A manual of practical hygiene

Front matter

YALE MEDICAL LIBRARY

HISTORICAL LIBRARY

THE GIFT OF MEDICAL LIBRARY ASSOCIATION EXCHANGE r

Preface

The great importance given to the study of Preventive Medicine, or more correctly speaking, " The Causes of Disease," has in the last few years revolutionized nearly all the branches of medicine, and Sanitary Science is now made a compulsory study in nearly all medical schools. With these points in view the authors of this manual have endeavored to prepare a text-book, the first complete work from an American standpoint. The microbic causes of disease and the methods of detecting and combating them are all given full consideration. The various subjects, Water, Air, Food, Habitations, etc., have been thoroughly gone into, each one receiving the consideration its importance merits, one main idea being carried through the whole, i. e., the causes of disease, their methods of ingress, and the available means for their prevention. Each subject is considered in its relation to disease production, and the method of prevention has been pointed out. It has been our desire to make the work a practical treatise, with a minimum of theory and a maximum of applicable fact. Where many methods of doing a thing are in vogue, the writers have assumed that the most satisfactory one, given in detail, would be more desirable than abridged descriptions of several.

Every attempt has been made to fully illustrate each section ; illustrations have been inserted wherever they would more clearly elucidate the text. A large number of these illustrations are from special drawings made by Dr. Bevan, and while of artistic value, are scientifically accurate. These are to a large extent diagrammatic, our experience having indicated the superiority of this class of illustrations. The source of those pictures that are not original is acknowledged in the list of illustrations, with the exception of those loaned by reputable manufacturers to whom we have already acknowledged our indebtedness.

v

VI PREFACE.

The many special subjects considered in this volume demanded much expert knowledge, and as it was the aim of the authors to make the book as accurate as possible, they have consulted with skilled specialists in various departments, and they wish to acknowledge here the kindness of National, State, and Municipal authorities who have granted valuable aid, and to thank Mr. Lockington for his help and advice in those sections where a knowledge of architecture was needed. We wish also to thank Mr. W. H. Smith, sanitary engineer, for valuable aid in supplying suitable illustrations for the article on Heating and Ventilation, and Drs. Leffmann and Beam, who have offered us the advantage of their wide experience in the study of Food Adulterations, Water Analysis, and collateral subjects. We are also indebted to Prof. J. W. Holland for valuable aid in certain chemical work.

In conclusion, we wish to thank the Publishers for many kindnesses and much labor in bringing the volume to its present condition of typographic and artistic perfection.

W. M. L. Coplin, Philadelphia, November ij, i8gj. D. Bevax.

Chapter I. Hygiene— Health— Cause And Prevention Of Disease

PAGE

Divisions of Hygiene in relation to Disease and Disease Prevention — Causes of Disease — Inheritance, Direct and Indirect — Inherited Susceptibility — Immunity, forms of — Temperament — Age — Sex — Race — Customs — Habit — Diathesis — Environment — Ingestive Diseases — Contagion — Infection— Bacteriology — Divisions and forms of Bacteria — Diseases due to Bacteria — Ptomaine Poisoning — Animal Parasites — Diseases due to Animal Parasites — Quarantine — Isolation — Segregation — Quarantinable Diseases— Prevention of Specific Diseases — Vaccination or Inoculation — Disinfectants — Deodorants — Methods of Securing Disinfection and Agents to be used — Physiological, Thermal, and Chemical Disinfectants — Disinfection of Patients, of Hands, of Clothing, of Habitations, of Mails, of Excreta, of the Sick, of the Dead, 25-81

Chapter II. Individual Or Personal Hygiene

Hygiene of the Infant, including Feeding, Clothing, Weaning, Bathing, Sleep, Dentition — Hygiene of the Child, including Exercise, Clothing, Diet, School, Baths, etc. — Hygiene of Young Adults and Adults — Special Hygiene — Eyes — Ear — Teeth — Hair — Feet — Sex 82-96

CPIAPTER III.

CLOTHING.

Materials of which Clothing is Constructed — Chemical and Microscopic Examination of Materials — Cotton — Linen — Wool — Silk — Jute — Skins of Animals — Rubber — Clothing for Protection Against Cold, for Protection Against Heat, for Protection against Winds — For Preventing Odor Absorption — Objectionably Constructed Clothing, 97-104

Chapter IV. Food

Uses of Food — Kinds of Food — Animal Foods — Milk — Diseases Attributa ble to Milk — Milk Examination, for Solids, for Cream — Milk Preserva-

vii

VI 11 TABLE OF CONTENTS.

PAGE

tives, Coloring Matters — Butter and Buttermilk — Butter Substitutes — Examination of Butter — Cheese, Quality, Composition and Adulteration — Meat, Forms and Composition of — Meat Inspection — Inspection of the Living Animal — Diseases Communicable by Meat — Animal and Vegetable Parasites found in Meat — Inspection of Dead Meat — Pickled Meats — Salted Meats — Sausage — Inspection of Poultry — Diseases Communicable to Man from Fowls, Fish, Oysters, Mussels, — Potatoes, Carrots, Cabbage, Beets, Turnips, Peas and Beans — Fruits — Evaporated, Tinned, Condensed and Preserved Foods, Sterilized Foods, Refrigerated Foods — Tea — Coffee — Alcoholic Beverages — Malt, Liquors — Diet as modified by Age, Sex, Climate, Occupation, Appetite, Administration, Cooking, Digestibility, Idiosyncrasy — Quantity of Food demanded — Calculation of Food Tables, 105-1S4

Chapter V. Water

Sources of Water — Storage of Water — Distribution of Water — Dangers arising from Deficient Water Supply — Impure Water and Diseases due to Impure Water — Purification of Water by Sedimentation, and by Filtration— Various forms of Filters — Water Examination including Collection, Odor, Color, Transparency, Solids, Organic Matter, Chlorin, Poisonous Metals, Biologic Examination, Microscopic Examination, Determination of Source, 1 85-2 12

Chapter VI. Air

Impurities in Air and their Source — Organic Matter in Air — Products of Combustion in Air — Contamination of Air by Trades — Sewer Air — Air of Marshes — Emanations from Made Ground — Carbon Compounds in Air — Diseases Attributable to Atmospheric Impurities — Air Examination— Solids, Vapors and Gases in Air, Detection of — Biologic Examination of Air, 213-236

Chapter VII. Climate

Elements of which Climate is Composed— Relation of Climate to Public Health — Climatologic Observations — Apparatus and Methods of Recording— Climate of Michigan, Mississippi, Minnesota, Kentucky, Washington, Georgia, Texas, California, North Carolina, Nebraska, Illinois, Nevada, Wisconsin, Iowa, South Carolina, North Dakota, Oklahoma, Arkansas, Louisiana, Tennessee, Utah, New Jersey, Maryland, New Mexico, New Vork, Pennsylvania, New England States, . 237-278

Chapter VIII. Soil

Telluric Impurities and their Relation to Public Health — Purification of

Soils — Diseasesdue to Impurities in Soils — Soil Examination — Soil air, . 279-291

TABLE OF CONTENTS. IX

Chapter IX. Habitations

PAGE

Selection of Site and Material for Construction — Methods of Constructing Foundations — Walls — Damp-proof Courses — Roof and Roofing, including Materials and Construction — Arrangement and Construction of Base ments or Cellars — Sanitary Arrangement of Kitchen with its Plumbing, Heating and Cooking Appurtenances — The Construction of Stairs — Ventilation, including the Factors which Demand Ventilation — Methods for Securing Ventilation — The Importance of Humidity in Ventilating Air — Selection of Air for Ventilating Purposes — The Degree of Impurity in Ventilation — The Quantity of Air to be Supplied — The Ideal Methods of Ventilation — Heating by Radiation, Conduction, or Convection— Direct Radiation — Indirect Radiation — Direct-indirect Radiation— Open Fire-places — Rifle back Fire-places — Floor-fed Fire-places — Under-fed Fire-places — Fire-places with Draft Radiators — Water-back Fire-places — Objections to Fire-places — Fire-places for Natural Gas — Stoves — Objections to Stoves — Methods for Reducing the Objectionable Features of Stove Heating to a Minimum — Best Form of Stoves — -Fuel for Stoves - Furnaces — Arrangement of Furnaces — Air Conduits — Registers — Size of Registers and Calculation of Heat Supply by Furnaces — Steam and Hot Water Heating — Theories Involved and Methods by which Steam and Hot Water are Applied for Heating Purposes— Heating by Steam or Hot Water Radiators — Direct Methods — Indirect Methods — Direct-indirect Methods — Ventilation and Heating Combined — The Exhaust and Plenum Systems of Heating and Ventilating— Thermostat for Regulating Heating Appliances — Estimation of Heat Supply — Quantity Demanded — Method for Estimating Quantity Supplied — Estimation of Humidity in Heating and Ventilating — Lighting, Natural and Artificial — Water-closets — Bad Forms of — Sanitary Forms of — Flush Tanks and Water-closet Plumbing — Traps, Sinks, Baths, and Lavatories, Connection and Plumbing of — Distribution of House Plumbing — Manholes — Drains — House Sewage — Joints, Properly and Improperly Constructed — Regulations which govern Modern Sanitary Plumbing — Fire-plugs — Road Gutters — Street Flushing — Sanitary Inspection of Dwellings — Space to be Allowed for Each House — Inspection of House Water Supply — House Drains — Spouting and Sewage of House — Nuisances— Inspection of Cellars, of Roofing, Rooms, Closets, Heating Appurtenances — Example of a Badly Constructed House — Space to be Allowed for Each Individual in Habitations, 292-387

Chapter X. Sewage

Sewage — Materials of which Sewage is Composed — Garbage — Incineration of Garbage — Final Disposition of Sewage, by Sedimentation, by Precipitation, by Filtration, and by Disruption — Electrolysis of Sewage, . . 388-394

X TABLE OF CONTENTS.

Chapter XI. Disposal Of The Dead

PAGE

Disposal of the Dead — Importance of Incineration — Burial Grounds — Location of Burial Sites— Arrangement of Graveyards — Proper Construction of Graves — Coffins — Dangers of Embalming — Rules and Regulations which should Cover Burial Grounds — Burial During Epidemics and on the Battle-field — Methods for Hastening Disruption of the Body, 395-397

Chapter XII. Technic

Microscope and Accessories — Jars for Preserving and Handling Specimens — Bacteriologic Technic — Culture Media — Plating — Fractional Plating — Counting Colonies — Cultivation of Anaerobes — Staining, Histologic and Bacteriologic — Inoculation Experiments — Examination of Sputum — Blood Examination — Examination of Feces — Microscopic Examination of Meats — Examination of Infectious Materials in Skin Diseases — Staining of the Thrush Fungus — Examination for Itch Parasites — Leprosy — Tetanus — Pneumonia — Rhinoscleroma — Erysipelas — Gonorrhea— Syphilis, 398-434

Appendix

Metric System — Barometer Scales — Thermometers — Thermal Disinfection,

Table of — Specifications in Blank, 435-441

LIST OF ILLUSTRATIONS.

FIG. PAGE

1. Saccharomycetes Cerevisiae {Original), 36

2. Monococci, Diplococci, Tetracocci, and Sarcina {Original), 37

3. Streptococcus Pyogenes (Color) (Original), 37

4. Ascococcus (Color) (Original), 38

5. Propagation by Fission (Original), 39

6. Spore Formation (Original), 39

7. Actinomyces (Color) (Original), : 41

8. Bacillus Anthracis (Color) (Original), 41

9. Spirillum Cholera Asiatica (Color) (Original) 42

10. Bacillus of Diphtheria (Color) (Original), 42

11. Streptococcus Erysipelatis (Color) (Original), 42

12. Favus (after Flugge), 43

12 A. Favus from Agar- agar Culture (Original), 43

13. Bacillus Mallei (Glanders) (Color) (Original), 43

14. Diplococcus of Gonorrhea (Color) (Original), 43

15. Bacillus of Leprosy (Color) (Original), 44

16. Diplococcus Pneumonia (Color) (Original), 44

17. Spirillum of Relapsing Fever (Color) (Original) 45

18. Saccharomycetes (Oidium) Albicans, or Thrush Fungus (Color) (Original), 46

19. Micrococcus Pyogenes Aureus (Color) (Original ), 46

20. Bacillus Tetani (Color) (Original) 46

21. Microsporon Furfur (Original), 47

22. Bacillus Tuberculosis (Color) (Original), 47

23. Bacillus Typhosus (Color) (Original), 47

24. Distoma Hepaticum (after Ltuckart), 49

25. Ascaris Lumbricoides and Eggs (Original), 50

26. Oxyuris Vermicularis (Original), 50

27. Simple Contrivance for Generating Sulphurous Acid Gas (Original), . . 7 1

28. Sectional View of a Dry-air Sterilizer (after Koch), 72

29. Arnold's Steam Stenlizer, First Form, 73

30. Arnold's Steam Sterilizer, Second Form, 73

31. Arnold's Steam Sterilizer, Third Form (form usedby Boston Health Board), 74

32. Contact Thermometer, Mercurial (Original), 75

33. Proper- Manner of Trimming Finger- Nails (Original), 95

34. Cotton Fibers (Original), 98

35. Linen Fibers (Original), 98

36. Woolen Fibers (Original), . . . 98

37. Silk Fibers (Original), 98

XI

Xll LIST OF ILLUSTRATIONS.

FIG. PAGE

38. Lactometers (Original) 112

39. Creamometer (Original), 113

40. Feser's Lactoscope (Original), 1 14

41. Beimling Patent Milk Test Machine, 114

42. Accessories for Beimling Patent Milk Test, 116

43. Actinomyces (Original), 135

44. Symptomatic Anthrax (Color) (Original ), _ . 138

45. Brain of Lamb, with Tracts of Ccenurus (after Leuckart), . 149

46. Measly Pork (Original), 149

47. Cysticercus Cellulose (after Leuckart), 150

4S. Tenia Solium (after Leuckart), 150

49. Tenia Mediocanellata (Original), 15 1

50. Trichina Spiralis (Original), 151

51. Tenia Echinococcus (after Leuckart), 152

52. Plan of Deep Well {Original), 188

53. Model of Reservoir, Slate Lined (Original), 189

54. Diagram of Filter for Public Water Supply (Original), 195

55. Large Domestic Filter (Original), . 196

56 A. Pasteur-Chamberland Filter, attached to Spigot, .... 197

56 B. Sectional View of 56 A (Original), 197

57. Pasteur Filter for Ice Water, 197

58. Pasteur-Chamberland Filter, Tourist Pattern, 198

59. Simple Filter for the Alum Process ( Original), 199

60. Sand Filter, constructed of Two Tomato Cans (Original ), 199

61. Candlewick Filter, for Laboratory Use ( Original), 21 1

62. Apparatus for Estimating the Amount of Oxygen in the Air by Eudiometry

(after Kenwood}, . 225

63. One form of Prof. Wolpert's Air Tester, 228

64. Hesse's Aeroscope (Original), 235

65. Simple form of Aeroscope (0 riginal), 236

66. Maximum and Minimum Thermometers and Method of Setting Them Up

( U. S. Weather Bureau) 243

67. Hydrometer or Thermoscope ( U. S. Weather Bureau), . 244

68. Barometer, as Supplied by Weather Bureau (U. S. Heather Bureau), . . 247

69. Barometer, showing Arrangement for Regulating the Height of Mercury in

the Cistern (U. S. Weather Bureau), 247

70. Vernier Scale (U. S. Weather Bureau), 248

71. Vernier Scale (U. S. Weather Bureau), 248

72. Vernier Scale (U. S. Weather Bureau), -248

73. Aneroid Barometer ( U. S. Weather Bureau), 251

74. Cased Aneroid Barometer with Index Hand, as usually sold, 251

75. Rain Gauge Set Up (U. S. Weather Bureau), 252

76. Vertical Section of Rain Gauge Set Up (U. S. Weather Bureau), .... 252

77. Receiver and Funnel Conducting Tube of Rain Gauge (U. S. Weather

Bureau), 252

78. Horizontal Section of Ram Gauije (U. S. Weather Bureau), 252

79. Scale of Rain Gauge ( U. S. Weather Bureau), 252

80. Wind Vane and Ceiling Dial (U. S. Weather Bureau), 254

LIST OF ILLUSTRATIONS. Xlll

FIG. PAGE

81. Robinson Anemometer {U. S. Weather Bureau), 255

82. Brooks' Drain and Subsoil Pipe {after Park), 283

83. Drain and Subsoil Pipe Laid Upon Crushed Stones {Original), 283

84. Hesse's Apparatus for Collecting Ground Air {Original), 290

85. English or Block Bond {Original, Drawn by W. P. Lockington), .... 300

86. Flemish Bond {Original, Drawn by W. P. Lockinglon), 300

87. Damp-proof Course with Ventilated Air Chamber {Original, Drawn by W.

P. Lockington), 30 1

88. Damp-proof Course {Original, Drawn by W. P. Lockington), 302

89. Iron Bonding Tie {Original, Drazvn by W. P. Lockington), 303

90. Section of Cornice and Rain Gutter or Channel ( Original, Drawn by W.

P. Lockington), 306

91. Cross Section of Rain Gutter {Original, Drawn by W. P. Lockington), . 306

92. Rain Gutter, Between Two Roofs, with Perforated Iron Guard {Original,

93. Rain Conductor Covered with Guard or Cap {Orginal, Drawn by W. P.

Lockington), 306

94. Front View of Kitchen Dresser {Original, Drawn by W. P. Lockington), 307

95. Side View of Kitchen Dresser {Original, Drawn by W. P. Lockington), . 308

96. Fresh Air Register {Original, Drawn by W. P. Lockington) , 319

97. Cross Section of German Stove {Original, Drawn by W. P. Lockington^, . 320

98. Plan of Cellar, showing Location of Heater, etc. {Original, Drawn by W.

P. L.ockington), 321

99. Wall Register, showing Relation of Parts {Original, Drawn by W. P.

Lockington), 323

100. Hot- water System, 324

101. Direct- indirect Heating, 326

102. Indirect Heating by Means of a Floor Register, 327

103. Indirect Heating by Means of a Wall Register, 328

104. Indirect Heating by Wall Register and Fresh-air Wall Conduit through

Oblique Radiator, 329

105. Indirect Radiation, Radiator for Cellar Use, 330

106. Indirect Radiation, Base of Heater Shown in Fig. 105, 331

107. Indirect Radiator, with Fan Attached, for Plenum System of Heating, . . 332

108. Thermostat for Regulating by Electricity the Heat Supply, 333

109. Dynamic Anemometer, 336

no. Hygrophant, 337

in. Enclosed Water-closet, 343

112. Back of " Sypho " Closet, , 344

113. Sectional View of " Sypho " Closet, 345

1 14. Showing Interior of an Ordinary Flush Tank, 349

115. Interior View of Flush Tank, with Discharge Controlled by Time Valve, . 350

116. Interior View of Double Chamber Flush Tank, 351

117. "Perfection" Flushing Pipe, 352

118. Sewer-gas and Back-water Trap, 354

119. Same Trap as Above, with Vent Connection Attached, 354

121. Kitchen Sink, 357

XIV LIST OF ILLUSTRATIONS.

FIG. PAGE

122. Glass-pipe Plumbing, showing Plan for Rigid Lines {Original, Drawn by

W. P. Lockington), 359

123. Plan of Sewage System in House [Original), 373

124. Unsanitary House, Ground Plan [Original, Drawn by W. P. Lockington), 385

125. Beck's Pathological Microscope Stand, 399

126. Abbe Condenser, with Iris Diaphragm, 400

127. Jelly Jar Used for Pathological and Anatomical Specimens and Shipping

128. Specimen and Stain Jars, with Accurately Fitting Ground Glass Tops, . . 405

129. Blake Bottle Used for Plating, 408

130. Koch's Plating Apparatus, as Arranged for " Setting " Agar or Gelatin Plates

[Redrawn from the Original), 409

131. Koch's Plating Apparatus, Moist Chamber [Redrawn from the Original), 409

132. Petri Dish [Original), 409

133. Sternberg's Anaerobic Culture Tube [Drawn from Tube in Use), .... 410

134. Ameba Coli [after Leuckart), 424

b. Cercomonas Intestinalis [after Leuckart),

c. Cercomonas Intestinalis [after Leuckart), 424

136. Cercomonas [after Leuckart), 424

137. The American Compressor, 426

138. Warren's Trocar and Cannula, 427

NTRODUCTION

When the undersigned was asked to prepare an introduction for this book, which at that time was only in outline, he was glad to consent, knowing that the practical experience and original work of the authors fitted them to prepare a manual pregnant with practical statements made in such a form as to be applicable in every-day life by the physician or sanitarian. The fact that numerous works on hygiene are already in existence proves that the importance of the subject is universally recognized, yet it is unfortunately true that in many instances these books are mere compilations of statistics or expositions of personal and, it may be, biased views. The want of a book on hygiene, written by a pen which at once recognized the needs of the physician, the student, and the public official, has never been more felt than now, and the authors of this book have not only recognized this fact, but occupy official positions which give them a personal insight into all the needs of those performing sanitary work. As an indication of the scope of this book, particular stress may be laid upon the chapters on the Causes of Diseases, chapters which are necessarily summaries of the advances made in bacteriology and kindred sciences within the last few years. Naturally, the methods of prevention of infection and the destruction of the products of disease processes are equally carefully considered, and in close relationship to this subject is the description of sophisticated and other forms of injurious food stuffs. The diseases of animals which are transmissible to man are also studied and original summaries of the latest discovered facts in this connection are presented, after thorough sifting of the uncertain statements from those which are reliable.

A grave deficiency in our medical learning has been the absence of reliable information about the various climates of the United States. Too often the climatologic reports are biased

xv

XVI INTRODUCTION.

by the personal interest of the author in his own region, and the American physician is often at a loss where to send his patients on this side of the Atlantic. The recognition of the importance of this subject has resulted in a careful analysis of all scientific material concerning this matter, and has presented the profession with the information it needs, so far as it is possible to obtain it.

One of the slurs cast upon hygiene as a study of the day has been that very often the recommendations of the authors are only founded on theory, and not practically useful. It is difficult for the mind trained to scientific research to meet the objections of practical builders and architects, and the authors have therefore put their information in such a form as to be practically valuable by submitting all architectural points to an expert builder and architect. Closely allied to this branch of the subject is that of habitations in relation to site and building materials, and the chapter on heating is necessarily a careful product of scientific deduction and practical experience.

To the physician who delights in the addition of truly original matter to our store of information this book is a pleasant one to read, for other reasons than those already named, for it is illustrated by original illustrations in many instances, illustrations made by the pencil of Dr. Bevan from the results obtained by the perfect technique of the authors.

Heretofore the busy practitioner has often neglected hygiene,

in its relation to private life, because the reliable books were,

most of them, based on military needs. The architect has found

that too often the stated scientific facts clashed with the utility

of his building, and, as a result, in many instances serious

hygienic sins were Committed. It is to meet such cases that

this book was planned and written, and that its objects have

been accomplished will be evident to any one who is wise

enough to study this important branch of knowledge in its

pages.

H. A. Hare.

A MANUAL

OF

PRACTICAL HYGIENE.