CLOTHING.--Clothing was originally used for purposes of ornament. Desire for protection from cold and dampness came later. The amount of clothing required varies greatly according to individual needs and habits, but it is increasingly recognized that light clothing is best, provided that the wearer is really protected from cold. Clothing should be porous in order to allow ventilation of the body, supported so far as possible from the shoulders, and clean and well aired. Dampness favors the growth of germs which may cause irritation of the skin.

Clothing should not constrict the body or hamper its movements. Perhaps the worst health menace for which clothing is to blame comes from the high heeled shoes on which many women prefer to limp through life. From the health standpoint shoes are of great importance. Bad shoes are responsible for many cases of flat feet, whose muscles have degenerated through non-use, and for much so-called "rheumatism," which is merely the protest of abused muscles. Bad shoes also, by distorting the feet, prevent comfortable walking, which is the only out-of-door exercise readily available for the vast majority of people; and still worse, the resulting unnatural position of the body sometimes has serious consequences by bringing injurious strains on other muscles and organs.

FOOD.--Two distinct problems are encountered here: the problem of nutrition, and the problem of preventing sickness. Nutrition, or proper feeding, is a subject beyond the scope of this book; it is nevertheless one of the most important, if not the most important, factor in maintaining health. Food preparation and care of children, the two most important functions of the home, are unfortunately relegated to the least intelligent and least interested members of most households in which servants are employed.

Most American families eat too much protein food, such as meat and eggs.

Excess of protein probably leads to degeneration of tissues, and plays a part in causing the degenerative diseases already mentioned. Habit is important here as in other ways of living, but cereals and vegetables should in large measure make up the diet of sedentary persons and indeed of everyone in warm weather.

The amount of food required in 24 hours depends on many factors: age, height, weight, occupation, season, and habit. Underweight and overweight are both abnormal conditions; probably the latter is the more easily remedied. Both require the advice of a physician. Rapid reduction of weight involves certain dangers, especially for persons with weak hearts.

Food may cause sickness either because it is in itself harmful, or because it carries disease germs. Meat from diseased animals should be destroyed before it reaches the market, but bacterial activities in food originally wholesome may form in it poisonous substances.

The chief diseases known to be carried by food, water, or milk are typhoid fever, paratyphoid, dysentery and other diarrhal diseases, scarlet fever, diphtheria, septic sore throat, and tuberculosis. The sole problem here is to keep human and animal excretions out of food, water, and milk. Since thorough cooking kills disease germs, danger arises chiefly from raw foods. All fruits and vegetables eaten raw should first be thoroughly washed.

Water is essential to health. At least three pints should be taken daily, the amount varying somewhat according to diet, exercise, temperature, and so forth. Most persons drink too little water.

Cities and towns should of course have public supplies of pure water.

Contamination of water, when it occurs, is caused chiefly by sewage from cesspools, privies, and drains. All well or spring water must be constantly watched and Boards of Health are always ready to examine samples of water and to report whether it is safe to drink. At the present time a porcelain filter is the only satisfactory kind for a household, but many domestic filters are so badly cared for that in actual practice they are worse than none. Danger from a filter containing an acc.u.mulation of impurities is greater than the danger from most ordinary water supplies. Boiling water for ten minutes kills all pathogenic germs, but this method is inconvenient on a large scale and is not practical for continued family use.

Every effort should be made to insure a regular supply of pure water in every house. It is not satisfactory to have two kinds, one for drinking and one for other purposes, since mistakes are sure to be made, especially by children. Some families who use only bottled or filtered water for drinking purposes habitually run the risk involved in using impure water from the tap for cleaning the teeth.

Freezing destroys most germs, but ice is not necessarily free from bacterial life, and should be used in drinking water only when known to be free from impurities. Neither does freezing milk or cream necessarily kill germs that may be contained in it.

Raw milk plays so important a part in the spread of disease that its fitness for human consumption is open to serious question. Certified milk, where obtainable, is safe but expensive. Boiled milk is safe, but changed in taste and to some extent in quality. If milk is heated to 142-145 F. and kept at that temperature for 30 minutes all disease germs in it are killed. This process, called pasteurization, renders milk safe. The objection is sometimes made that continued use of pasteurized milk for infants causes scurvy, but in New York City where over 90 per cent. of the milk is pasteurized no increase in scurvy has been noticed, while a large diminution in deaths of infants from diarrhal diseases has resulted, as in all cities where pasteurization is required.

The following is a simple method for pasteurizing a quart bottle of milk. If the directions are exactly followed the milk will be pasteurized at the end of the process; no thermometer need be used. To prevent the bottle from breaking, it is first warmed by placing it for a few minutes in a pail of warm water.

"From the results of the experiments it was concluded that any housewife can pasteurize a one quart bottle of milk by:

1. Boiling 2 quarts of water in a large agate saucepan; or better

2. Boiling 2 quarts of water in a 10 pound tin lard pail, placing the slightly warmed bottle from the ice chest in it, covering with a cloth and setting in a warm place. At the end of one hour the bottle of milk should be removed and chilled promptly. The water must be boiled in the container in which the pasteurization is to be done."--(Ruth Vories, in "Health News," Sept., 1916.)

ELIMINATION.--Careful attention should be paid to elimination through the bowels and kidneys. Constipation is responsible for many common ailments; among them are headache, disinclination to work, irritable temper, and lowered resistance. If long continued, constipation becomes serious both from congestion and displacement of pelvic organs, and from absorption over a considerable time of even small amounts of the poisonous substances resulting from decomposition of food in the large intestine. The bowels can best be regulated by diet, water, exercise, and habit. The habitual use of cathartic and laxative drugs is most unwise, because they tend to aggravate the trouble. Moreover the habitual and continued use of injections and "internal baths" is harmful, and would not be considered necessary if bran and coa.r.s.e flour and vegetables were subst.i.tuted for concentrated foods. Greed, laziness, and lack of intelligence lead most persons suffering with constipation to prefer pills to the restraints demanded by hygienic living. The habit of evacuating the bowels at a regular time, if established in early childhood and rigidly adhered to, will prevent constipation among most healthy people. Any person who thinks drugs necessary should consult a physician, and be prepared to follow the regime he advises over a considerable period of time and at the cost of some self-denial.

For healthy people, voiding urine presents no difficulty if a sufficient amount of water is taken; but some persons reduce the amount of liquid taken in order to escape the inconvenience of urination. This practice is harmful, and may involve insufficient cleansing of the entire system.

If frequent urination disturbs sleep, liquids may be withheld during the evening; but the total amount of water taken in 24 hours should not be diminished.

REST AND FATIGUE.--A fatigued person is a poisoned person. Muscular exertion burns the fuel const.i.tuents of the body, as we recognize by the greater heat generated within us during muscular exertion. Waste products, resulting from this burning process, acc.u.mulate if not removed, and clog the body in somewhat the same way that ashes and cinders clog a furnace. The fatigued person remains fatigued, consequently, until the acc.u.mulations of waste matter are removed by the normal action of the lungs, skin, and kidneys.

Fatigue is caused by both mental and physical work, and when excessive, affects the nervous system most disastrously. The body can and should respond to occasional extra drafts on strength and endurance; its flexibility and power of adjusting to varying conditions may even be stimulated thereby. But even slight fatigue, if continued and especially if a.s.sociated with anxiety or worry, has caused many nervous and mental breakdowns.

Work carried beyond the point of normal fatigue requires a proportionately longer time for recovery. For example, if the point of fatigue has been reached by a certain finger muscle after 15 contractions, and if half an hour is required to rest it completely, one might suppose that one hour would rest it after 30 contractions. This is not so, however; after 30 contractions 2 hours are required, or 4 times as much rest for twice the amount of work, if continued beyond the point of fatigue. Laboratory experiments and experience alike show that this principle holds true in other forms of fatigue. Thus the output of factories has been shown in many instances to be greater, other things being equal, when operatives work 8 hours a day than when they work longer. Excessive hours in any kind of work are the poorest economy.

Fatigue is increased in direct proportion not only to muscular exertion but also to the amount of speed, complexity, responsibility, monotony, noise, and confusion involved in an occupation. Ability to bear fatigue differs greatly with different people, as ability varies to bear other kinds of strain. Rest at night and on Sunday, and the annual vacation should be enough to keep a person in good condition. If not, there is probably something wrong with the worker's health, the nature of his work, or his adaptation to his particular kind of work. This statement is not only true of persons regularly employed, but of those living at home, including children in school, women in "society," and especially mothers of families.

SLEEP.--A sufficient amount of sleep is essential to health, but individual requirements vary widely. Each person should know and regard his own need, and children and young people should be obliged to go to bed early. Ability to sleep is largely habit; good habits should be formed and continued. Sleep-producing drugs should never be taken, except by a doctor's prescription.

RECREATION.--Owing to the speed, complexity, and worry of modern life among all cla.s.ses, and to the monotony of work in industry, recreation has become a matter of vital importance for everyone. Some muscular activity, preferably in the open air, is needed by every healthy person.

Recreation should be as unlike the regular occupation as possible: going to the theatre, for example, is not the best exercise for sedentary workers employed all day in artificially lighted offices. The element of pleasure is essential. Hoisting dumb-bells purely from conscientious motives is seldom beneficial, and is generally soon abandoned.

The part played by habit in matters of health is often overlooked.

Although the body adjusts itself to widely varying conditions and even to unfavorable ones, the importance of forming desirable habits cannot be overemphasized. Sudden or radical changes in living, however, particularly among people no longer young, may play havoc. New and violent systems of exercise, weight reduction, and food fads forced on families by enthusiastic discoverers involve considerable risk.

Many elements enter into health; in no single one is found hygienic salvation. Temptation always exists to emphasize one element at the expense of others. For instance, people who insist upon overventilating rooms regardless of others' comfort may themselves be utterly careless in regard to necessary sleep, and more than one fastidiously clean person has disregarded the highly unclean condition of constipation. To maintain sound health only a rational program will suffice: properly balanced work and play, sleep and food and all other elements must be included in due proportion. And over-anxious health seekers might well remember that health is not so much an end in itself, as a means to a happy and productive life; even in concern over health, it is possible for him that saveth his life to lose it.

EXERCISES

1. Explain the difference between an hereditary disease and hereditary susceptibility to a disease. How may hereditary susceptibility to a disease be combatted?

2. What are the essentials of good ventilation?

3. What is the proper temperature for a living room? What are the effects of higher temperatures? Of lower temperatures?

4. Describe methods for maintaining household cleanliness.

5. Discuss the importance from the point of view of health, of dust; of insects; of garbage; of sewage.

6. What principles should guide one in deciding whether a certain water supply is safe to use for drinking purposes? What are the dangers of impure water? How can impure water be rendered safe?

7. What diseases may be carried by milk? How can milk be rendered safe?

8. Explain the health aspects of personal cleanliness.

9. What care should be given the teeth and mouth? Why?

10. What bad results frequently follow constipation? How should constipation be remedied?

11. Name seven factors that are important in causing fatigue. Why is it uneconomical to continue work, either physical or mental, beyond the point of fatigue?

12. What facilities for recreation, especially in the open air, does your community provide for little children? For school children? For working boys and girls? For grown people?

FOR FURTHER READING

Health and Disease--Roger I. Lee, Introduction and Chapters I, III-V, VII-IX.

How to Live--Fisher and Fisk, Chapters I, III-V.

The Human Mechanism--Hough and Sedgwick, Chapters V, XXII-XXIX.

Disease and Its Causes--Councilman, Chapters X, XII.

Fatigue and Efficiency--Goldmark, Chapters II, III.

Preventive Medicine and Hygiene--Rosenau.