Home hygiene and prevention of disease

Introduction

One of the most important developments of modern medicine has been the fact that it is now realized that it is far better to avoid than to contract illness, even if the modern methods of treatment have robbed disease of many of its old-time terrors. A consequence of this has been that the modern physician takes every opportunity to instruct his clientele how to avoid contracting disease.

It is with a belief that this part of the physician's instructions can be advantageously supplemented with information which the average person can have constantly at hand that has made the publishing of this book seem distinctly called for. Simple as a physician 's advice may seem for the avoidance of any disease, it is often necessary to have this advice in a form where it can be more carefully studied and digested if we are to develop a " hygienic sense" which will enable us more or less instinctively to avoid the paths which lead to disease.

The public as a class has been saved much suffering and avoidance of future inconvenience by the knowledge which it has assimilated on first aid to the injured. Similar benefit should result from popular appreciation of the methods of first aid to the sick. For often, in the case of illness "a stitch in time saves nine. ' '

One justification of a popular work of this kind is that not only can its readers render the best aid to the incipient or slight invalid; but they should be enabled to better appreciate when an ailment has become serious enough to require expert medical attendance, or when a disease is from the outset beyond the aid of unskilled hands.

There are few in our modern era of civilization who do not understand the workings and failings of automobiles, engines, phonographs, sewing machines and household appliances. It would seem the part of discretion therefore if we knew at least as much about a few of the commoner workings and failings of the human body — a machine of

INTRODUCTION

far more importance to all of us than all the mechanical appliances in the world.

It is with this purpose in view that the author of this work ventures to place it in the hands of the public, expressing, at the same time, the hope that some of the more technical of the information imparted will be employed with discretion. To those living in rural districts where the service of physicians is difficultly obtainable it is hoped that the information herein contained will be a means of saving life and avoiding unnecessary suffering. To those living less far from the trodden highways it is hoped this work will prove to be an aid to the physician — educating the human kind to a more intelligent appreciation of his efforts, lessening the numberless irritations and infinite inconvenience resulting from the human gad-fly ''minor ailments"; and materially lightening the load of longsuffering humanity from preventable sickness.

In many cases it is difficult to judge from a patient's symptoms the precise character of the disease from which he is suffering, and it is obvious that except in the simplest cases no one but a medical man can form a reliable opinion. It must be made clear that the object of this book is not to displace the family doctor, but to furnish the reader with general information regarding medical subjects; and that while pains have been taken to ensure accuracy, the author and publishers can accept no responsibility for errors. Nearly all the medicines mentioned in the text (except those marked Poison) may be obtained from licensed druggists without the prescription or signature of a medical man, but persons who treat themselves in accordance with the directions contained in the book must realize that they do so on their own responsibility.

N. E. D.

HOME HYGIENE AND PREVENTION OF DISEASE

HOME HYGIENE AND PREVENTION OF DISEASE

Abscess. — When some part of the body is damaged byinjury or poisoned by a germ, inflammation is set up, and the symptoms of heat, redness, swelling, and pain, begin to appear. If the supply of good blood is sufficient to overcome the poison or to repair the damage done, then the inflammation grows less and less until at last the mischief is as far repaired as ever it can be. But if the poison is too strong, or the damage too severe, then the inflammation increases in intensity, until there is formed a swelling which has in the middle of it an isolated collection of dead bloodcells, constituting what we call "matter," or "pus," surrounded by a red ring of inflammation. The results of the struggle between the blood and the poison are thus walled in so that they cannot do much more damage, and this state of the part is called an abscess.

If possible we try to avoid the formation of an abscess, either by destroying the bacteria causing the trouble, by helping the inflammation or by relieving the process by cutting into it and washing out the poison.

The first may be accomplished by applying wet dressings composed of sterile gauze saturated with a solution of bichloride of mercury (1-2000) or aluminium acetate.

The inflammation may sometimes be helped by causing an increased flow of blood to the part by applying a vacuum cup. Warm applications may hasten the formation of an abscess, but when an abscess has once formed the sooner it is opened the better. If, on looking at an inflamed swelling, you can see a yellowish spot anywhere, then the swelling has become an abscess, and ought to be opened at once, and the pus let out.

Nowadays the fear of the surgeon's knife is unnecessary. A doctor will always save the patient pain by using some

2 ACNE

anaesthetic to deaden the feeling in the part. (See "Anaesthetics.) And the sooner the cutting is done the smaller will be the scar, and the sooner the whole trouble will be over.

Acidity (Sour Stomach, Heartburn) . — This is not a disease in itself, but merely one of the symptoms of indigestion or dyspepsia. It is a sign that either too much food is being taken, more than can be thoroughly digested, or that there is something radically wrong with the digestive process — that is, with the kind of food taken. A change is needed. Not that you must go away to the seaside, but that you must alter your mode of living, eating, and drinking. The sour taste in your mouth, the feeling of weariness after a night's rest, the dream-harassed slumber — all these may be removed by simple means. First, get your teeth attended to, so that the food may be properly chewed. Then, have your meals at stated intervals punctually. Avoid all spirituous liquors, drink only at the end , of a meal, avoid too much meat, and pastry, and cheese, and pickles; and take a teaspoonful of bicarbonate of soda and a teaspoonful of carbonate of magnesia in a tumbler of water every night at bedtime. In addition, go to bed early, rise early, take plenty of exercise, and your "sour stomach" will soon be only a memory of a disagreeable past. (See also "Indigestion.")

(1) For acidity and sour-smelling diarrhea in children under 10: — Sodium bicarbonate, 2 grains; mercury and chalk, 2 grains ; magnesium carbonate, 5 grains. (Mix and make a powder to be taken every other night.)

(2) For acidity, heartburn and painful digestion: — Liquor of bismuth, 1 drachm ; infusion of quassia, 1 ounce. (This draught to be taken three times every day.)

(3) Powders for acidity and heartburn : — White bismuth, 10 grains; magnesium carbonate, 10 grains. (Make a powder to be taken in half a bottle of soda water twice a day.)

Acne. — (See "Blackheads.") The little pores and follicles in the skin sometimes get blocked up by dirt, and as described under "Blackheads," there remain little tiny pouches of fatty matter, which can be squeezed out by pressure with a key, or by the finger-nails. Sometimes the dirt which blocks the entrance to the pores remains fixed in the tubes, and then the blackheads become red and in-

ADENOIDS 3

flamed and are called acne spots. These pustules, or small abscesses, presently come to a head, and then burst, discharging matter. This matter — pus — is poisonous, and if carried by scratching finger-nails to another part of the skin, causes fresh acne spots there. Acne spots leave unsightly scars. In older people a variety of "acne" is apt to appear on the nose, especially on the red shiny nose of the alcoholic drunkard.

Treatment. — In young people too much smoking, and indigestion due to bolting the food are the general causes of the complaint. The first and last of the treatment is summed up in the word cleanliness. The skin must be kept very clean indeed, not only by frequent washing, but by rubbing violently with rough towels after the washing. The rubbing makes the skin red, and that is what is wanted, for the increase of blood improves the nourishment of the skin and helps it to fight against the evil effects of dirt and germs.

Thin people with acne ought to take cod-liver oil, and fat ones should drink a purgative mineral water, or take a Seidlitz powder every morning. When the acne pustules are already formed, steam the skin, and clean it well with friction and soap, and then, using a new needle, prick the yellow point in each spot and squeeze out the pus, and wipe it away with a cloth dipped in peroxide of hydrogen. Then bathe the skin well, and rub in white lotion. This may be reapplied several times during the day.

All the cotton-wool, gauze or lint which has been used is to be burnt, and the needle also. And the hands should be washed, and the nails scrubbed, with carbolic soap.

Adenoids. — Adenoids, or, properly speaking, "adenoid vegetations, ' ' are overgrowths of the glandular tissue which is found in the back of the upper part of the throat, just where the nasal cavity opens behind. They are allied to the enlarged glands which are so common about the angles of the jaws in children and in their necks ; and their presence causes a great susceptibility to catching cold. The adenoids, if plentiful, block up part of the passage through which breathing takes place and prevent the proper development of the lungs. Not only that, but they . cause deafness. About ninety per cent, of all the cases of deafness among children are due to adenoids. Children with adenoids generally look stupid, keep the mouth open, and

4 AGE AND WEIGHT

breathe through it, and are listless and lack concentration. Lastly, such children are often nervous and irritable and are prone to bed-wetting and to have nightmares.

Treatment. — If the child cannot sleep with its mouth shut, or play without getting out of breath, the adenoids ought to be removed by operation. There is nothing else of any use.

Age and Weight. — The proper relations between age and weight are shown in the following tables; which, however, are not to be taken as representing an invariable standard. Many persons of less weight than is here shown enjoy excellent health.

I.— CHILDREN.

Years of age

Boys

Girls lbs.

lbs.

. 8

II.— ADULTS.

Male

Female

Height

Weight

Height

Weight ft. in.

lbs.

ft. in.

lbs.

5 2

4 10

5 3

4 11

5 4

5 5

5 1

5 6

5 2

5 7

5 3

5 8

5 4

5 9

5 5

5 10

5 6

5 11

5 7

5 8

ALCOHOLIC DRINKS 5

Alcohol, Acute Poisoning by. — When spirits are given to children, or when adults go in for a debauch and drink excessive quantities of alcoholic liquors, the alcohol acts as a deadly poison and sometimes kills on the spot.

If death does not occur, the drinker to excess becomes more or less collapsed, his muscles are relaxed and he lies helpless and perhaps insensible. If left in this state he may sink and die, or he may perhaps sleep it off, or he may catch inflammation of the lungs and die of that in a very short time. The treatment is to empty the stomach first ; give a drink of warm mustard and water. "When the doctor comes he will probably give a stronger emetic, if the mustard-water has not yet acted, and then will administer hot, strong coffee injections into the rectum (or back passage) with a Higginson syringe, and rouse the patient by every possible means. Later on the sick man will require a long rest and plenty of liquid nourishment.

The delirium, which sometimes comes on at the end of a long spell of drinking, and which is known as "D.T.'s" or Delirium Tremens, may be fatal after a few hours of horrible suffering and mental agony. Careful and constant nursing is required, sleep and plenty of food. These cases should be treated by a doctor.

Alcoholic Drinks, Moderation in. — The writer pleads for moderation in the drinking of alcohol, as in all things else — for conscience sake, for the stomach's sake and for the sake of society, the comfort and well-being of which all are bound to consider.

Probably never, throughout the world's history, has been seen so widespread and drastic a movement against the use of alcoholic drinks as the modern so-called Temperance Movement ; so-called because the most of the reformers aim, not at "temperance," which means moderation, but at total-abstinence. It cannot be denied that there is much that is admirable in this movement in a time of excessive drinking, and that the motives of the promoters are lofty and command respect. Seeing around them the millions who are being made unhappy, unhealthy, criminal, or mad, by excess of alcohol, the total abstainers are teaching that even the moderate use of alcohol is full of danger, and that everyone owes it to himself to give up every form of it. The last word of science up-to-date is definitely on the side of the reformers, and against alcohol even in moderation.

6 ALCOHOLIC DRINKS

"Even the smallest doses," says the scientist, "lessen energy and efficiency to some extent, and have the inevitable reaction of depression." These truths are pretty generally known by this time, and if, in consequence, all who dearly value their health do not at once become total abstainers, it is probably because they realize that most people have funds of health and energy within them, far greater than are required in the mere daily routine of life ; and they are of opinion, too, that with that superfluity of energy they ought to be allowed to do as they please. To be a lifelong total abstainer means to be quite safe from a host of diseases — to be on the safe side entirely as regards the diseases due to alcohol. It means never to be brainfuddled, never to be sentimentally maudlin ; easily to avoid being grossly impure or vicious; or at any time entirely at the mercy of ruffianly men or scheming and evil women ; and lastly, it means to save much money which would otherwise be spent on the vices which seem to be inseparable from excessive indulgence. And the really healthy youth, starting in life with an equable commonplace temperament, a fair knowledge of the possible evils of drunkenness, and no drinking companions to prompt him, would almost certainly prefer to do without alcohol altogether, and would go on his way rejoicing, healthy, happy and sober-minded — even if a bit of a prig.

The moderate drinker, on the other hand, desirous of an occasional emotional excitement in the dull routine of life, lives in a different set of circumstances. He knows, or may know, of loftier flights of imagination (as well as deeper depths of depression) than the teetotaler; he has generally more sympathy with the poor, the afflicted, and the tempted, than the total abstainer, who is too apt to be self-righteous. Among the moderate drinkers have been some of the world's greatest men and most honored names.

All the serious disadvantages of alcohol are connected with its abuse; it would be ignorant and foolish to deny the advantages of its use. Just as a tired horse at the sound or touch of the whip makes a grand effort to complete its task, despite fatigue, so will a man or woman sometimes overcome a serious difficulty by the help of the stimulus supplied by alcohol.

The great majority of mankind in every land have always used alcohol, more or less in moderation ; the general

ALCOHOLIC DRINKS 7

feeling everywhere has been always against the abuse of it. Hence arises the question, so very difficult for the individual to solve — "What is moderation?"

We have all of us seen plenty of examples of men and women of advanced age, who are in good health, and who are known to have drunk beer, cider, wine or spirits all their lives ; so that there can be no doubt that it is possible, for some of us at any rate, to enjoy the benefits of alcohol in moderation, and to reach a healthy old age.

Now all alcoholic beverages produce, in moderate doses and well diluted, a certain pleasurable effect called stimulation. If the majority of alcoholic drinks were not as shamefully adulterated as they undoubtedly are, people would find that the stimulant effect came sooner and with smaller quantities, and that the after-effects are less disagreeable. It is the cheap adulterated rubbish that nearly every publican sells so much of to the poor which does harm to those who honestly desire moderation. The drink manufacturer makes large profits, and almost in every case adds something to the liquor he sells to increase the thirstiness of the customer. No wonder moderation is difficult to maintain.

By a "stimulant" effect we mean a sense of well being, an elation, a hopefulness, warmth, and good humor. The same small dose gives appetite, increases the rate of the pulse, and supplies, sometimes, fresh energy for a disagreeable task.

Now, every stimulant effect has a corresponding period of depression. This will be noticed, perhaps, an hour afterwards, and may last an hour or two ; or the period may be spent in sleep, when the depression passes unnoticed and recuperation takes place as well.

When a hard task has to be long continued, even a small dose of alcohol does more harm than good, and to repeat the dose will do even more harm. After a long task is completed a dose of alcohol is comforting, sedative and refreshing and promotes the sleep that is so greatly needed. One thing is certain, namely, that alcohol does not confer any additional working power. It may give a temporary stimulus to body work or brain work, but reaction succeeds, and leaves the body and mind less active than before.

We come then, to this conclusion, that the greatest difficulty, as regards moderate drinking, lies in the fact that

8 ANOSMIA

just as no two persons are alike in size, weight, constitution or appetite, so the quantity of alcoholic liquor which will help one man and do him no harm, repeated daily for years, may entirely ruin a man who has weak organs or some disease of the heart, liver, or kidneys. What may be moderation in you may lead to my early death. How then is a person to judge whether he may take any alcohol or not, and how much, and how often?

The answers are, after all, fairly definite. Drink none at all if you desire perfect safety, and especially if any relations or ancestors of yours were of drunken habits. If you will drink, drink as little as you can, especially if your life is sedentary and you cannot get much exercise. Drink, in any case, only at meal times, and you will not go far wrong. Set your face against the senseless parrot cry, ''Come and have a drink," and the foolishness of creating an artificial thirst, which leads to the benefit of one person only — the drink-seller. It is natural and proper for young people to like convivial society, but the society of the public-house bar has nothing to recommend it. Young women do not find it necessary to be continually taking nips of alcohol to bring out their wit and gayety, and young men would do well to bear the fact in mind. There is nothing "manly" in the silly sleepiness, or the bubbling frothy gayety induced by too many drinks. Directly you feel the stimulus of the first drink, alcohol has done all the good in its power, and more alcohol does harm. It is when the stimulation is felt, of course, that there is the greatest temptation to secure some more, and then begins the poisoning of the system and the overworking of the liver and kidneys. Actual experiment has shown that from 1 ounce to 1% ounces of absolute alcohol represents the quantity of alcohol which a healthy man may daily consume without ill effecte. (See also "Beverages.")

Anaemia. — Ancemia means bloodlessness, but nobody is bloodless, and so the word is used to mean any state of health in which the blood is not of as good a quality as it should be. The pink color of the lips and other "mucous membranes" is due to the red color of the blood which circulates under the surface of them. A person may be anaamic (or poor blooded) because he has lost a quantity of blood by accident, or because he is badly nourished, or because he is poisoned by some disease, or chemical poison

ANEMIA 9

such as lead. Or he may be anaemic because his bloodmaking powers are not up to the mark. We shall describe only the more common forms of anaemia, such as is not caused by loss of blood.

1. — Chlorosis or Green Sickness. This is the anaemia so common in young girls about 13 or 14 years of age. In a bad case of this kind of anaemia, the girl looks pale, or yellowish and sallow-tinted, her lips pale pink, her cheeks a little flushed. On the backs of the hands the veins show pink through the whitish skin instead of purplish through a pink skin. She is languid, weak and tired, and is liable to headaches, giddiness, fainting-fits, shortness of breath on going upstairs, and swollen ankles at bedtime. Her appetite is poor and she complains of a feeling of a heavy weight on the chest after meals. At the same time, she may be fat, or at any rate plump. Such girls are very often emotional and hysterical (see "Hysteria") and full of sentimental sickly fancies. They nearly always have some disturbance of the female functions; very often in anaemia the courses stop altogether, and the girl grows irritable and apt to shut herself up or moon about alone.

Treatment. — This may be summed up in a sentence. Take iron and keep the boivels freely open. Iron, in some form or another, will have to be taken continuously for three months or more. Iron, if given in large doses and often enough, will cure nearly all cases. But even iron is useless unless the bowels are kept freely open. This is Sir Andrew Clark's medicine for chlorosis, and it will be found suitable for a large number of cases, though not for all:—

Sulphate of magnesium, 6 drachms ; sulphate of iron, 24 grains ; aromatic sulphuric acid, 1 drachm ; tincture of ginger, 2 drachms; compound infusion of gentian, to 8 ounces — a sixth part to be taken twice a day.

2.— Anaemia in Adults. The treatment of this must depend upon the cause of it. Lead-poisoning (see "Lead- Poisoning"), gout, syphilis, kidney-disease, malaria, severe bleeding piles, discharges, stomach inflammations — all these may be causes of anaemia.

Iron, given in some form which will not upset digestion, is the real cure for anaemia. To begin treatment the patient must take a smart purge of Epsom salts, then continue

10 ANEURISM

with iron and a bitter tonic like quinine. Thus — Tincture of perchloride of iron, 10 fluid drachms; sulphate of quinine, 1 drachm, 20 grains ; glycerine, 2 fluid ounces ; water to 8 fluid ounces. Take two teaspoonfuls of this mixture in a wineglassful of water thrice daily after meals.

Persons who are very weak as well as anaemic may find the following pill very useful : — To make one pill — Arseniate of iron, a quarter of a grain; reduced iron, 5 grains. Take one pill morning and evening after meals.

One of the most widely used of all iron preparations in the treatment of anaemia is Blaud's pill in combination with cascara or some other laxative. There is another form of anaemia known as pernicious anaemia which is difficultly curable and which may terminate in death. Therefore in the case of any anaemia which does not respond readily and quickly to the ordinary modes of treatment for anaemia, a good physician should be quickly consulted.

Anaesthetics. — This is the word which means all the different medicines used to send people to sleep — the artificial sleep and insensibility to pain, called anaesthesia. The art of using anaesthetics is now so well understood that no one need be afraid of them. A very few deaths occur every year from anaesthetics in the case of people with unsuspected bad heart disease or broken-down constitutions.

The chief drugs used are ether, chloroform and nitrous oxide gas for producing artificial sleep, and cocaine, eucaine and ethyl chloride to produce insensibility of the skin. The choice of anaesthetic must, of course, be left entirely to the judgment of an expert, but as a matter of fact there are almost no cases of illness (in which an operation is really required), for which a suitable anaesthetic cannot be found.

Aneurism. — Inside the blood vessels, of course, there is always a great pressure of blood, caused every moment by the beating of the heart, which pumps blood round the whole body. The pressure is great, and the blood vessels (arteries and veins) have to bear it without giving way. This they could not do unless they were elastic, as in fact they are. The arteries are elastic tubes, dilating when more blood rushes through them, and contracting when there is less blood. An artery never ruptures, even when the heart is beating furiously, so long as it retains its

ANTISEPTICS 11

elasticity. But in old age the arteries become less elastic, less able to cope with sudden alterations of pressure, and the same thing happens even in youth in the presence of such diseases as gout, syphilis, and alcoholism. The weakening of the arteries in these diseases may affect all the blood vessels of the body, or only certain of them, or sometimes only small patches on a very few of them. This disease of the arteries is called atheroma, and everyone with atheromatous arteries who is subjected to physical strain or hard manual labor, is liable to have an aneurism. An aneurism is a blood-tumor connected with an artery and caused by the weakened inner wall of the artery dilating and giving way before suddenly-increased pressure of blood. Once an aneurism is formed, it has a slight tendency to self-cure, and will get well spontaneously if suitable medical treatment and nursing can be obtained. Of course, the signs and symptoms of an aneurism depend altogether on the position of it — it may be behind the knee, in the chest, in the lungs, in the abdomen, or almost anywhere else. The symptoms are always pain, more or less, and the results of the pressure on other organs. Nothing more can be said here about aneurisms ; they are in no way suited for home-doctoring, and, in fact, often tax the ingenuity and skill of the cleverest and most experienced medical man.

Angina Pectoris, or Breast Pang, is a sudden cramp of the heart itself. The first attack often proves fatal, but some people have several attacks before they die. The pain is intense, like no other pain on earth, and accompanied by a fear of impending death. It lasts about a minute. The cause of the condition is almost unknown.

Persons who have had one attack must regard themselves as likely to have another, and they should always carry about with them small glass capsules of amyl nitrite, the vapor of which, released by breaking the tube, is to be inhaled by the patient. Recurrence of the attacks may, perhaps, be prevented by avoidance of excitement.

Antiseptics are substances, mostly of a chemical or mineral nature, which possess the property of arresting or preventing the growth of bacterial organisms which are capable of producing poisonous substances in animal tissues with death or decay of the body cells. The changes which take place in a wound or ulcer or sore when germs

12 APOPLEXY

get into it are called septic processes, sepsis, or putrefaction. (See also " Abscesses'' and "Inflammation.")

The choice of an antiseptic must depend upon the purpose for which it is to be used.

The following is a list of the better known antiseptics.

Bichloride of Mercury or Corrosive Sublimate. Prepared in tablets. Used in strengths of 1 in 1000 or in 1 in 2000 parts of water, for inflammatory processes of bacterial origin.

Peroxide of Hydrogen. Used in full or % strength to cleanse dirty and infected wounds.

Boracic Acid. Saturated or y 2 saturated solution. For mild inflammations of mucous membranes.