Maxims of public health

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II

In sanitation it must not be forgotten that there is an immeasurable distance between organic and organized matter. In passing from the former to the latter, chemistry affords us no aid. Give the chemist a handful of sound wheat and also an equal handful of ground wheat. His science can not tell the difference between the two. The dead elements of the one are exactly equal, in quantity and quality, to the dead elements of the other. Yet, from another point of view, how different are the two ! The handful of unground wheat, the organized wheat, has within it the power to multiply itself, under favorable circumstances, till it covers the world with harvests. The ground wheat may nourish an animal or a plant, or it may mingle with the inert elements of the earth, but under no conditions can it multiply itself. You may give the chemist some healthy unbroken eggs and also some crushed eggs. As chemist, he can not discover the difference between the two. Both furnish to him the same elements. Yet there is a chasm between them as wide as the bourne between life and death. The whole eggs, under favoring conditions, will hatch, produce animals of their kind, which may at length people whole continents. The broken eggs have ended their existence, except as lifeless matter, which may enter into an endless series of other forms, but they can never "increase and multiply." This is what makes the germ-theory of infectious diseases so important. The germs, being organized matter, may increase, like the whole wheat or the unbroken eggs, in geometric ratio. No other theory can wholly account for the devastating epidemics that rapidly sweep over large regions of the inhabited parts of the globe. Under favoring conditions of season, temperature, moisture, perhaps electricity, or more subtile elements, the germs of yellow fever, cholera, scarlet fever, the plague, and other zymotic diseases, that otherwise would remain dormant or have only a feeble growth, may multiply myriads and myriads of times, decimating the population of whole nations. Then mankind reap the benefits arising from the absence of filth which nourishes above all things else the growth of these invisible foes of life. Then we need the resisting vigor of health that comes from cleanly habits of living.

III

The average cost of educating a child at school — food, clothing, home care, tuition — all things included, is not less than one hundred and fifty dollars a year. The unsanitary conditions of school-buildings neutralize the work of education to the extent of at least one third. The foul air of unventilated and crowded school-rooms, the unequal heating, the poisonous sewer-gas in the outhouses or in the building, cause depression, loss of energy, nervous irritability, dullness of brain, waste of time from ill-health, which increase the friction and slacken the speed of educational progress more than one third. But call the loss one third, which is certainly a minimum. 'Mow, one third of the yearly cost of one hundred and fifty dollars is fifty dollars. The number of children at school in a city of one hundred thousand inhabitants is about twenty thousand. The loss on the whole number, therefore, amounts to the enormous sum of one million dollars per annum. The loss falls on the parents of the children, distributed throughout the city. And this is not all. The habit of dullness, begotten by the unsanitary conditions of school-buildings, lasts during life, and more or less cripples the productive energy of each generation of citizens. Moreover, this vital question touches the pride and hope of almost every household. We must reckon also the cost of increased sickness, and a larger percentage of death. It seems heartless to dwell upon the economic side of such a great and important subject. Above all, and beyond all, are human suffering, constitutions broken for life, seeds of disease earlysown, pain too deep for tears in the panting breast of many a little one, the heartache of parents, the shroud, the emblems of mourning, the solemn "dust to dust" and "ashes to ashes," closing blighted careers which sanitary wisdom might have prolonged over the customary years of usefulness.

The preservation of the public health, before the nineteenth century, was an unknown or forgotten art among Christian nations. The hygienic formula of the -old Greek, Hippocrates, "Pure air, pure water, and a pure soil," was scarcely less comprehensive than the sanitary commands of Moses. The best modern science confirms the wisdom of the heathen physician, and not even the Hon. Eobert Ingersoll has discovered any sanitary mistakes made by the Hebrew lawgiver. The Saracens practiced temperance and cleanliness during the Middle Ages, and consequently suffered less from epidemics than the dirty and drunken Christians of Europe.

The new era, in which the State assumes the guardianship of the public health, is bright with promises of physical good to Christian peoples. It was a great preacher of the gospel of Christ who declared " Cleanliness to be akin to Godliness. " Hygienic redemption of bodies is next in personal importance to spiritual redemption of souls. Fortunately, it is no longer fashionable in the church to mortify the flesh with visible or invisible vermin. The "black death" was not a good means of grace even in the days of Procopius, Boccaccio, or De Foe.

The Greek brigand and revolutionist, Theodore Kolokotrones, speaking from bitter experience, complained in his " Memoirs " " of the suffering caused by the filth of long- worn garments as rivaling the pangs of hunger." Through several miles of sewers in the skin are daily eliminated from the body about thirty ounces, nearly two pints, of liquid waste, two and one half per cent of which may be reckoned as solid matter. The excrement from the skin, when undergoing putrefactive decomposition, is quite as poisonous as the excrement from the kidneys or from the intestines. The two pints daily of excreta from the integument of the body rapidly saturate the clothing. Dirty linen in an unventilated closet will soon become as offensive and dangerous as an unclean urinal or water-closet. The excrement saturating clothes worn too long without washing putrefies and makes the person offensive. This is the reason why a room filled with people will in a brief time smell like a charnelhouse, if not thoroughly ventilated. The body in a few days will become smeared all over with the decomposing waste. People will live, and eat, and sleep, go to church, move about the streets, frequent assemblies, attend parties, get into public conveyances, and occupy their places of business, with unwashed skins, clothed in unwashed garments, not even suspecting that, from a sanitary point of view, they are as unclean as the idiot who does not know enough to obey the calls of nature. A sponge-bath every morning is a necessity of decent living. We ought to be grateful to the Mohammedans for teaching dirty Christian Europe to wash herself. Water from the wash-tub and the bath-tub belongs with sewage, and requires the same care in its disposal as in the disposal of the contents of water-closets. The Greek brigand was right : a dirty shirt is as bad as hunger. Mr. Emerson says truly that the best of us had rather eat with a washed sinner than with a dirty saint.

A public sanitary conscience can be created only by the enactment and enforcement of wise sanitary laws. "I have given it as my deliberate opinion," says Alexander Bain, " that authority or punishment is the commencement of that state of mind recognized under the various names of conscience, the moral sense, the sentiment of obligation. The major part of every community adopt certain rules of conduct necessary for the common preservation of, or ministering to, the common well-being. They find it not merely their interest, but the very condition of their existence, to observe a certain number of maxims of self-restraint and of respect to one another's feelings on such points as person, property, and good name.

Obedience must be spontaneous on the part of the larger number, or on those whose influence preponderates in society ; as regards the rest, compulsion must be brought to bear." "Compulsion must be brought to bear " to secure respect for health and life, as well as for property and good name.

Sarcastic old Rabelais makes his hero find a book in the library of a convent, entitled "The Meditations of a Holy Nun in the Perils of Childbirth." A book, entitled " The Meditations of a Quack Midwife in the Act of Killing new-born Babies," might be profitably written, if any one could suppose that an ignorant, presumptuous creature, venturing to approach the lying-in woman, at the sacred hour of maternity, with unskilled and often unclean hands, is mentally or morally capable of meditating at all. Educated midwives are a boon to the poor. Women who offer their services without knowledge — knowledge ascertained and certified to by a properly appoiuted public authority — should be treated as criminals. The number of " still-births " in all our mortuary records is fearful. Quack midwifery is among the obvious causes, but not the sole cause. Liberty to slaughter innocents seems to be quite as dear to the feminine as to the masculine heart. These Lucretia Borgias of the bed-side will in due time have a proper place in the history of peoples.

VIII

Whoever tries to live entirely by rule may end by not living at all. It would be a fatal mistake, however, to take encouragement from this to live an irregular life.

The house in which a man dwells is his outer garment. If the walls are damp, he is in the condition of one sitting in wet clothes. Colds, rheumatism, pneumonia, consumption, and other distempers may come from such a source. Walls built of brick from the foundation are always damp. Water is carried up from the earth by capillary attraction. A brick will absorb a pound of water. So you may have as many pounds of water in the walls as there are bricks in the house. The remedy is simple. There should be a course of slate, vitrified brick, or asphalt, a little way up from the earth, all around. Stone foundations are safer than brick, yet not altogether secure. Another thing of very great importance is connected herewith. Dry walls are pervious to air. By means of a properly shaped tube a candle may be blown out through a dry brick. As soon as cold weather comes, when the habit is to close windows and doors, and the fires are lighted, there will be an interchange of air between the outside and the inside of a house through dry walls. Thus the house will be ventilated without draughts. In fact, this is the most important factor in natural ventilation.

On the other hand, wet walls are impervious to air. No ventilation can take place in the manner described. The air, therefore, in a damp house is always close and foul. In it flourish all sorts of microscopic things belonging both to the animal and vegetable kingdoms. Even larger and visible fungi flourish in a damp house. Things become "moldy," as we say. As all organizations that live and grow must decay and die, it follows that the air of a damp house will be more or less poisoned with dead bacteria and rotting bacilli. Human life is worth a great deal more in a dry house than in a wet one. So build your habitation in a way to keep it dry.

x.

Oxygen is nature's favorite disinfectant. Combustion is rapid oxidation. The atmosphere is the great source of oxygen acting as a purifier. Foul liquids are rendered harmless by filtration through aerated earth. But it is not so much the earth that purifies as the air that permeates it. Underdrained land is very porous, and contains a large supply of air. In the air with which the pores of the earth are filled there is a superabundance of oxygen. The porous earth acts as a. sieve, which breaks up the liquid filth into fine particles, bringing it into contact with the oxygen of the contained air. All organic matters are rendered harmless by oxidation. Oxygen is, indeed, the most abundant product of nature. It constitutes about one half, by weight, of the earth's crust. Sand is more than half oxygen. It constitutes 48 per cent of limestone. Clay contains 50 per cent of it. It is 89 per cent of water, in oceans, rivers, lakes, The atmosphere contains 23 per cent of oxygen.

If, then, water contains so much larger a percentage of oxygen than air, and organic filth is purified by oxygen, why does not water purify it more rapidly than air ? For this simple reason, that oxygen is chemically combined with hydrogen to form water, while it is mechanically combined with nitrogen to form air. In the latter, oxygen is a free agent. In the former, it is combined with something else. Ordinary combustion consists in union with oxygen. "Water is burnt hydrogen. Air is simply oxygen diluted with nitrogen. Hence, the free oxygen of the atmosphere unites with, or burns, putrescible matters and renders them harmless. Still water makes a " dead bree " of the same matters, instead of giving up its oxygen to burn them. Water, when violently agitated, as in turbulent streams, or lakes swept by winds, contains some admixture of air, the free oxygen of which purifies a limited amount of filth thrown into it.

And, in the air itself, ozone, which, according to Dr. De Chaumont, is an intensified oxygen with a greater number of atoms, is probably the most powerful and rapidly destructive agent of putrefying organic matters. "Ozone," he says, "oxidizes (burns, in fact) organic matter with great rapidity, much more rapidly, in fact, than ordinary oxygen. In this way it may be considered the great scavenger of the air."

XI.

All matter may exist in a solid, liquid, or gaseous state. A whole book might be written on this subject. As a rule, poisons are least dangerous in the solid form, and most dangerous in the gaseous form. Gases are invisible. Hence, we are often in the midst of unseen dangers. How few know anything about the gases of organic decay that frequently peryade the living-rooms of habitations ! Those who do know about them give them no heed for the most part. Out of sight, out of mind. Some even refuse to believe what they can not see. Let such wrestle with the whirlwind, which is only an invisible gas in violent motion. Touch, and smell, and hearing help out the imagination and assist belief. Yet deadly things exist which none of the unaided senses can recognize. The spectroscope, the microscope, and chemistry reveal for us new realms. And the reasoning intellect builds for us ladders of science on which we laboriously climb to truth, as we are carried on the wings of faith to the supersensual.

The often-quoted aphorism of Franklin, " Public health is a nation's wealth," is a one-sided truth. Thrift, industry, integrity, sobriety, education, prudence, judgment, patriotism, are important factors, as well as health, in national prosperity. A healthy spendthrift can squander an inheritance quicker than a sickly one. A lazy invalid is not so expensive as an able-bodied beef -eater. A vigorous knave can appropriate more of the earnings of honest people than one who is bed-ridden. A drunkard of physical capacity can waste more than a milksop. A muscular fool can upset more things than a feeble one. A hearty rattlebrains can always beat a puny one in begetting disasters. A robust crank is always more dangerous than one who is weakly. An athletic revolutionist can annihilate more national wealth than one who frequently seeks a hospital. Let us have things in proportion, in sanitation as elsewhere.

In a city of considerable size, I had six acres of beautiful, planted ground. Close by the house was a well of sweet, cool, clear water. A trench, dug in the street, just twenty-three rods away, for the purpose of constructing a sewer, cut off the source, and the well dried up. Suppose somebody had sunk a privy-vault or cesspool near or over the vein of water in the earth supplying the well. In due time, persons drinking the water would have slowly sickened with a typhoid type of fever, and some of them would probably have died. If some one infected with cholera or enteric fever had used the vault or cesspool, the disease would have been conveyed through my well to those drinking its water. If the sewer had not cut off the vein, leakage from it might have caused the same disasters. A skilled sanitary inspector would have been troubled to discover the source of the poison. A well in London, the water of which was clear, sparkling, and pleasant to the taste, was found to be scattering zymotic diseases among the people in the neighborhood using it. A government chemist demonstrated that the water was impregnated with the products of decay in surrounding cesspools and grave-yards. Yet the people protested against the official closure of the infected well. So difficult is it to convert sanitary sinners ! No one should drink water from a well or spring within an inhabited area till the good time comes when the earth about human habitations shall no longer be polluted with vaults, dunghills, heaps of garbage, etc. — when all organic wastes shall be removed without allowing them to touch and defile the soil on which man lives, or infect the air of heaven which he breathes. In the mean while — and it may be a long while — if you and the dear ones of your household must use water thus exposed, boil it before drinking it. Nearly all disease-germs are killed by cooking. Never be deceived by the look and taste of water ; judge it also by the surroundings.

XIV.

In the cities of China all filth is thrown into the streets. It looks bad enough. It smells bad enough. Yet Chinese cities are remarkably free from typhoid fever and other filth-diseases. Why ? Simply because in China all filth is quickly removed from the streets for manure. The filth is not left long enough to undergo putrefaction. The gas resulting from putrefaction contains the disease-generating poison. Most people suppose that fresh excrement is already in a state of decomposition. This is not so. Like a dead cat, it undergoes putrefaction more or less swiftly according to surrounding conditions of temperature, moisture, etc. Sulphureted hydrogen is like the bark of a dog that is not very terrible for its bite. The gas of putrefaction is like the bite of a dog that gives no warning bark. Besides, filth putrefying in the open air is not so dangerous as filth putrefying in close vaults, cesspools, and badly constructed sewers. A basketful of dead rats in the street are not half so offensive as one dead rat in the wall. It would be interesting to know what the Chinese think of our methods. There is a perilous journey from sanitary ignorance to sanitary science, from unsuspecting sanitary innocence to conscious sanitary virtue.

xv.

Stables, in cities or elsewhere, are a necessity. Men can not do without horses. And these faithful slaves of mankind must be housed. As a rule, a stable is a nuisance, by reason of noise and smell. A stable, however, need not be a nuisance. The fault is in the building and maintenance. The site of a stable should be thoroughly underdrained. The floors should be of concrete covered with a pavement of Bermuda asphalt, like the pavement in the streets of Washington. Plank floors are noisy. Wood absorbs the urine of horses and becomes foul and stinking. Most stablefloors of plank leak, and the ground underneath becomes gradually saturated with liquids undergoing putrefactive decomposition. Old livery-stables, the habitations of several scores of horses, are among the worst nuisances of villages and cities. Ordinances, statutes, and the common law afford sufferers in the neighborhood means of relief, if they choose to employ a lawyer and seek their remedy. All liquids from a stable, public or private, should be conveyed to a sewer, or other proper place, with as much care as the sewage from a house. Manure should not be thrown outside on the ground. It should be put in a proper box inside, kept dry, and frequently removed to the land. Many persons assert that the smell of a stable is healthy. There are dunces who think that the smell of a sewer or a vault is not unhealthy. The gases arising from the putrefactive decomposition of the excreta of horses are poisonous, like the gases arising from the decomposition of any other animal matter. The urine of horses contains about six times as much putrescible matter as the dung, and is therefore six times more dangerous, as well as being six times more valuable for manure. Horses are very sensitive to unsanitary conditions. Men will stand an atmosphere containing one part in two hundred and fifty of sulphureted hydrogen. Half that amount will sicken a horse. Veterinary surgeons in European armies have recently saved a vast expenditure in horses by underdraining and ventilating stables. It costs but little more to make and maintain a sanitary and noiseless stable than it does to make and maintain one that annoys the neighborhood with foul odors and reverberating sounds. The increase of expenditure will be returned manifold by the healthier condition of the animals. Every nuisance stable should be treated without toleration. The horse is a noble animal ; he knows more and suffers more than you think he does ; and you should treat him, as the Arab does, with tenderness and humanity, like a gentleman.

XYI.

Dr. Buchanan, in England, and Dr. Bowditch, in the United States, simultaneously demonstrated that the wetness of soil is at least the exciting cause of phthisis. Surface accumulations of water are not only inconvenient and unsightly, but also disagreeable and unhealthy. Subsoil dampness makes the sight of any habitation incompatible with comfort and duration of life. Therefore, the first care in the preparation of the abodes of man, and, it might be added, of domestic animals, should be the drainage of the soil. Eemoval of water from beneath and around the house and outbuildings increases warmth, fertility, and wholesomeness. What is true in this respect of an isolated habitation, is also true of collections of habitations in the village and groups of villages constituting the city. The only known means of preventing malarial diseases is good drainage. Surface drainage does much in this way. Drainage of the soil to the depth of two or three feet, as in the agricultural regions .of England, does more. Entirely effective drainage of land should be to the depth of four or five feet. Drainage of the site of a habitation should be lower than the cellar and the foundation.

XVII.

The backhouse is not a relic of barbarism. Whereever found, there is barbarism. Moses and the cat have taught mankind better than to construct and maintain such a Hindoo temple of filth. The great hole in the ground, near the habitation, to be gradually filled with the vilest human excrement, which undergoes constant putrefaction evolving poisonous gases, infecting and gradually supersaturating the surrounding earth, perhaps seeping into the water of an adjacent well, becoming the nidus of swiftly multiplying germs of infectious diseases that nature labors to eliminate by the secreting functions of intestines, kidneys, or skin, is an abomination tolerated by ignorance, apathy, and vile habit. Clean it out, remove the dangerous contents far off to the hungry land, disinfect the desecrated place, fill it with clean earth, and sin no more. You can make a wholesome vault for seventy-five cents, if you are not too lazy, stupid, and obstinate. Buy an empty kerosene-barrel at the nearest grocery. Saw it in two, in the middle, and thus make of it two tubs which will not leak. Place the two on top of the ground under the holes in the privy-seat. Keep the contents of the tubs dry with the house ashes or with dry earth gathered in the summer. The contents of the tubs will evolve no gas, will not undergo putrefaction, will not smell to heaven or the other place, will not maintain the life of bacteria or disease germs, as long as such contents are kept perfectly dry by the admixture of ashes or desiccated earth. When the tubs are full, pull them out and spade the contents into the garden. In the mysterious alembic of nature the filth will be transformed into grass, fruit, or flowers, causing no nuisance. If you have no garden, send the tubs away to be emptied on the land. This will cost much less than the cleaning of a devil's magazine of pestilence called a privy- vault. The simplest and cheapest form of the earth-closet is here commended.

XVIII.

Investigators must not forget the fact that microscopic plants and animals become the causes of diseases in man only when they are parasitic. Neither must investigators forget the further fact that microscopic animals, like other animals, breed by fecundated ova ; and that microscopic plants, like other plants, are propagated by fertilized seeds. Bisection, budding, transplanting, growth from layers, etc., are subordinate to the main facts, yet important. It is not sufficient, for example, to study the Bacillus antliracis as a plant which gives a milder form of splenic fever, which is easily destroyed by the heat of boiling water ; but the spores must also be studied, which give the deadly form of the same fever, which, as Professor Tyndall has demonstrated, can be destroyed only by about 340° of heat. The subject opens up a wide field for hypothesis and experiment. It is well known that a "black" frost entirely arrests yellow fever. A " black " frost may kill the yellow-fever plant and arrest the germination of its spores. Yet the same spores may germinate with the returning warmth of the following season and continue the disease. A frost will kill the young corn-plant. Yet seed-corn may be hung up in an atmosphere below zero all winter without losing its vital power to sprout — under proper conditions of soil, moisture, and warmth — the following summer. Wheat has grown well after remaining several thousand years in an Egyptian tomb. Heat is more likely to destroy germs than cold. Boil seed-corn, and it will not grow. It is a known fact that steam will disinfect a ship of yellow-fever. It is a known fact that freezing will not. Yet sanitary "cranks" persist in advising the destruction of yellow-fever germs in ships by cold. I predict that in due time superheated steam will be used to destroy germs of cholera, typhoid, typhus, and other zymotic diseases, not only in ships, but in other places where it can be made available.

At a meeting of the French Horticultural Society, says Colonel Waring, there was a discussion as to the influence of plants on water containing putrefying organic matter ; and evidence was adduced to show that, while such water, left to itself, retains its putrescent character, the same water in which roots of growing plants are feeding loses entirely the bacteria which accompany putrescence and contains only the larger infusorias which are peculiar to wholesome water. It was sufficient to allow a living root to act for five days, for the water to lose all its bad smell and to become purified. It is a sound instinct of humanity that leads to the planting of trees around a spring or well. An elm or soft maple, planted over a buried vault, will in time do scavenger- work that ought to have been done more promptly at the outset. A bed of sunflower-plants will rapidly appropriate foul moisture in a neglected or abused corner of the yard or garden. The eucalyptus, above all other trees, drinks up a vast quantity of malarial water. A judicious planting of the thirsty eucalyptus has made wide regions of Italy and Algeria healthy. I cut the following from a newspaper : " "Where there is surplus moisture to dispose of, as, for example, a cesspool to keep dry, a large eucalyptus will accomplish not a little, and a group of them will dispose of house-sewage. But if you have water which you do not wish to exhaust, as in a good well, it would be wise to put the eucalyptus very far away. Daniel Sweet, of Bay Island Farm, Alameda County, Cal., recently found a curious rootformation of eucalyptus in the bottom of his well, about sixteen feet below the surface. The tree to which the roots belonged stood fifty feet from the well. Two shoots pierced through the brick wall of the well, and, sending off millions of fibers, formed a dense mat that completely covered the bottom of the well. Most of these fibers were no larger than threads, and were so woven and intertwisted as to form a mat as impenetrable and strong as though regularly woven in a loom. The mat, when first taken out of the well, was watersoaked and covered with mud, and nearly all a man could lift, but, when dry, it was nearly as soft to the touch as wool, and weighed only a few ounces. This is a good illustration of how the eucalyptus absorbs moisture, its roots going so far to find water, pushing themselves through a brick wall, and then developing enormously after the water is reached. Mr. Sweet thinks one of the causes of the drying up of wells is the insatiable thirst of these vegetable monsters." The eucalyptus flourishes well in our Southern States and in California, Plant-life of all kinds feeds on the dangerous decay of animal life. Flower-beds around habitations are wholesome as well as pleasant to the eye.