[Ill.u.s.tration: A HEALTHFUL ARRANGEMENT OF WINDOWS AND SHADES

The windows face in more than one direction. The shades are hung in the middle, not only regulating the light in the room, but allowing free pa.s.sage of air at the top.]

Windows should reach well up toward the ceiling and be opened _at the top_, because the foul air given off from the lungs at the temperature of the body is warmer than the air of the room and consequently rises toward the ceiling. It is just as important in ventilation to _let the foul air out_ as to let the fresh air in. In fact, one is impossible without the other. Air, though you can neither see it, nor grasp it, nor weigh it, is just as solid as granite when it comes to filling or emptying a room. Not a foot, not an inch of it can be forced into a room anywhere, until a corresponding foot or inch is let out of it somewhere.

Therefore, never open a window at the bottom until you have opened it at the top. If you do, the cold fresh air will pour in onto the floor, while the hot foul air will rise and bank up against the ceiling in a layer that gets thicker and thicker, and comes further and further down, until you may be actually sitting with your head and shoulders in a layer of warm foul air, and your body and feet in a pool of cool pure air. Then you will wonder why your head is so hot, and your feet so cold!

Currents and Circulation of Air. In fact, this tendency of hot air to rise, and of cold air to sink, or rush in and take its place, which is the mainspring of nature's outdoor system of ventilation, is one of our greatest difficulties when we wall in a tiny section of the universe and call it a room. The difficulty is, of course, greatest in winter time, when the only pure air there is--that out of doors--is usually cold.

This is one of the few points at which our instincts seem to fail us.

For when it comes to a choice between being warm or well ventilated, we are sadly p.r.o.ne to choose the former every time. Still we would much rather be warm _and_ well ventilated than hot and stuffy, and this is what we should aim for.

The main problem is the cost of the necessary fuel, as it naturally takes more to heat a current of air which is kept moving through the room, no matter how slowly, than it does a room full of air which is boxed in, as it were, and kept from moving on after it has been warmed.

The extra fuel, however, means the difference between comfort and stuffiness, between health and disease. Fortunately, the very same cold which makes a room harder to heat makes it easier to ventilate. When air is warmed, it expands and makes a "low pressure," which sucks the surrounding cooler air into it, as in the making of winds; so that the warmer the air inside the room, or the colder the air outside of it, which is practically the same thing, the more eagerly and swiftly will the outdoor air rush into it. So keen is this draft, so high this pressure, that some loosely-built houses and rooms, with only a few people in them, will in very cold weather be almost sufficiently ventilated through the natural cracks and leaks without opening a window or a door at all. And what is of great practical importance, an opening of an inch or two at the top of a window will admit as much fresh air on a cold day as an opening of a foot and a half in spring or summer, so swiftly does cold air pour in.

Bearing this in mind, and also that it is always best to ventilate through as many openings as possible, both to keep drafts of cold air from becoming too intense, and to give as many openings for the escape of the foul air as possible, there will be little difficulty in keeping any room which has proper window arrangements well ventilated in winter.

An opening of an inch at the top of each of three windows is better than a three-inch opening at the top of one. But you must use your brains about it, watching the direction of the wind, and frequently changing the position of the window sashes to match the changes of heat in the room, or of cold outside.

No arrangement of windows, however perfect, is likely to remain satisfactory for more than an hour at a time, except in warm weather.

This watchfulness and attention takes time, but it is time well spent.

"Eternal vigilance" is the price of good ventilation, as well as of liberty; and you will get far more work done in the course of a morning by interrupting it occasionally to go and raise or lower a window, than you will by sitting still and slaving in a stuffy, ill-smelling room.

Plenty of Heat Needed. Any method of heating--open fireplace, stove, hot air, furnace, hot water, or steam--which will keep a room _with the windows open_ comfortably warm in cold weather is satisfactory and healthful. The worst fault, from a sanitary point of view, that a heating system can have is that it does not give enough warmth, so that you are compelled to keep the windows shut. Too little heat is often as dangerous as too much; for you will insist on keeping warm, no matter what it may cost you in the future, and a cold room usually means hermetically sealed windows. Remember that coal is cheaper than colds, to say nothing of consumption and pneumonia.

[Ill.u.s.tration: A HEALTHFUL BEDROOM

Windows on two sides; shades rolling from the middle; draperies few and washable; no carpet, but rugs by the bedside.]

Ventilating the Bedroom. The same principles that apply to ventilating a living-room or day-room apply to ventilating a bedroom. Here you can almost disregard drafts, except in the very coldest weather, and, by putting on plenty of covering, sleep three hundred days out of the year with your windows wide open and your room within ten degrees of the temperature outdoors. You need not be afraid of catching cold. On the contrary, by sleeping in a room like this you will escape three out of four colds that you usually catch. Sleeping with the windows wide open is the method we now use to cure consumption, and it is equally good to prevent it.

No bedroom window ought to be closed at the top, except when necessary to keep rain or snow from driving in. Close the windows for a short time before going to bed, and again before rising in the morning, to warm up the room to undress and dress in; or have a small inside dressing-room, with your bed out on a screened balcony or porch. But sleep at least three hundred nights of the year with the free air of heaven blowing across your face. You will soon feel that you cannot sleep without it.

In winter, have a light-weight warm comforter and enough warm, but light, blankets on your bed, and leave the heat on in the room, if necessary--but _open the windows_.

COLDS, CONSUMPTION, AND PNEUMONIA

Disease Germs. In all foul air there are scores of different kinds of germs--many of them comparatively harmless, like the yeasts, the moulds, the germs that sour milk, and the bacteria that cause dead plants and animals to decay. But among them there are a dozen or more kinds which have gained the power of living in, and attacking, the human body. In so doing, they usually produce disease, and hence are known as _disease germs_.

[Ill.u.s.tration: DISEASE GERMS

(Greatly magnified)

(1) Bacilli of tuberculosis; (2) Bacilli of typhoid fever.]

These germs--most of which are known, according to their shape, as _bacilli_ ("rod-shaped" organisms), or as _cocci_ (round, or "berry-shaped" organisms)--are so tiny that a thousand of them would have to be rolled together in a ball to make a speck visible to the naked eye. But they have some little weight, after all, and seldom float around in the air, so to speak, of their own accord, but only where currents of air are kept stirred up and moving, without much opportunity to escape, and especially where there is a good deal of dust floating, to the tiny particles of which they seem to cling and be borne about like thistle-down. This is one reason why dusty air has always been regarded as so unwholesome, and why a very high death rate from consumption, and other diseases of the lungs, is found among those who work at trades and occupations in which a great deal of dust is constantly driven into the air, such as knife-grinders, stone-masons, and printers, and workers in cotton and woolen mills, shoddy mills, carpet factories, etc.

[Ill.u.s.tration: A VACUUM CLEANER

Most of the dust being emptied from the bag, would, in ordinary sweeping, have been merely blown around the room. By the vacuum process the dust is sucked up through the tube into the storing receptacle.]

In cleaning a room and its furniture, it is always best to use a carpet sweeper, a vacuum cleaner, or a damp cloth, as much as possible, the broom as little as may be, and the feather duster never. The two latter stir up disease germs resting peacefully on the floor or furniture, and set them floating in the air, where you can suck them into your lungs.

There are three great groups of disease germs which may be found floating in the air wherever people are crowded together without proper ventilation--for most of these disease germs cannot live long outside of the body, and hence come more or less directly from somebody else's lungs, throat, or nose. The most numerous, but fortunately the mildest group, of these are the germs of various sorts which give rise to _colds_, _coughs_, and _sore throats_. Then there are two other exceedingly deadly germs, which kill more people than any other disease known to humanity--the bacillus of consumption, and the coccus of pneumonia.

Our best protection against all these is, first, to have our rooms well ventilated, well lighted, and well sunned; for most of these germs die quickly when exposed to direct sunlight, and even to bright, clear daylight. The next most important thing is to avoid, so far as we can, coming in contact with people who have any of these diseases, whether mild or severe; and the third is to build up our vigor and resisting power by good food, bathing, and exercise in the open air, so that these germs cannot get a foothold in our throats and lungs.

Colds. Two-thirds of all colds are infectious, and due, not to cold pure air, but to foul, stuffy air, with the crop of germs that such air is almost certain to contain. They should be called "fouls," not "colds." They spread from one person to another; they run through families, schools, and shops. They are accompanied by fever, with headache, backache, and often chills; they "run their course" until the body has manufactured enough ant.i.toxins to stop them, and then they get well of their own accord. This is why so many different remedies have a great reputation for curing colds.

If you "catch cold," stay in your own room or in the open air for a few days, if possible, and keep away from everybody else. You only waste your time trying to work in that condition, and will get better much more quickly by keeping quiet, and will at the same time avoid infecting anybody else. Get your doctor to tell you what mild antiseptic to use in your nose and throat; and then keep it in stock against future attacks.

Often it is advisable to rest quietly in bed a few days, so as not to overtax the body in its weakened condition.

[Ill.u.s.tration: EXERCISE IN THE COLD IS A GOOD PREVENTIVE OF COLDS]

Keep away from foul, stuffy air as much as possible, especially in crowded rooms; bathe or splash in cool water every morning; sleep with your windows open; and take plenty of exercise in the open air; and you will catch few colds and have little difficulty in throwing off those that you do catch. Colds are comparatively trifling things in themselves; but, like all infections however mild, they may set up serious inflammations in some one of the deeper organs--lungs, kidneys, heart, or nervous system, and frequently make an opening for the entrance of the germs of tuberculosis or pneumonia. Don't neglect them; and if you find that you take cold easily, find out what is wrong with yourself, and reform your unhealthful habits.

[Ill.u.s.tration: A YEAR OF CONSUMPTION ON MANHATTAN ISLAND

Every black dot represents one case reported. The groupings show how rapidly the disease spreads from one household to another in the same locality.]

HOW TO CONQUER CONSUMPTION

Different Forms of Tuberculosis. The terrible disease tuberculosis is the most serious and deadly enemy which the human body has to face. It kills every year, in the United States, over a hundred and fifty thousand men, women, and children--_more lives than were lost in battle in the four years of our Civil War_. It is caused by a tiny germ--the _tubercle bacillus_--so called because it forms little mustard-seed-like lumps, or ma.s.ses, in the lungs, called _tubercles_, or "little tubers."

For some reason it attacks most frequently and does its greatest damage in the lungs, where it is called _consumption_; but it may penetrate and attack any tissue or part of the body. Tuberculosis of the glands, or "kernels," of the neck and skin, is called _scrofula_; tuberculosis of the hip is _hip-joint disease_; and tuberculosis of the knee, _white swelling_. "Spinal disease" and "hunch-back" are, nine times out of ten, tuberculosis of the backbone. Tuberculosis of the bowels often causes fatal wasting away, with diarrhea, in babies and young children; and tuberculosis of the brain (called _tubercular meningitis_) causes fatal convulsions in infancy.

[Ill.u.s.tration: CONSUMPTION IN CHICAGO

Four hundred and seventy-seven cases in one month--February, 1909.]

Tuberculosis of the Lungs--How to Keep it from Spreading. Tuberculosis of the lungs is the most dangerous of all forms, both because the lungs appear to have less power of resistance against the tubercle bacillus, and also because from the lung, the bacilli can readily be coughed up and blown into the air again, or spit onto the floor, to be breathed into the lungs of other people, and thus give them the disease.

Two-thirds of all who die of tuberculosis die of the pulmonary, or lung, form of the disease, popularly called consumption.

The first thing then to be done to put a stop to this frightful waste of human life every year is to _stop the circulation of the bacillus from one person to another_. This can be done partially and gradually by seeing that every consumptive holds a handkerchief, or cloth, before his mouth whenever he coughs; that he uses a paper napkin, pasteboard box, flask, or other receptacle whenever he spits; and that these things in which the sputum is caught are promptly burned, boiled, or otherwise sterilized by heat. The only sure and certain way, however, of stopping its spread is by placing the consumptive where he is in no danger of infecting any one else. And as it fortunately so happens that such a place--that is to say, a properly regulated sanatorium, or camp--is the place which will give him his best chance of recovery, at least five times as good as if he were left in his own home, this is the plan which is almost certain to be adopted in the future. Its only real drawback is the expense.

But when you remember that consumption destroys a hundred and fifty thousand lives every year in this country alone, and that it is estimated that every human life is worth at least three thousand dollars to the community, you will see at once that consumption costs us in deaths alone, four hundred and fifty million dollars a year! And when you further remember that each person who dies has usually been sick from two to three years, and that two-thirds of such persons are workers, or heads of families, and that tens of thousands of other persons who do not die of it, have been disabled for months and damaged or crippled for life by it, you can readily see what an enormous sum we could well afford to pay in order to stamp it out entirely.

One of the most important safeguards against the disease is the law that prevents spitting in public places. Not only the germs of consumption, but those of pneumonia, colds, catarrhs, diphtheria, and other diseases, can be spread by spitting. The habit is not only dangerous, but disgusting, unnecessary, and vulgar, so that most cities and many states have now pa.s.sed laws prohibiting spitting in public places, under penalty of fine and imprisonment.

[Ill.u.s.tration: A REPORT-FORM FROM A HEALTH DEPARTMENT LABORATORY

In a suspected case, the physician sends a specimen of the sputum to the Laboratory to be tested, and receives a reply according to the result of the test. The form is filled in with the name of the patient and signed by the Director of the Laboratory.]

The next best safeguard is plenty of fresh air and sunlight in every room of the house. These things are doubly helpful, both because they increase the vigor and resisting power of those who occupy the rooms and might catch the disease, and because direct sunlight, and even bright daylight, will rapidly kill the bacilli when it can get directly at them.

How great is the actual risk of infection in crowded, ill-ventilated houses is well shown by the reports of the tuberculosis dispensaries of New York and other large cities. Whenever a patient comes in with tuberculosis, they send a visiting nurse to his home, to show him how best to ventilate his rooms, and to bring in all the other members of the family to the dispensary for examination. No less than from _one-fourth to one-half_ of the children in these families are found to be already infected with tuberculosis. The places where we look for our new cases of tuberculosis now are in the same rooms or houses with old ones. A careful consumptive is no source of danger; but alas, not more than one in three are of that character.

[Ill.u.s.tration: A SIGN THAT OUGHT NOT TO BE NECESSARY

But, being necessary, it should be strictly respected and obeyed.]

It has been estimated that any city or county could provide proper camps, or sanatoria, to accommodate all its consumptives and cure two-thirds of them in the process, support their families meanwhile, and stop the spread of the disease, at an expense not to exceed five dollars each per annum for five years, rapidly diminishing after that. If this were done, within thirty years consumption would probably become as rare as smallpox is now. Some day, when the community is ready to spend the money, this will be done, but in the mean time, we must attack the disease by slower and less certain methods.