beginning.

These results strongly point to the conclusion that previous estimates as
to the quantity of food required are erroneous, and that man can not only
live, but may continue in strength and health on much smaller amounts. It
is highly probable that this discrepancy may be accounted for, at least
to a considerable extent, by the assumption that much of the food
ordinarily taken is rejected by the system, and passes out as waste,
while, when small quantities are eaten, it is for the most part absorbed.

_Mastication._--Thorough chewing of the food is absolutely essential for
proper digestion. While it is true that this, like all other good things
in life, may be, and often is, carried to an unnecessary extreme, it is
certainly true that we would be infinitely better off if we were to go
to the extent in this direction of so called "Fletcherism" rather than
perform this most important function in an indifferent manner.

This rule applies with especial force to food of a starchy
nature,--bread, potatoes, oatmeal, rice, etc. In order to digest food of
this character it must be very thoroughly cooked and when finally placed
upon the table it should be of such consistence that it requires chewing
before it can be swallowed. Not only is this necessary from the
standpoint of breaking up the larger particles into smaller ones, thus
permitting the food to pass freely through the stomach and intestine, but
it is of the greatest importance for it to be thoroughly soaked with the
saliva during the process. It is thus of no advantage for starches to be
served in a finely divided form--in fact it is directly the contrary,
since under such circumstances it is almost always the case that such
foods are swallowed without having been insalivated.

What has been said concerning the mastication of starches applies with
almost equal force to other foods. Without exception their digestibility
is much increased by thorough chewing. As the result of recent
experiments carried out by means of the X-ray, it has been shown that
particles of food of any considerable size will not pass from the stomach
into the intestine; as often as an object of this kind attempts to force
its way from the former into the latter the opening between the two
closes, and as a consequence the food is retained in the stomach longer
than it is in health--resulting in the course of time in catarrhal
conditions of the organ just named, and an unnatural relaxation of its
muscular walls. Under such circumstances the patient quickly develops
symptoms of indigestion, and if his habits be not corrected the trouble
gradually grows worse until the sufferer becomes a chronic dyspeptic.

_Classes of Nutritive Substances._--All substances that are of any
appreciable value in nutrition may be divided into those that are
nitrogenous in character (albumins, legumins), the carbohydrates
(starches and sugars) and compound ethers (fats). Of all these the
nitrogenous foods are the most important, since they contain the material
from which the great bulk of the body is largely composed, and at the
same time there is every evidence that in case of need they may be broken
up into chemical substances that may take the place of any of the other
kinds of foods; upon nitrogenous food, then, a man may live alone, while
this cannot be done on other articles of diet. The fats, starches and
sugars are very closely related to each other, and it is generally
believed that they subserve much the same end in the economy; by
undergoing chemical change they furnish energy (heat and muscular force)
and are undoubtedly largely responsible for the formation of the fats of
the body. While there is some evidence that under certain conditions
alcohol may be a food, its value is certainly very small, and it is not
of sufficient importance to be considered in this connection. The ideal
diet then for a healthy man is a proper proportion of nitrogenous
(albuminous) food, along with a reasonable portion of fats, starches and
sugars. Professors Voight and Atwater have calculated the following
table, which fairly represents the amount of proteids, fats and
carbohydrates that should compose the rations for twenty-four hours for
the ordinary adult male.

  ADULT MALE OF AVERAGE WEIGHT.

                   At Rest.    Moderate Labor.   Severe Labor.
  Proteids        110 grammes    118 grammes     145 grammes.
  Fats             50    "        50    "        100    "
  Carbohydrates   450    "       500    "        500    "

The tables that follow, which were arranged by Hutchinson, give a very
good idea of the generally accepted views as to the relative quantities
of the different foods that are thought necessary for the average adult
engaged in ordinary muscular work:--

                                                                Fuel
  Food Materials.   Amount.   Albumins.   Fats.   Starches.    Value.
  1.                 Ozs.       Lbs.      Lbs.      Lbs.      Calories.
  Beef, round st'k    13        0.14      0.12      ....         695
  Butter               3        ....      0.16      ....         680
  Potatoes             6        0.02      ....      0.15         320
  Bread               22        0.12      0.02      0.75        1760
                      --        ----      ----      ----        ----
    Totals            44        0.28      0.30      0.90        3455

  2.
  Pork, salt           4        ....      0.21      ....         880
  Butter               2        ....      0.11      ....         450
  Beans               16        0.23      0.02      0.59        1615
  Bread                8        0.04      0.01      0.28         640
                      --        ----      ----      ----        ----
    Totals            30        0.27      0.35      0.87        3585

  3.
  Beef, neck          10        0.10      0.09      ....         550
  Butter               1        ....      0.05      ....         225
  Milk, one pint      16        0.04      0.04      0.05         325
  Potatoes            16        0.02      ....      0.15         320
  Oatmeal              4        0.04      0.02      0.17         460
  Bread               16        0.09      0.02      0.56        1280
  Sugar                3        ....      ....      0.19         345
                      --        ----      ----      ----        ----
  Totals              66        0.29      0.22      1.12        3505

  4.
  Beef, up. sh'lder   10        0.09      0.13      ....         800
  Ham                  6        0.06      0.13      ....         650
  Eggs, two            3        0.03      0.02      ....         135
  Butter               2        ....      0.11      ....         450
  Milk, one pint      16        0.04      0.04      0.05         325
  Potatoes            12        0.01      ....      0.11         240
  Flour                9        0.05      0.01      0.38         825
  Sugar                1        ....      ....      0.06         115
                      --        ----      ----      ----        ----
  Totals              59        0.28      0.44      0.60        3540

  5.
  Sausage              4        0.03      0.11      ....         510
  Codfish             14        0.07      ....      ....         140
  Butter               2        ....      0.11      ....         450
  Milk, one pint      16        0.04      0.04      0.05         325
  Beans                5        0.01      ....      0.18         505
  Rice                 2        0.01      ....      0.10         205
  Potatoes            16        0.01      ....      0.23         420
  Bread                9        0.04      0.01      0.28         640
  Sugar                3        ....      ....      0.19         345
                      --        ----      ----      ----        ----
  Totals              71        0.27      0.28      1.03        3540

  6. Beef              8        0.08      0.10      ....         560
  Mackerel, salt       4        0.04      0.04      ....         230
  Eggs, two            3        0.03      0.02      ....         135
  Butter               2-1/2    ....      0.13      ....         565
  Cheese               1        0.02      0.02      ....         130
  Milk, one pint      16        0.04      0.04      0.05         325
  Potatoes             8        0.01      ....      0.08         160
  Rice                 2        0.01      ....      0.10         205
  Bread                9        0.05      0.01      0.32         720
  Sugar                1-1/2    ....      ....      0.09         175
                      --        ----      ----      ----        ----
  Totals              55        0.28      0.36      0.64        3205

_Calories Defined._--It should be explained that the term "calorie" is
one which has been adopted as a scientific expression for the fuel-value
of substances undergoing oxidation, and in this connection refers to the
heat-producing capacity of foods. The "calorie" is the amount of heat
required to raise the temperature of one gramme of water 1 deg.C. It has been
estimated that starches, sugars and albumins liberate during combustion
4.1 calories per gramme, while fats produce 9.3 calories. It will be
noted that in the tables just given the total number of calories is in
each instance somewhere in the neighborhood of 3,500, which is
considered to be about the number of heat units required by the average
man at moderate muscular work. The weight of the average woman being less
than that of the adult male, a reduction of about 20 per cent. from the
foregoing figures would approximate the amount of food required by the
former.




CHAPTER VI

BREAD AND ITS RELATIONS


At all times, and among all peoples, bread has been recognized as one of
the great staple articles of diet. Although its commonly quoted
designation, "the staff of life," would more appropriately belong to the
albumins, there can be no question that breads of one kind or another are
among the most wholesome and necessary of all food-substances. Not alone
is this true on account of the starch of which they are largely composed,
but they contain more or less vegetable albumin; it is thus seen that
bread is a mixture of the two most important food-stuffs, starch and
albumin, but the quantity of the latter is so small that an individual
would have to eat an enormous amount of the mixture to secure enough of
this ingredient to meet the needs of the body. For practical purposes,
then, we may regard bread as being starch.

     Within recent years quacks have disseminated very widely throughout
     this country the error that foods are more digestible when raw. It
     was long ago demonstrated that pure albumins, of which eggs and
     milk are the nearest natural examples among foods, are assimilated
     somewhat better when eaten raw, but this applies to no other foods
     except sugars. Any success that has followed the teachings just
     referred to undoubtedly rests purely on the fact that their
     followers are instructed to live largely on raw eggs and milk, and
     as the patient usually discovers in a short time that these two
     foods agree with him while other uncooked ones do not, he naturally
     eats them to the exclusion of the rest and where he takes a
     sufficient quantity increases in weight and strength.

     The idea that starches are more digestible when eaten raw could be
     easily refuted by any intelligent farm-boy who recalls one or more
     sad experiences from over-indulgence in raw sweet potatoes.

What shall we look upon as bread? Of course all such food-stuffs as are
commonly included within this designation are to be accepted; such as
wheat-bread, graham-bread, whole-wheat bread, biscuits, rolls, light
bread, bakers' bread, waffles and batter-cakes, rye bread, corn bread,
preparations of corn-starch, with which we should place those articles of
diet so commonly used in the south, usually called grits, hominy,
egg-bread, muffins, corn-meal cakes, potatoes, both sweet and Irish,
arrowroot and the so-called cereals or breakfast-foods, including
oatmeal.

Now which of these is the most wholesome? This inquiry cannot be answered
conclusively for the reason that the digestibility of this, as of other
foods, depends largely on the individual. For the sake of clearness the
various breads will now be considered in detail.

_Wheat-bread the Best._--It may be confidently asserted that well-cooked
and perfectly dry wheat-breads are to be regarded as being generally the
most digestible of all bread-stuffs. This is not dependent on any
inherent property in wheaten starch as a result of which it is acted upon
more readily by the juices whose office it is to render it fit for
absorption in the body, but is wholly due to the fact that breads of
wheat-flour may be made very dry and light.

As has been already explained, it is particularly necessary that starches
should be thoroughly soaked in saliva, and this can only be accomplished
when the bread is of such consistence that it must be chewed for a time,
and so dry that it will readily absorb the salivary secretion. The
writer, then, would advocate well cooked light-bread or bakers' bread, or
toast made from either, as being the best of all food-stuffs of this
character. The crusts of biscuit a day or so old are quite digestible, as
are also waffles, if made with little grease and cooked thoroughly. The
soft inner portion of biscuit and that of hot rolls, as well as
batter-cakes, is decidedly unwholesome.

Graham-bread should not be constantly indulged in for the reason that it
contains multitudes of sharp particles of the husk of the grain that cut
the delicate mucous membrane of the stomach and intestines as it passes
along, and if its use be long and continued, severe ill effects
necessarily follow.

     In this connection attention should also be called to the common
     error that particles of husk are of advantage to breads of all
     sorts; the former consist chemically of exactly the same thing as
     sand, and are quite as indigestible, and this, in connection with
     what has just been said of their action on the delicate mucous
     membranes of the intestinal tract, should be quite enough to
     convince anyone that they are not only useless, but injurious. It
     is true that the irritation produced by the husk will oftentimes
     cause the bowels to act, but results of the same character may be
     induced by many other agencies, within themselves less harmful.

_Rye-bread._--There is no reason why rye-bread should not be prepared in
quite as wholesome a way as is wheaten-bread, and this grain should
undoubtedly rank as one of the best of the cereals. Its use, however, is
so limited in this country that it is scarcely necessary to go into a
lengthy discussion as to its merits. It may be remarked that the ergot
fungus frequently grows on this grain, and when ground up with it
occasionally poisons the consumer where the quantity of the substance is
large and the bread is eaten in considerable quantities. Instances of
this kind are not uncommon among the peasantry of Europe, where a black
bread made from rye is the staple article of diet. Of course, when making
food-preparations of rye, we should be careful to have the flour
thoroughly winnowed, and to cook the bread until sufficiently dry to
acquire a proper consistency for chewing.

_Corn-bread and Corn Food-products._--When made from perfectly sound
grain, and if not allowed to undergo fermentative changes afterward,
there can be no question that food-products of corn are entirely
wholesome, and, from the standpoint of chemical composition, quite as
nourishing as similar articles of diet prepared from other grains. It is,
however, unfortunately true that we cannot, in the majority of instances,
definitely assure ourselves that our corn-bread is made from grain that
comes up to the above specification, nor can we be sure that the meal is
fresh, or preserved at such a temperature as would forbid the growth of
various germs. It has long been known that bad corn would kill horses,
but notwithstanding this, we have accepted the view that no amount of
deterioration in the grain could result harmfully to man. That this
latter assumption is incorrect seems now in the highest degree probable.

     _Pellagra._--It is known that a very curious and fatal disease
     called pellagra is prevalent to a considerable degree at the
     present time in the United States, and it is not going too far to
     say that all of those best capable of judging are of the opinion
     that the malady is the result of eating just such corn as we know
     kills horses.

     It is likewise true that the nutritive power of this grain could in
     no way be increased by allowing it to decay before consumption;
     indeed, the contrary must be the case, and, if it were in no manner
     actually harmful, our sense of the aesthetic and of what is proper
     to eat, should make us reject in this case, as with other foods,
     that which is unsightly to the eye and unpleasant to the taste. We
     should no more eat bad grain than a rotten apple, or putrefying
     meat. The increased prevalence of pellagra is exciting attention
     all over the United States, and is very generally assumed to be the
     result of lack of care in the harvesting and preservation of our
     corn. Instead of being cut before it is ripe, and shocked in the
     field during the latter part of the summer, it should be allowed to
     ripen on the stalk, and after cold weather sets in gathered while
     dry, and preserved in well-covered and well-ventilated barns. Every
     care should be taken to keep it dry while being shipped from one
     part of the country to another, and similar precaution should be
     observed with the various food-products made from it. If kept in a
     cold place, meal or grits made of good corn may be preserved in
     excellent condition for eating throughout the winter; but as soon
     as the warm weather begins they should be stored in the
     refrigerator, and should there remain during the summer; similar
     precaution should be taken with meal or other corn-products during
     the hot months.

Over a large area of the United States corn-bread is an article of daily
diet with a great majority of the inhabitants, and its wholesomeness as
compared with other breads becomes, therefore, an important question.
Unfortunately, corn-meal does not lend itself to the preparation of a dry
bread having sufficient consistency to require chewing. It is true that
the crusts of the bread made from this grain answer these requirements
fairly well, and there is therefore no reason why this part of it should
not be used to any extent, provided it be prepared from good meal. We
should endeavor to cook thin pones of the bread rather than the thicker
ones so common in the south. The objection that corn-bread can only be
masticated with difficulty applies to the other preparations of this
cereal, such as egg-bread, muffins, etc., and they are not, therefore,
with the exception of the crusts, to be looked upon as being the best
form of bread. Corn-cakes, like all batter-bread, are to be mentioned
only to be condemned. Grits and hominy are soft and moist and cannot be
properly chewed, and are, therefore, not to be recommended as good
breads. Corn-starch preparations are likewise entirely lacking in the
elements required to make good bread, and should only be used
occasionally and in small amounts.

_Disadvantages of Potatoes._--Irish potatoes are eaten almost as commonly
in some portions of the United States as are corn-products in others, and
therefore deserve the careful consideration of the hygienist. While it is
not believed that, like the latter, potatoes give rise to any definite
disease, it is unfortunately true that they are theoretically worse
breads than those made from the grain just referred to. In whatever way
cooked, they are moist and require no chewing, and as a consequence many
persons with delicate digestions do not assimilate them properly.

_Arrowroot._--The preparations of arrowroot are considered digestible,
though here again we find that such articles of diet are generally moist
and of not proper consistence to be chewed, and they are, therefore, not
as valuable as are breads made from wheaten flour.

_Rice._--Rice is used by a large portion of the world's inhabitants. When
cooked thoroughly and very dry, it is perhaps almost as good bread as is
that made from wheat. The starch granules of the former, like those of
arrowroot, are somewhat smaller than those of wheat.

If it were possible to keep rice-flour in good condition, and if it could
be made into light-bread, it is likely that it would be superior to
wheaten flour, but this does not appear feasible.

A peculiar and very fatal disease prevails in the East, known as "kak-ke"
or "beri-beri," which is now generally regarded as being the result of
eating decomposed rice. The writer has seen one or two examples of what
he considers American beri-beri, but as our rice-eating population is
small, it is not likely that this disease will ever become a serious
problem in the United States.

_Cereals or Breakfast-foods._--Lastly we will consider the so-called
breakfast-foods, which are neither more nor less than various
preparations of the different varieties of starch. They are generally
made from oats or corn-starch. They are nothing more than bread, and as
some of them have been put through a sort of fermentation it is difficult
to understand how they could be regarded as being quite as wholesome as
the original products from which they were made. This, however, is not
the principal objection to them. The real trouble lies in the fact that
they are, in the majority of instances, served with cream and sugar. When
we remember what has already been said about starches that are soft and
cannot be chewed, and of the ill effects of sweets on persons who have
any inclination towards dyspepsia, it will be seen that these foods are
not to be regarded as being wholesome. The real reason that would appear
to explain the coming into existence of these preparations is that they
are mixed with cream and sugar, which appeals strongly to the
"sweet-tooth" of the average person. They are nothing but bread, and very
bad bread at that. The remarks made concerning breakfast-foods apply with
equal force to oatmeal, which, as generally used, has the additional
disadvantage of containing particles of husk.

In concluding this discussion on starchy foods the writer desires
particularly to call attention to a very common error in the way they are
eaten. Mention has already been made of the fact that fats after being
melted are by no means so wholesome as in their natural state, and
produce, when heated with starches, a very indigestible mixture. Thus,
theoretically, it is bad to use any great amount of lard, butter or other
fat in the preparation of breads, and it is likewise undesirable to
spread butter on heated breads, as is so often done just before eating
biscuits, waffles and batter-cakes. The combination is certainly a
seductive one, and pleasing to the taste of most persons, but this in no
way invalidates the fact that the mixture is exceedingly indigestible.

_Pastries and Cakes._--Peculiarly unwholesome are pastries containing any
considerable proportion of fat, and also most varieties of cake. With the
exception possibly of hot batter-cakes served with an abundance of butter
and syrup, cooks have so far produced no compound so heinous and totally
depraved as pound-cake. Fruit-cake also stands high up in the list of
undesirable sweets. It certainly passes all understanding why cooks
should continue to persecute the stomachs of a dependent world with such
highly obnoxious concoctions; the only excuse that can be given for them
is that the mixtures are palatable. Where a housekeeper feels it
necessary to prepare cake, she should select some receipt free from
butter or other fat, such as angel-cake or sponge-cake, both of which
when properly made are exceedingly good to the taste, and lack the
undesirable quality of containing fats. Explanation for the peculiarly
unwholesome character of food containing melted grease lies probably in
the fact that the grains of starch under such circumstances must be to a
greater or less extent covered by a thin layer of the fatty substances,
and as a consequence it is impossible for the saliva to penetrate to the
starch and perform its normal digestive function.




CHAPTER VII

MEATS, SUGARS AND MILK


First in the list of foods the writer would place those nitrogenous
substances commonly eaten that belong to the class of albumins. That
these substances are in reality the most important of all food-stuffs
there can be no sort of question, since they, of all things eaten by the
human being, are alone absolutely essential for his well being and even
his existence. They are the substances that almost exclusively go to make
up the muscle and tendons. Along with the lime-salts they enter largely
into the composition of the bones and cartilages, brain, spinal cord and
nerves. Other foods are incapable of taking the place of the albumins, so
that they are absolutely essential for normal life in the human being.

The amount of albumin necessary for the normal adult has been variously
estimated, the tendency at the present time being to place the quantity
needed somewhat lower than was at one time done. It is probable that
about two ounces of pure albumins is somewhere near the amount required
in twenty-four hours by a normal adult.

It is well, since we are so dependent on foods of this class, that we
have two quite distinct sources from which they may be taken. The great
bulk comes to us in the form of meats, including poultry, game, oysters
and fish of various kinds, in addition to beef, mutton, and hog-meat in
its several forms. Of animal origin also we have eggs, which are among
the most valuable of all foods of this class on account of their high
digestibility.

From the vegetable world we get albumins known as legumins, which differ
somewhat from those obtained from animal sources, though taking their
place in the economy in all essential particulars. Unfortunately the
legumins are usually so mixed with starches and other vegetable
substances less digestible, that it is necessary to take a large bulk of
foods of this latter class in order to secure anything like the requisite
amount of the former.

Before taking up individually the various albuminous foods, the writer
would again direct attention to the chapter on cooking, and would
strongly urge upon the reader the proper methods of preparing nitrogenous
foods therein stated. Where the albumins are in a nearly pure state, as
in milk and eggs, they are slightly more digestible when raw, but all
meats should be cooked until only the faintest tinge of red remains if we
wish to have them prepared in the most wholesome way for those with
delicate digestions. Meats are, as a rule, most wholesome when cooked
"very done."

     It has long been the cry of sentimentalists that no living being
     should die in order that man might exist. Unfortunately for such
     theories, the stern and unbending edict of nature has negatived
     views of this kind ages before the altruistic philosopher came on
     the scene, and we are daily constrained to bow to this mandate of
     one of the primal laws of existence. However much we might desire
     it otherwise, it has been written that "only in death is there
     life;" nor may any animal being disobey and continue to exist. As
     has been already explained, the human being cannot thrive on
     vegetable substances alone; from them he may get a certain amount
     of nitrogen in the form of legumin, but there is not enough to
     make up for the waste of this substance that constantly goes on in
     the body.

Theoretically it is of very little importance which of the meats are
selected to supply our nitrogenous food, but it is unfortunately true
that such foods vary much in digestibility, and it will therefore be
necessary to consider them separately.

_Beef._--When tender and cooked to a proper degree, beef is considered
one of our most wholesome of meats. Like other foods of this kind, it
should not be fried, but should be broiled or roasted, and a certain
amount of fat may be eaten along with the lean portions without injury,
and in many persons unquestionably with benefit.

_Mutton._--Of all the coarser meats, mutton is unquestionably the most
digestible, and when cooked in the same way as directed for beef is
eminently wholesome.

_Hog-meats._--On account of the large portion of fat between the
muscle-fibers, hog-meat, particularly when fresh, is not usually regarded
as being digestible. Some persons eat it with impunity, but for the vast
majority it should be taken only in small quantities. It should not be
fried. In the form of ham, hog meat is more wholesome than when fresh,
but even in this condition many dyspeptics find much difficulty in
digesting it. The best method of cooking it is to boil thoroughly. After
being cooked in this way and then broiled, it is most appetizing, and is
much more wholesome than when broiled without being previously cooked. As
bacon, hog-meat enters largely into the dietary of a great portion of the
laborers of this country, and there can be no doubt that on the whole it
answers the purpose of a staple food admirably. It contains even more fat
than nitrogenous substances, and may therefore be looked upon as a
mixture of butter and meat. Dyspeptics cannot eat it with impunity in
many instances, though it agrees far better with them than does ham or
the fresh meat. If it were generally eaten boiled it would provoke less
trouble than when fried. At this point the writer would repeat his
warning concerning the indigestible character of melted grease, of which
the gravy from bacon is a striking example.

When "cured" in a somewhat different way hog-meat as "breakfast-bacon"
is very generally used throughout the civilized world, and is one of its
most wholesome forms. This when broiled is both appetizing and wholesome,
and should form a part of the daily dietary of everyone able to afford
it.

_Poultry and Game._--Among the more delicate and most wholesome forms in
which albumins are taken we find poultry and game well up toward the head
of the list. Meats of this character should be very thoroughly cooked by
being either baked, smothered or broiled.

_Fish._--Fish of almost all kinds are wholesome provided they be fresh
and properly cooked. The culinary artist prepares of them most appetizing
and nutritious dishes, and they are therefore properly to be recommended
as among the best of the albuminous foods.

_Oysters and Clams._--Oysters and clams are usually considered somewhat
apart from the generality of the foods of this character. When fresh they
are wholesome and delicious when eaten raw, and may be cooked in a great
variety of ways. The reader should be especially warned that fried
oysters are not so wholesome as when they are prepared by other methods,
for the reason that they are surrounded by a batter containing quantities
of melted grease.

_Eggs._--Among the most delicate, digestible, and nutritious of all foods
we may place eggs. Though somewhat more digestible when raw, they agree,
as a rule, even with the most fastidious stomach, however cooked, even
when hard-boiled. Eggs lend themselves readily to the formation of many
delicious dishes, such as omelets, souffles, etc.; but unfortunately they
do not contain nutriment in a very concentrated form, and where an adult
is living on them alone it requires from one and a half to two dozen
daily to furnish the necessary amount of food.

_Fats._--Under the term "fats" are included all oily substances, such as
butter, lard, olive and cotton-seed oils, and to a great extent the fat
contained in meats. These substances are closely related to starches and
sugars, and undoubtedly play a more or less similar role when taken into
the body as food. From the standpoint of heat-producing capacity they
more than double, weight for weight, meats and starches, and are,
therefore, instinctively highly prized by dwellers in cold countries
where much heat is necessary. In warmer countries the necessity for
excessive heat-production in the body does not exist.

     While oily substances are certainly capable of adding to the
     cushion of fat commonly found beneath the skin in normal
     individuals, they are not looked upon as being to any extent
     tissue-builders, resembling in this particular the starches and
     sugars.

     When fats are to be eaten, care should be taken that they be as
     fresh as possible, or, if this is not feasible, they should be
     preserved in such a way as to prevent their becoming rancid--a
     condition which is the result of the formation of fatty acids,
     lending a peculiarly unpleasant odor and taste, and producing a
     decided decrease in food-value. This alteration may be largely
     prevented by keeping fats in a refrigerator at a low temperature,
     and may also be greatly retarded by the addition of salt. In this
     country butter is usually treated with a very considerable amount
     of salt, but in Europe it is universally served fresh. Within
     recent years facts have been established that show that Americans
     use an excessive amount of this substance--possibly causing disease
     in some cases; and doubtless we would be better off if we were to
     follow the European practice.

     Oily substances when in good condition are certainly of high value
     as foods, but should be taken more or less with an eye to the
     climate, and to the season of the year. When placed on cold bread
     and eaten along with it they are extremely palatable, and may be
     taken in reasonable amounts with decided benefit to the whole body.
     In temperate climates it is generally estimated that about three
     ounces is a desirable amount for the average adult. In this
     connection it may not be out of place to mention that the various
     preparations of cod-liver oil, advertised so freely in the lay
     press, in some instances actually do not contain a single particle
     of the substance that they are supposed to be principally composed
     of; and it may be further stated that there is no good reason to
     believe that bulk for bulk oils of this kind are in any way
     superior to those fats commonly eaten. The writer often recalls the
     saying of a very wise old physician of his acquaintance that
     "cod-liver oil is nearly as good as butter."

_Sugars._--This term includes the large number of different substances of
a more or less sweetish taste that belong to the group of carbohydrates.
They are closely related to the starches, and it is generally assumed
that they play much the same part after being taken into the body. Some
of these are of animal and some of vegetable origin--but except the sugar
found in milk, the only ones commonly consumed are those derived from
cane, beets, and fruits; the sugar from the first two is known as cane
sugar or dextrose, and that from the latter as grape sugar or glucose.
Like albumins they may be eaten without having been previously cooked,
and are unique in that they undergo no chemical change whatever as a
result of ordinary degrees of heat.

While the consumption of sugars in all civilized nations is rapidly
increasing, there can be no question that, irrespective of fruits, they
are, of all foods, the most frequent causes of digestive disturbances. It
is only within comparatively recent times that mankind has possessed
means of separating sugars in any great bulk from the plants containing
them, and as a consequence they have only entered prominently into our
every-day diet for a relatively short period of time. Before this, it is
true, they were consumed to a greater or less extent in various fruits,
but the quantity was insignificant as compared with the amount now
universally eaten. As a result of this we are now confronted with a new
dietetic problem. For ages the human stomach has been accustomed to deal
with only small quantities of these substances, and developed
accordingly a capacity to digest them proportionate to the amounts then
eaten. Now, however, we constantly call upon our digestive organs to deal
with large quantities of such foods, and it is not strange that there has
been more or less rebellion on their part.

     Experiments have shown that a small amount of sugar assists in the
     normal chemical changes that go on in the body, and it is,
     therefore, obvious that nature intends us to take a certain
     quantity of it. Moreover it is true that sugars while being burned
     in the body give off much energy--mainly manifested in muscular
     power; where then we are taking active physical exercise foods of
     this kind are peculiarly appropriate. It would, therefore, not be
     wise for us to leave this food entirely out of the dietetic list,
     but to use it only in small amounts--particularly where we lead
     sedentary lives. Sugar and alcohol play a more or less similar role
     in the animal economy. It is well known that those who do not use
     alcohol are peculiarly prone to consume considerable quantities of
     sugar; and it is equally a matter of common observation that those
     who habitually take alcohol rarely eat sweets to any extent.

     When sugar is properly assimilated, as seems to be done most easily
     by children, it is an excellent food, but where sweets are
     over-eaten, and not properly digested, they give rise to a great
     accumulation of gas in the intestine, and produce in many persons
     a marked acidity of the stomach, frequently accompanied by severe
     insomnia. Nothing so quickly relieves such sleeplessness, caused by
     a "sour stomach," as allowing ten or fifteen grains of ordinary
     cooking-soda to slowly dissolve in the mouth and swallowing the
     saliva rendered alkaline in this way.

_Milk._--Milk may be looked upon as an ideal food, it being composed of
water carrying in solution the three great natural foods--albumins in the
form of casein, carbohydrates as milk-sugar or lactose, and fat. Mixed in
the proportion in which they here occur, they are most admirably adapted
to the delicate digestive apparatus of the infant--the relative
proportion of the different substances even gradually changing as the
assimilative powers of the youthful organism increase; it is thus seen
that milk itself is not of constant composition, even in the same animal,
and that it alters in such a manner as to meet best the needs of the
delicate being depending upon it for proper sustenance. It is also the
case that the composition of milk varies in different animals--showing
again how admirably nature exerts its powers in meeting desired ends.

The lesson of practicable importance that we learn from this is that the
milk of one of the lower animals is not in its natural state quite suited
to the delicate stomach of the growing infant, and that if it be
substituted for the mother's milk it must be more or less altered,
depending upon the age of the child. It is particularly important that
sweet milk be taken slowly, as otherwise large curds, difficult of
digestion, form as soon as it gets into the stomach.




CHAPTER VIII

FOOD-VALUE OF VEGETABLES


In recent times we hear much of vegetarianism, which has its advocates
among many highly intelligent people, and which, as a consequence, has
achieved a certain vogue throughout the civilized world. It is rarely the
case, however, that those who affect to practice this cult in reality
live exclusively on a vegetable diet. As a rule it will be found that
they are milk-drinkers, and not infrequently add eggs to their dietary.
It is, of course, absurd to regard as vegetarians those who simply avoid
meat, since it is true that the nitrogenous substances contained in milk
and eggs differ in no essential particular from similar substances found
in flesh of all kinds.

Experiments on a somewhat extended scale have shown within recent years
that young and vigorous individuals at least may live and thrive on a
diet composed largely of vegetables; no one has yet shown that a strict
vegetable diet is that best adapted to the average individual, and no
competent authority on this subject at the present time advocates a diet
purely of this kind. It is true that the vegetables ordinarily eaten
contain all of the elements that are essential to the animal system, such
as starch, sugar, fat and albumins. Unfortunately, however, the amount of
the last-named substance is usually so small in food-plants that the
quantity that would have to be eaten by a normal individual taking active
exercise would cost considerably more than if a reasonable proportion of
animal food were included, and--which is of even greater importance--the
digestive powers of the individual who attempted to live only on food of
this character would be severely taxed, and, in the long run, probably
seriously impaired. Furthermore, vegetables and fruits contain
substances, usually in great quantity, that are scarcely acted upon at
all by the digestive juices. Chief among the latter is cellulose, which,
while forming the great bulk of the food of herbivorous animals, is
scarcely suited to the weaker digestive capacity of the human being;
practically none of it is converted to the uses of the body. It is thus
seen that in the average man or woman a dietary consisting largely of
vegetables would result in the presence in the intestines of a greater or
less bulk of indigestible materials, which could subserve no good purpose
other than that they would by their mechanical presence have a tendency
to cause the bowels to act; as is the case with fruits, however, it is
unfortunately true that this large residue of undigested food, in one way
or another, often gives rise to considerable irritation of the mucous
membrane of the intestine, and frequently produces dyspeptic
disturbances, among which looseness of the bowels is common.

This brings us to a consideration of the digestibility of vegetables in
general, which is always the paramount consideration when dealing with
the value of any substance to be used as a food. It has been before
remarked that young and vigorous persons seem to thrive on a dietary
largely of vegetable character, but the case is certainly quite different
with older people, particularly where their digestive powers are
impaired. In the latter we often find that severe intestinal disturbances
follow even after moderate indulgence in vegetable foods--particularly
where they are served with vinegar, or some other fruit acid. Another
peculiarity of foods of this kind that makes decidedly against their
digestibility lies in the fact that, being soft and containing a large
proportion of water, they are scarcely ever properly chewed, and as a
consequence they are swallowed in comparatively large masses without
having been adequately insalivated.

Vegetables may be roughly classified as legumes, roots and tubers, and
green vegetables, and will now be considered briefly in the order named.

_Legumes,--Beans, Peas, Lentils, and Peanuts._--With the exception of the
cereals, the legumes are the most valuable of all vegetable foods. Their
nutritious properties are mainly due to their relatively high percentage
of nitrogenous material, though they also contain starch and fat. Hence
these vegetables contain the ingredients necessary to supply all the
needs of the human economy; unfortunately, however, when eaten alone in
sufficient bulk to furnish the nourishment required, they often--even in
healthy individuals--give rise after a little time to dyspeptic
disturbances.

Of beans, a large number of different varieties are in common use
including string-beans (or snap-beans), lima-beans, kidney-beans, red
beans, the frijole, and the Soya bean. String-beans are exceedingly
palatable, and are very much prized as an article of diet by the peoples
of all countries. When gathered young and thoroughly cooked while still
fresh they are exceedingly wholesome, and are very well assimilated, when
properly chewed, by even those whose digestions are considerably
impaired. The other beans named are generally eaten dry after having been
removed from the pod in which they grow. When they are soaked in water
until they become soft and then thoroughly cooked they make an excellent
food, and, when not taken in too great quantities, are fairly digestible.
When cooked with onions, parsley, and red pepper in proper proportions
they make a very delicious dish. In Japan the Soya bean forms the basis
for a kind of vegetable cheese which is eaten with rice, and furnishes
the nitrogenous materials in which the latter is deficient. Peas are
wholesome when young and fresh and when properly cooked, and as they come
on in the early spring when other fresh vegetables cannot be obtained,
they furnish a most acceptable addition to the dietary. When old, after
their skins become tough, they cease to be digestible, and should not be
eaten except in the form of purees, during the preparation of which the
hull is removed.

Lentils are scarcely eaten at all in America, but are much prized in some
portions of the Old World, as the basis of soups.

Peanuts belong to the group of legumes, though, unlike the others that
serve as food, they grow beneath the surface of the ground. They are
highly nutritious, but are, unfortunately, indigestible, owing largely to
the high percentage of oil that they contain. The latter is extracted,
and is sometimes sold as olive-oil; in a somewhat different form it is
made into a sort of butter which is quite palatable.

_Roots, Tubers, and Yams._--Sweet and Irish potatoes, which constitute
the most important members of this group, have already been discussed
under the head of breads. Of those that remain, some few, as beets and
artichokes, may be regarded as related to those just referred to, while
others, such as carrots, turnips, radishes, parsnips, etc., are generally
reckoned among the succulent tubers on account of the large proportion of
juice that they contain. Irrespective of the beet, which furnishes a
considerable portion of the sugar of commerce, none of them may be looked
upon as foods of a very important character, as they contain only
relatively small proportions of sugars, starches, and nitrogenous
materials. Beets, however, do contain a very high percentage of that
which makes potatoes so popular,--about eighty-five per cent. of starches
and sugars, with only a trifle of nitrogenous material. When young and
tender they are often eaten as a salad, either alone or mixed with other
vegetables, and are generally regarded as being wholesome and highly
nutritious. They should not be eaten by dyspeptics when pickled, on
account of the vinegar.

Artichokes are occasionally eaten, but are not nutritious, although they
agree well with many persons.

Carrots, when young and fresh, are fairly digestible, but like other
vegetables are exceedingly apt, particularly if old, to produce
intestinal disturbances in dyspeptics. They are not very commonly eaten
in the United States, but where selected with care we would profit by
their more frequent use. They contain a small percentage of starches,
with an insignificant proportion of vegetable albumin.

Turnips are exceedingly unwholesome, contain very little nourishment, and
may be eaten with impunity only by persons in vigorous health. The same
remarks apply to radishes, and to parsnips.

_Green Vegetables._--Vegetables of this class are of much more value from
the standpoint of their agreeable taste, and the consequent stimulating
effect upon the appetite, than from the nutritive materials that they
contain. Some of them are eaten cooked, while others are usually consumed
in a raw state. They are all much less indigestible if eaten when quite
young and fresh--drying seemingly having the effect of producing
alterations in them that predispose to dyspeptic disturbances in those so
inclined.

Spinach is one of the most digestible of the entire group, and is much
eaten in all parts of the world.

Turnip-tops differ in no essential particular from spinach. They have a
somewhat bitter taste, but when young and fresh are highly palatable, and
if thoroughly cooked cause comparatively little intestinal trouble, but
like spinach they contain practically no nourishment. The same may be
said of the leaves of various other plants commonly served as greens,
among them beet-tops, and dandelion-tops.

Cabbages, many different kinds of which are habitually eaten as food in
civilized countries, have comparatively little nutritive value, and are,
generally speaking, decidedly indigestible, although young and vigorous
persons, particularly where they take abundant out-door exercise, find no
difficulty in assimilating the inner portions of the fresh cabbage
"head." As in the case with other vegetables, the soil and locality in
which the cabbage is grown largely influences its taste, and to some
extent its digestibility. It should never be given to infants. Sauerkraut
is a preparation of cabbage leaves produced by adding salt, and later
crushing them with considerable pressure; after a time alterations occur
of a fermentative character, and the product is generally regarded as
more wholesome than fresh cabbage.

Cauliflower consists of masses of the somewhat modified flowers of a
plant closely related to the cabbage, and is, when properly prepared,
palatable, and perhaps somewhat more digestible than cabbage. Cole, and
Brussels sprouts, are plants of the cabbage family, and are perhaps even
more indigestible.

_Salad Plants._--The leaves of the lettuce are usually eaten raw, most
commonly being served as a salad in combination with oil and vinegar, or
lemon juice. That the leaves possess, when treated in this way, a very
palatable taste all will perhaps agree, but they cannot be said to be of
any nutritive value, nor are the acids just referred to conducive to
their digestibility.

On account of their somewhat pungent taste, watercresses are used in many
parts of the world as ingredients of salads, but they are, of all
vegetables, the ones that are most liable to transmit disease to man, for
in addition to the possibility of contracting in this way typhoid fever,
dysentery, cholera, and the ordinary intestinal worms, the human being is
apt to receive with them the eggs of the flukes, and the spores of the
amoebae that produce chronic tropical dysentery. As they are probably
never grown under such conditions as to preclude the possibility of this
danger, it would be the part of wisdom to absolutely refrain from their
use.

_Onions, Leeks, Shallots, and Garlic._--Vegetables of this group are
eaten either raw or cooked, and of all those consumed in the former state
are least liable to transmit disease, owing to the fact that they are
nearly always thoroughly peeled before being eaten. They have the
advantage, furthermore, that they may be preserved for long periods of
time in such a way as to be fit for food, and when properly cooked have a
delicate flavor, and are quite wholesome although furnishing little food
for the body. Garlic is never eaten as a vegetable, but serves as the
basis for many of the delicate sauces for which the French cooks are so
justly celebrated.

The tomato has been used as a food only within comparatively recent
times, it having been formerly thought to be poisonous. Like the onion it
may be eaten either raw or cooked, and if taken in moderation does not,
as a rule, produce any serious harm. When eaten in greater quantities,
both on account of the acid that it contains and its relatively small
proportion of assimilable nutriment, the tomato is exceedingly prone to
cause intestinal disturbances, and should rather be regarded as a fruit
than a vegetable. Growing at some distance from the ground, it is rather
less apt to convey diseases than the majority of vegetables eaten in a
raw state.

While celery is generally eaten raw, it furnishes a palatable dish when
cooked in milk. It should not be eaten by dyspeptics or children,
particularly if raw. Similarly the cucumber has a well-merited reputation
for producing dyspeptic disturbances. It is only eaten raw, is frequently
served as a salad, and should be used only when very young and fresh,
and eaten only by persons of sound digestion.

Okra is much prized in the Southern States as the principal ingredient of
a very palatable soup, but is not as a rule looked upon with favor by the
uninitiated. It is also much eaten boiled and served with a little butter
and pepper. When fresh and young it is fairly digestible, and furnishes a
very agreeable addition to the dinner.

     In addition to those already referred to, there are a number of
     vegetables that are very popular either alone, or in combination as
     salads--particularly in the South; among them are green peppers,
     parsley, mint, capers, endive, and chicory. The remarks already
     made concerning green vegetables apply equally to these just
     mentioned, and it should here again be particularly insisted upon
     that salads containing acids are unwholesome for infants and
     children, and should be used sparingly even by those in health.
     None contains much nourishment.

     Among easily digestible vegetables asparagus probably takes front
     rank, and in addition to this has the merit of being exceedingly
     agreeable to the taste. It possesses little nutritive value, but
     when young, fresh, and well cooked, it may be taken even by infants
     without harm.

     Rhubarb, or "pie plant," is eaten stewed, and made into pie. It is
     said to be somewhat laxative, and is decidedly more wholesome than
     many others. The squash, when properly cooked is comparatively
     wholesome, but contains little nourishment, and is of no particular
     value as a food, and the pumpkin is not much better, although
     useful during the winter for making pies after the ordinary
     vegetables and fruits are gone.

     Cranberries, when thoroughly cooked and separated from the hulls,
     form the basis of a delicious jelly that is widely eaten in the
     winter over all portions of the United States. Like all sweets it
     is not entirely wholesome for dyspeptics or infants, but as it is
     usually eaten with meats and not in great quantities, it may be
     looked upon as being one of the most wholesome of all foods of this
     class. It does not seem to have such a tendency to produce sour
     stomach in many dyspeptics as is so frequently done by other foods
     containing vegetable acids.




CHAPTER IX

DANGER IN FRUITS AND PICKLES


It is an error shared almost universally by both medical men and the
laity that fruits and raw foods are wholesome. Everyone is familiar with
the fact that fruits produce intestinal disturbances in children,--not
only when they are very young, but after their digestive apparatus is
fully developed. Rather curiously, however, instead of ascribing the
disturbances that follow to the real cause, we generally dismiss the
matter with the assertion that "early fruits are unhealthy," or trace the
resulting ill effects to some other equally imaginary factor. In reality
the reason why diarrhoea and other intestinal troubles so often occur
after eating fruits in the early spring is that the boy or girl after a
winter's fast greedily devours enormous quantities of them when they
first ripen, and disturbances follow in proportion to the amount and
character of these substances taken.

There can be no question that fruits, while extremely palatable, usually
produce trouble in dyspeptics, and even in those who still possess
unimpaired digestive organs ill effects quite constantly follow on the
heels of the taking of food of this character. Unfortunately, however,
the great majority of dyspeptics have symptoms that in no way outwardly
point toward digestive errors; as common examples, we might refer to the
blackheads, pimples and small boils, so frequently observed on the faces
of young boys and girls, or the rheumatic pains, and, at a later time,
the "Bright's disease," that occur in older people. When you tell such
patients that their trouble is indigestion, they are often mildly
indignant, and loudly protest that they can eat anything with impunity;
that they never have heart-burn, feelings of heaviness after eating,
pains in the abdomen, or other symptoms referable to the stomach and
intestines. We are rather disposed to be proud of our digestive powers,
just as we are of our bodily strength, and nothing is more common than
for chronic dyspeptics to maintain that they have never had indigestion
in their lives, and to resent any insinuation to the contrary.

Another popular error, almost universally accepted, is that fruits are
highly nutritious; as a matter of fact they consist almost wholly of
water, and of materials that are utterly indigestible. The latter
substances pass through the alimentary tract, therefore, in much the same
condition that they enter and serve no better purpose than to promote,
somewhat, activity in the bowels. Nevertheless the writer does not wish
to be misunderstood as advocating total abstinence from such a palatable
class of foods; no harm results in most people if they only take
perfectly ripe and fresh fruits in moderation now and then; and these
should be always eaten after meals rather than before.

The fruits that contain comparatively little acid are, as a rule, more
wholesome than those that are rich in substance of this kind. For
example, perfectly fresh and ripe figs or peaches may be taken by most
persons with impunity if they be eaten after meals, and at intervals of
at least two or three days. Acid fruits, particularly lemons, seem to be
peculiarly unwholesome; apples are prone to cause trouble and can rarely
be eaten without ill effects, however mellow and palatable they may be.
It sometimes happens that persons take grape-fruit with less harm than
others.

Closely akin to fruits in their deleterious action on the digestive
apparatus are sours in any form whatever. Women, especially, indulge
freely and at irregular hours in foods containing much vinegar,
lemon-juice, etc.,--usually in the form of pickles or salads. In healthy
persons, in moderation, foods of this character perhaps produce no
appreciable trouble, but nothing is more thoroughly established than that
they act harmfully on the general run of dyspeptics, such as most of us
are to a greater or less degree after thirty years of age. This leads to
the remark that here, as in everything else, we must regard individual
peculiarities--it being true that one person can eat without ill effects
what may produce decided disturbances in others, or suffer from excess
when moderation would entail no ill-effects.




CHAPTER X

DRINKS--PROPER AND HARMFUL


An immense amount of rubbish has been written during the last few decades
concerning the supposed good effect of excessive water-drinking on the
human economy. Something like a quarter of a century ago a London
physician by the name of Haig brought forward and strenuously advocated
the view that a large number of minor ailments were the result of the
presence in the body of excessive quantities of uric acid; applying the
well known fact that the substance just mentioned requires a large amount
of water to dissolve it he conceived the idea that the proper remedy was
to flood the body with enormous quantities of liquids, and thus, as it
were, wash the offending substance out of the system. So plausible did he
make this theory appear that it was accepted very largely by medical men,
who in turn taught it to the general public. Within recent times it has
been fortunately shown that Haig's theory was wholly chimerical, and
that quantities of uric acid greatly in excess of the normal amount could
collect in the body, or might be injected into the blood-vessels, without
the least harm resulting; thus, at one blow, this widely accepted theory
was annihilated, and there now remains no sort of reason for attempting
to remove uric acid by excessive water-drinking, or by other means.

     It is fortunate that the uric-acid theory has been disproved, for
     the excessive use of water is not only unnecessary, but highly
     injurious to the digestive organs, particularly when the fluids are
     taken at or about meals. Experience has shown that excessive
     stomach-acidity, which is the most common form of indigestion, is
     in a large degree dependent on the taking of liquids while eating,
     and that even in those who are healthy any more than small
     quantities cannot be looked upon as being wholesome. In dyspeptics
     liquids seem to act in a hurtful way in several different
     directions. For example, where persons constantly take liquids
     while eating the necessity of properly chewing the food is largely
     done away with; in addition to this the mere presence of water in
     the stomach seems to tend to the production of increased acidity,
     for it has often been observed by the writer that even where food
     was eaten dry indigestion would follow in many dyspeptics if they
     took water just before or immediately after eating.

The only sensible advice that can be given in this connection is that
persons should take no more liquids that they feel a desire for, and they
should avoid taking them in any quantity about meal time. What has just
been said concerning water applies equally well to milk. When taken alone
it very frequently agrees with patients much better than does solid food,
but when mixed with the latter is prone to produce indigestion, just as
does water. Fermented milk in the form of buttermilk is a very popular
beverage in some parts of the world, but it may be well doubted as to
whether it deserves the reputation for wholesomeness generally accorded
it; being a liquid, and at the same time acid, it is peculiarly prone to
increase acidity, and is not tolerated by persons who suffer with sour
stomach. It should, however, be said that it, on the other hand, seems to
agree particularly well with some people, and has been known when taken
alone, at least temporarily, to relieve obstinate forms of indigestion.

_Coffee._--The most universal beverage taken at meal time in America is
undoubtedly coffee. Each morning countless thousands are cheered and
stimulated by its invigorating properties to undertake their daily tasks,
but, as is always the case after taking drugs that have such action the
system has to pay the penalty in a reaction following later, during which
the capacity for work is diminished. It is, however, true that the effect
last referred to is not of such importance as to constitute in itself a
serious objection to the use of coffee, but other ill results are rather
prone to ensue that in many instances change the aspect of the question
entirely. In a great many people, particularly after the first vigor of
youth has passed, coffee produces anything but pleasant effects, and on
some it seems to act as a downright poison. Like all liquids taken at
meal time, it predisposes to acid indigestion, particularly when it is
sweetened. It is likewise true that when it contains any considerable
quantity of cream the liability to dyspeptic disturbances following its
use are particularly great--doubtless as a result of the considerable
quantity of melted fats that it contains under such circumstances.

     From the foregoing it appears then that coffee without either cream
     or sugar is less unwholesome than when these substances are added
     to it, but even when it is taken in this way it causes decided
     symptoms of indigestion in many persons. The writer is not of the
     opinion that the habitual taking of coffee is to be commended, and
     would, therefore, not advise its constant use; it, however, must be
     admitted--as is the case with all other substances that cause
     indigestion--that in many people, and particularly in those who
     live out-of-doors and are actively engaged in physical occupations,
     the use of coffee seems to result in no harm. Like other substances
     that cause indigestion in a concentrated form, coffee when largely
     diluted is less apt to produce disturbances of this kind; for
     example, a beverage consisting of two-thirds of hot skimmed milk
     and one-third coffee may be taken by many dyspeptics in reasonable
     amounts without any particular harm. Parents should be warned
     against allowing growing children to drink coffee; it seriously
     interferes with the normal chemical changes going on in their
     bodies, and is almost certain to be followed in later life by
     nervous dyspepsia.

_Tea._--The stimulating principle of tea is chemically so nearly like
that of coffee that they are generally considered as being one and the
same. That they differ decidedly in their action on the stomach and the
body generally there can, however, be no doubt. The stimulating action of
tea comes on more slowly than that of coffee, and is correspondingly
prolonged. In most persons it is not so apt to produce nervousness, nor
is its action in preventing sleep so pronounced. On the stomach it also
produces effects that are diametrically opposed to those induced by
coffee, since, instead of stimulating, it seems actually to retard the
secretion of acids. It is, therefore, probably true that we should look
upon tea as a beverage with much less disfavor than we do coffee--though,
of course, it should always be remembered that there may be, and
unquestionably are, many exceptions to this judgment.

     Probably no other daily article of food or drink is so commonly
     prepared in an improper manner as tea--which is all the more
     curious when we consider that perhaps none other that requires heat
     for its preparation is so easily made. It should be brewed by
     simply pouring boiling water upon the leaves, but the vessel
     containing the decoction should not be placed over the fire while
     the tea is being prepared. Of even greater importance is the
     necessity of allowing the water to remain in contact with the
     leaves only a few moments--_never more than a minute if we wish
     the tea to be good._ The reason for the latter precaution lies in
     the fact that tea-leaves contain a considerable amount of tannic
     acid, and, as the longer the water and leaves remain together the
     more of this substance is extracted from the latter, it is not
     difficult to see that we should be careful to allow only a brief
     contact between the two; the presence of this acid is undesirable,
     not only on account of the fact that it gives to the decoction a
     bitter and unpleasant taste, but because it has a tendency to cause
     digestive disturbances. It is seemingly not generally known that
     there are many varieties of tea, and that some of them are so
     superior in flavor and bouquet to others that they might well be
     entirely different substances. The best of all (in the writer's
     opinion) are those that are composed largely of leaves grown in
     Ceylon, usually mixed with India tea. If we will demand of our
     grocer a first-class Ceylon tea we will find that a beverage may be
     made from it that will appeal quite as much to the palate as a good
     coffee.

     Before dismissing this subject finally, some reference should be
     made to ice-tea. This beverage is exceedingly palatable when
     properly prepared, and under such circumstances by no means
     deserves the disfavor with which it is regarded by many. The latter
     circumstance is entirely due to two things; first, we find too
     frequently that it is the habit of house-keepers to pour boiling
     water on the leaves when the midday meal is cooked and to allow
     them to soak together until night, and second, the fact that
     lemon-juice is very commonly added to the tea before being drunk.
     The ice that the tea contains has little or nothing to do with the
     dyspeptic disturbances that frequently follow the drinking of cold
     tea. If we will leave out the lemon and pour off the water after it
     has been in contact with the tea leaves for something like a
     minute, it will be discovered that practically all of the ill
     effects usually ascribed to this palatable beverage have been done
     away with.

_Alcohol._--A discussion of beverages would not be complete without some
mention of those containing alcohol. This at once brings us face to face
with the bitter controversy on this subject that has been waged so long
throughout the United States, and which can only be considered here from
the standpoint of the effects of alcohol on the human economy, and to
draw corresponding conclusions.

That alcohol, even in very small quantities, reduces the general strength
and capacity for work there can be no question, and in addition we find
from experiments carefully conducted on the lower animals that the
liability to infection by various disease-producing germs is greatly
increased by the administration of even minute amounts of the drug. A
man then who is a habitual user of alcoholic drinks not only thereby
diminishes his capacity to labor effectually, but at the same time
renders himself more liable to disease. No more striking example of this
could be brought forward than the well established fact that persons who
use alcohol are exceedingly prone to consumption--so true is this,
indeed, that we might almost look upon the drug as being practically the
cause of this disease in most instances. Of course the bacillus of
tuberculosis must be present in order for the malady to develop, but we
find that the alcohol has prepared a soil for the growth of the germ
which would not otherwise exist. This holds with equal force as regards
other infectious diseases.

Again, it is true that maladies that result from bad digestion and
improper assimilation are frequently produced by the habitual use of
alcoholic liquors. Gout and Bright's disease are in the vast majority of
cases the indirect off-spring of habitual drinking. It should be
noted--and the distinction is of importance--that the affections of a
grave character most frequently produced by the alcoholic habit do not
ensue as a consequence of what could be rightly called intemperate taking
of the drug,--its moderate use more commonly resulting in serious disease
than when it is taken in great excess.

     The explanation of this probably lies, at least in part, in the
     fact that the majority of drunkards only take alcohol at greater or
     less intervals, and as a consequence the system has time to
     recuperate between sprees. The typical dipsomaniac goes weeks,
     months, and even years without drinking at all, but when he is
     seized by the desire for drink he throws everything else aside and
     spends days and weeks in a prolonged debauch; during this period he
     eats very little, and as a consequence largely avoids the grave
     dyspeptic disturbances that would otherwise inevitably result.
     Alcoholics of this class acquire catarrhal conditions of their
     stomachs, and if seized with some acute disease, like pneumonia,
     during or just after a spree, quickly die in a large proportion of
     cases, but they do not develop gout or Bright's disease as a rule,
     nor do they very commonly become consumptive, as is the case with
     those who take the drug in small quantities day by day.
     Furthermore, it would appear that the grave disorders that so
     frequently follow the long-continued use of alcohol cannot be said
     to be the direct result of the use of the drug, but ensue as a
     consequence of the stimulating action of the alcohol on the
     appetite, leading to over-eating. Under such circumstances
     indigestion follows from excessive over-feeding, and this is added
     to by the naturally irritating effect of the alcohol on the
     stomach. When this is continued through a series of years, the
     assimilating power of the organism gradually deteriorates, and we
     begin to meet with chronic dyspepsia, acute Bright's disease, and
     cirrhosis of the liver. Let no one then consider that he is not
     misusing alcohol for the reason that he only takes a drink before
     meals--it would be far better if he were to go on a moderate spree
     occasionally.

In this connection mention should be made of the great evil of patent
medicines containing, and in reality essentially consisting, of alcohol.
A vast number of them are widely sold under the misleading statement
that they relieve catarrh, cure diseases of the kidneys, and that
they act as tonics and general invigorants of the entire system.
Masquerading under one guise or another they are sold to the unsuspecting
public--prohibitionists for the most part--who fondly imagine that their
glass of "bitters," "liver-regulator," or "safe cure for the kidneys," is
entirely harmless. Let all such be warned that with scarcely an exception
patent medicines of this class are nothing more nor less than poor
whisky containing some bitter to disguise the taste, and that they are in
fact taking a drink when they use nostrums of this kind. The ultimate
effect of this kind of drinking is to produce serious and grave diseases.

This discussion of the effect of alcohol on the human body would not be
complete without calling attention to the extraordinary fact that those
peoples to whom we owe our modern civilization have from time immemorial,
most of all others, consumed the greatest amount of alcohol. Explain it
as we may, the fact remains that the greatest achievements of the world
were brought about by a society in which a very large proportion of its
members were in the habit of more or less constantly taking alcoholic
beverages. Naturally, the query is forced upon us whether this drug may
not have played some important part in the great results achieved.
Unfortunately, no one can answer one way or another, but our very
ignorance should emphasize the importance of looking at the question from
every side, and not jumping at conclusions before they are warranted by
facts. It is true that most of our positive knowledge on this subject
would condemn alcohol as being the greatest curse of the ages, but it
may be that it has played a beneficent part in the affairs of mankind
through devious paths impossible to trace. Unquestionably a drug, the
taking of which assists us in momentarily throwing our troubles aside,
must be of a certain positive value to mankind. If only it possessed
these good qualities with none of its bad ones!

Having considered very briefly the general effects of alcohol on the
system a few remarks may be appropriately made concerning the several
beverages commonly consumed in the United States for which it serves as a
basis.

_Whisky._--Under the term whisky will here be included all of those
stronger alcoholic beverages that are the product of distillation. In
addition to those commonly designated as such we may reckon brandy, gin,
and rum, and at the same time those subtle combinations called
mixed-drinks, for which they serve as a basis. It will, perhaps, startle
the average reader when the statement is made that whisky and its near
relatives just referred to, particularly when diluted by water, are by
far the least harmful of all alcoholic drinks. Their bad reputation lies
in the fact that on account of their large percentage of alcohol they are
usually preferred by drunkards, and that when consumed in excessive
amounts by those unaccustomed to their use there often follow those
frightful crimes with which these particular forms of alcohol are so
odiously associated. The facts are, however, that when taken in
moderation they are much less prone to produce indigestion than wines or
malt liquors, and where one is determined to drink, they should
unquestionably receive the preference. It should not be understood that
the writer is in any way advocating their use, but the facts of
experience compel him to state frankly that the least harmful of all
alcoholic beverages is whisky, or its near relatives.

_Wines._--There are a large number of fermented juices of fruits that are
known as wines. They are either sweet or acid in taste, and both are
peculiarly prone to induce dyspepsia in persons with delicate stomachs.
Irrespective of their delicate flavor, which, in many instances, appeals
strongly to the palate, the only virtue that they may be said to possess
is that they contain alcohol in small amounts; this, however, is off-set
entirely by their large percentage of sugars and acids, causing them to
be much more unwholesome than plain whisky.

_Beers and Malt Liquors._--It is very fortunate that in those states of
the American Union that have recently enacted prohibition laws, beer and
other malt liquors are now being widely sold under the plea that they are
non-intoxicating and that they are in no way unwholesome. While it is
true that the former claim is in a measure correct, it is a fact well
understood by those who have given the matter study that they are perhaps
the most unwholesome of all alcoholic beverages. Those in the habit of
using them are almost universally under the impression that they are
harmless, and as the taste for them is easily cultivated, those who once
acquire the habit are very apt to take them in greater or less quantities
daily. As a result of this, chronic digestive disturbances are always
sooner or later set up, and the victim in the course of time often
acquires a gouty tendency, which is all the more dangerous for the
reason that in America it scarcely ever manifests itself in acute joint
inflammations. The patient gets into what has been called a "lithemic"
state, which is but another name for gout, and sooner or later is
exceedingly apt to develop a chronic form of Bright's disease. It is
greatly to be deplored that some of our professional national
school-masters do not address themselves to this subject rather than to
appealing to the worst passions of the ignorant in attacking the great
institutions of our country, and in assailing the fundamental principles
of our government that come down to us as a priceless heritage from the
wise and patriotic statesmen who first brought our nation into life.

In addition to the three great classes of alcoholic beverages already
considered there are innumerable others, fortunately but little known to
the general public, and prized only by connoisseurs in such matters. As
we happily have no problem confronting us in any way similar to the
absinthe-habit, so common in France, it is not deemed necessary here to
do more than merely to refer to them.




CHAPTER XI

IMPORTANCE OF GOOD COOKING


Reference has already been made to certain misconceptions concerning
cooking diligently circulated in recent years by various quacks. The
victim is advised that he must take large quantities of raw eggs and
milk, and at the same time is instructed to eat a number of other
specially prepared articles furnished at a stiff price and certified as
being raw by the "medical company" furnishing the "treatment." Since it
is quickly discovered by those who are entrapped by charlatans of this
kind that the only raw foods that they can take with comfort and without
disgust are milk and eggs, they naturally practically live on these
alone, and as these foods are extremely digestible and nutritious,
improvement in the patient's condition not uncommonly results.

Nevertheless, it is unquestionably true that the vast majority of foods
are greatly improved in digestibility, and are rendered much more
palatable by thorough cooking. After being properly cooked there develop
in foods certain flavors and odors that are highly appetizing, and
unquestionably aid in the subsequent digestion of the same. With but few
exceptions, foods are so altered by heat that their proper mastication
becomes much easier, and cooking, therefore, materially aids in reducing
them to a state in which they are much more readily acted upon by the
digestive juices. It should never be forgotten, also, that cooking is of
the utmost importance from the standpoint of killing bacteria and animal
parasites that may be present in food. If we were to adopt universally
the habit of eating everything raw, the general mortality would certainly
be considerably increased.

_Cooking of Starchy Foods._--Nothing in the whole art and science of
preparing food for the human being is of so much importance as the proper
cooking of starches. As a result of the heat employed, certain chemical
changes are induced in the starch-granules, as a consequence of which
they are rendered digestible. It is of fundamental importance that at
all times and under all circumstances the cooking of this class of foods
should be as thorough as is possible, for when this is not done digestive
disturbances are sure to follow, and much of the food is actually wasted.
There are but few cardinal principles in the ordinary hygiene of life
that are so commonly neglected as this, since it is the habit of a large
proportion of the American people to consume three times a day masses of
tenacious starch which has not been acted upon by heat sufficiently to
render it digestible.

Of all the different methods of cooking starches, by far the most common,
and, therefore, the most important, is the process called baking. While
it is not possible in this volume to go into the subject with the
thoroughness that it deserves, the principal points deserve some mention.
They may be briefly stated as follows:

     (1) The flour must be made into a dough in which are incorporated
     substances that produce a gas called carbon dioxide, which, forming
     in innumerable small bubbles throughout the mass, cause the whole
     to swell; when this is completed the bread is said to have
     "risen." Of course the object of this is to produce a thorough
     breaking up of the sticky dough--with the result that when the
     bread is finally cooked it is light and fluffy, and can be readily
     masticated.

     (2) After the process just described has been completed the bread
     should be thoroughly cooked, for reasons which have already been
     explained.

     (3) After cooking has been accomplished the bread should be
     thoroughly dried, either by keeping it hot until this occurs, or,
     what is better, permitting it to remain warm for a time and then
     allowing the process to be completed in a natural way by putting
     the bread aside for several days. It is necessary for bread to be
     dried in order that it may be thoroughly soaked in saliva during
     the process of chewing.

If the principles above enunciated be properly followed out, good
wholesome bread will result. There are, of course, many details connected
with the preparation of food known to expert cooks into which it will not
be possible for us to go here, and for which the reader is referred to
any good cook-book.

Some starchy foods such as rice and potatoes, do not lend themselves
readily to the production of breads, and are consequently usually cooked
in some other manner. It cannot be too strongly insisted upon that they
should be rather _steamed_ than boiled,--the process being usually
carried out by placing a small amount of water with them and allowing it
to boil away; we should remember also that the principles just insisted
upon in connection with making bread apply here with equal force--we
should cook thoroughly and serve both as dry as is possible.

_Cooking of Meats._--Here again it is necessary to insist upon the
necessity of thorough cooking. The error has long prevailed that raw
meats are wholesome, but within recent years it has been clearly
demonstrated that this old view is erroneous. The muscle-fibers that
constitute the bulk of the nourishment of meats are separated from each
other by a substance which cannot be acted upon by the juices of the
stomach until it has been heated to a temperature which results in the
cooking of the entire mass. It is true that the muscular substance proper
may be digested without heat--resembling in this way the white of the
egg, to which it is chemically closely related; by scraping meat with
some dull instrument the muscle fibers may be separated in a more or
less pure state--leaving the substance that requires heat in order to
become digestible behind--and after having been removed in this way, of
course, may be eaten in a raw or semi-cooked condition without ill
effects. In preparing meat it is not absolutely essential that it be
cooked until thoroughly "done"--a slight tinge of red being allowable.

_Healthful Recipes._--In an Appendix to this volume will be found a
series of recipes for the preparation of common foods, for which the
author is indebted to Dr. Mary E. Lapham, of Highlands, N. C. They will
be found extremely practicable for making not only very palatable but
thoroughly wholesome dishes; and are earnestly recommended to young
housewives, who err through ignorance, as a rule, rather than because of
carelessness or of lack of good materials. It has often been said that
the road to a man's heart lies through his stomach. It would not be
surprising to learn that this aphorism fell first from the lips of some
wise woman who had observed that in a great number of cases unhappiness
in home-life had resulted primarily from lack of home-comfort, and
chiefly from unvaried, unappetizing meals and table-service. Another
point is well worth remembering, especially by young married women: a man
whose home is pleasant and comfortable is likely to spend as much of his
time there as he can--if it is otherwise, he will seek some place that
has these desirable qualities, such as his club, or an arm-chair in some
corner saloon. Furthermore, a man who is not only abundantly, but
_nicely_ fed, has far less desire for the stimulants which lead to
drunkenness, than the man who is denied at home the properly cooked and
seasonably varied food which his system craves. No better work in the
"Temperance cause" can be done than to make an attractive home.

These are facts which many a young housewife needs to learn and keep in
mind; and it is for her benefit that Dr. Lapham has prepared her simple
but excellent cooking directions presented in the Appendix.




CHAPTER XII

SEVEN AVOIDABLE DISEASES


MALARIA FEVER.

Malaria, in its various manifestations, has ever constituted the
principal obstacle to the civilization of all tropical and semi-tropical
countries, and as a consequence vast tracts of the richest and fairest
portions of the world have remained uncultivated and unredeemed from
their primitive savage state. Recent investigations have shown that this
disease can be easily prevented if the matter is taken up intelligently.

Malaria is a disease produced by a parasite belonging to the very lowest
order of animal life--the _Plasmodium malaria_, which is conveyed from
man to man by that genus of mosquitoes called the Anopheles. The parasite
attacks and destroys the red cells of the blood, and produces a poison
that causes the symptoms characteristic of malaria.

_Course of the Disease._--The most common and well-recognized symptoms of
malaria are those that occur in that variety of the disease which is
known as malarial or intermittent fever. In this type the patient--who
may or may not have at intervals for some days noticed chilly sensations,
a feeling of fullness in the head, and general bodily depression--is
suddenly seized with a chill followed by a high fever and subsequent
profuse perspiration; after these symptoms subdue, which generally
requires several hours, the patient returns to a practically normal
condition and feels, on the whole, well until the next attack occurs.
These chills-and-fever paroxysms occur at various intervals depending
upon the character of the parasite inducing them, the most common form
being that which produces a chill every day. In some instances the malady
comes on more insidiously, there being no marked chills but only
periodical elevations of temperature.

In the more chronic forms of the disease the unfortunate victim is
frequently subjected for years to attacks of fever coming on at irregular
intervals, the patient being more or less of an invalid throughout the
course of the disease. In other instances the brain becomes affected,
producing very alarming symptoms; and in quite a proportion of cases the
malady ultimately terminates in chronic Bright's disease.

_Treatment of the Disease._--Most fortunately, we have in quinine, when
properly administered, a medicine that in practically all instances acts
as a specific in this affection; but it should be used only on the advice
and under the directions of a physician. In the more chronic forms of the
disease, combinations of arsenic, with such tonics as nux vomica, iron,
and small doses of some of the preparations of mercury, produce permanent
cures where quinine has failed. It is of the utmost importance that
attention be given to the treatment, as, so long as the patient remains
with the parasites in his blood, so long is he a mena

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