Patients too weak to use a cup should use moist rags, which should at once be burned. If cloths are used they should not be carried loose in the pocket, but in a waterproof receptacle (tobacco pouch), which should be frequently boiled. A consumptive should never swallow his expectoration.

A consumptive should have his own bed, and, if possible, his own room. The room should always have an abundance of fresh air--the window should be open day and night. The patient's soiled wash-cloths and bed linen should be handled as little as possible when dry, but should be placed in water until ready for washing.

Rooms should be cleaned daily, but in order to prevent the raising of dust, all floors must be well sprinkled before sweeping, and all dusting, etc., done with damp cloths.

If the matter coughed up be rendered harmless, a consumptive may frequently not only do his usual work without giving the disease to others, but may also thus improve his own condition and increase his chances of getting well.

Rooms which have been occupied by consumptives should be thoroughly cleaned, scrubbed, and whitewashed, painted, or papered before they are again occupied. Carpets, rugs, bedding, etc., from rooms which have been occupied by consumptives, should be disinfected. Such articles, if the Department of Health be notified, will be sent for, disinfected, and returned to the owner free of charge, or, if he so desires, they will be destroyed.

When consumptives move they should notify the department of health. Consumptives are warned against the many widely advertised cures, specifics, and special methods of treating consumption. No cure can be expected from any kind of medicine or method except the regularly accepted treatment, which depends upon pure air, an out-of-door life, and nourishing food.

Consumptives having an opportunity of entering a sanatorium, should do so at once.

WHEN DELAY IS DANGEROUS.--Inasmuch as it is mother's duty to watch over the health and the efficiency of all members of the household, she would do well to establish a rule to err on the safe side in every case of sickness. That rule should be never to delay too long in obtaining medical aid.

In nearly twenty years of active general practice I have had hundreds of "hurry" calls to "come at once." In not over a dozen of these calls did any of the cases demand immediate attention from a medical standpoint.

Most of them, however, should have had earlier aid. People wait too long in the hope of spontaneous recovery, and when, instead of recovery, they realize that the patient is quite sick, they become conscience-stricken and send a "rush" call for the doctor. After delaying from day to day they decide to get professional advice and send a messenger for a physician with instructions to "go for another if he can't come at once." It is imperative he should come instantly, though they have delayed for a week in requesting his services. Every physician has these calls every week of his life. If an individual has survived a week's neglect, it is quite within reason to a.s.sume that he will survive another hour,--and during that hour the physician may have time to complete whatever he may be doing when the call comes.

If you have been guilty of bad judgment in not sending earlier for aid, don't add discourtesy to your sins. The world demands of us, and every person has the right to expect, a certain degree of consideration and courtesy. If we do not give it, we only harm ourselves because the lack of cultivation is a detriment which limits growth and happiness. The degree of attainable happiness is limited by the degree of "goodness"

that is in us. If you are not considerate, depend upon it, there is an element of happiness which escapes you, and you cannot attain it till you are considerate.

It is inconsiderate and it is discourteous to send an immediate demand for a physician "to come at once" if there is no urgent need for his services, and if you have just been inspired for aid after a week's blindness, there is no urgency in the matter. A call in an hour would do just as well.

Take the following case: A mother discovers a small quant.i.ty of blood in the diaper of her two months old baby. There is a larger quant.i.ty in the afternoon and she decides to give the baby a dose of castor oil. During the night it slept fitfully and in the morning it has a large stool as a result of the castor oil and there is a large quant.i.ty of blood in the stool. She sends a "rush" call for a physician. The physician discovers the following facts: The baby is being artificially fed; it has been vomiting its food for a week; its stools have been green, foul and contained mucus; it had a fever for a number of days; it has lost much weight and looked pale and sickly. The physician obtained this history from the mother--she therefore knew the baby's condition. Why did she delay sending for a physician? How sick did she want the child to be before the need for aid seemed justifiable to her? Why didn't the sight of blood in the stool suggest the need of a.s.sistance? What do the public expect of physicians in such cases? But why ask questions? Many mothers will doubt the existence of such a mother as is described above. They need not; she was one of my own patients. I do not understand such women; I only know that such mothers exist in quite large numbers. This particular mother has other children; she is a good housekeeper, is personally attractive, and is thought well of in the community. If such seemingly heartless conduct can spring from such a source is it not evidence of the fact that the average mother needs instruction, needs education, and does it not bespeak the need of eugenics being sown broadcast throughout the land?

Delays are dangerous in all sicknesses that last, despite a thorough cleaning out of the bowels. To wait, hoping that "things will change,"

is bad practice. It is unjust to the medical profession, and it is infinitely more unjust to the victim.

There are two kinds of surgical operations--those of choice and those of necessity.

Every one knows about the operations of necessity, most of which must be performed as a result of accident, but few people understand the dangers of delaying what are termed "operations of choice." These are for such conditions as appendicitis, cancer, and stomach and bowel troubles.

Delaying an operation of choice lessens the chances of living, and really makes an operation of necessity with fewer chances of recovery than from the operations that must promptly follow injuries.

When we feel that an operation is needed, or are in doubt about it, the wise thing to do is to consult medical authority. Then, if it is found there should be an operation, there is plenty of time to make every arrangement. We can begin to diet, which is generally necessary and there is every chance for speedy recovery.

If a man breaks a leg and it has been set badly, the surgeons do not rebreak it at once, but allow it to heal and the patient to regain his strength, when it is again broken and reset properly. This is an operation of choice.

But if a terrible fracture of the leg results from a fall, with the shattered bone protruding, an operation of necessity must follow to mend torn arteries.

It has been learned through recently gathered statistics that about thirty per cent. of the people operated on for appendicitis die simply because they delay the operation. This should have been an operation of choice, when every arrangement could have been made long beforehand; the delay makes it an operation of necessity, with the victim in such poor physical condition that he has not half the strength to recover that he would have had if he had been wise enough to consult a physician when he first suspected that something was wrong.

These same statistics go to show that fully 99 per cent. of the appendicitis cases, when taken in time, are cured by means of the operation, thus affording the strongest proof of the folly of delaying such things.

The total number of deaths from appendicitis each year, due to delay in operating, is greater than the number of deaths during the Spanish-American War. There are instances where the doctors do not advise operations soon enough.

Above all things, when a reputable physician advises operation, do not think you know more than the physician, but have the operation performed at once. Nine times out of ten this will be the means of saving your life.

WHAT TO EAT AND WEAR IN HOT WEATHER

No faith should be placed in the so-called "hot-weather" foods. The cereals and other manufactured foods advertised as possessing marvelous qualities, have in reality no advantage. Some of them have more or less value as ordinary food, but they certainly possess no unusual superiority. Home cooking is the best in summer or any other time.

Great care should be taken to keep the system in the best possible condition. This will prove the most effectual safeguard against the heat. Some foods do not agree with certain individuals, and these should be carefully avoided in summer. Every person will have to judge for himself in this matter. Otherwise the diet should be balanced carefully so that enough, and yet not too much, is eaten. As much fruit as possible should be eaten, and meat never more than once a day. It is not well, however, to omit it entirely.

Food sustains the body through the heat it generates chemically, and it is therefore impossible to eliminate a certain heating effect. If the system is kept normal, however, and the diet properly balanced, this should not be felt. Work is performed by the body and energy expended.

This must be replaced with the heat value of food. A certain amount of fat, starch, and the other const.i.tuents of a well-balanced diet is essential.

Fat meats and other forms of fat are the most heating of all foods and may be minimized in summer. The amount of food necessary is, of course, largely governed by the nature of the work performed by the individual.

Brain workers can eat very little in the morning and during the day, reserving until evening the single heavy meal. If they have been doing this the year around they probably will be cooler during the morning and afternoon if a light breakfast and luncheon are eaten. It is not well, however, to make any radical change from one's regular habits.

Manual workers require more food, and the heavy meal had best be eaten in the middle of the day. All three meals should be substantial. There is no danger of eating too much if the system is not overburdened.

Not only is pork rich and fat, and therefore very heating, but it is the quickest of all meats to spoil. Veal also spoils very quickly if not kept at the proper temperature. Of all meats mutton has the best keeping qualities. Beef also keeps well and is a safe meat to eat in summer.

Flies are dangerous under any conditions, but particularly should they be avoided where meat is kept. The bacteria they carry thrive particularly on meat, and therefore are apt more rapidly to multiply than if deposited on some other food. Care should be taken to buy meat only from places where adequate protection is provided against flies.

It is of the greatest importance to keep the meat at a uniform cold temperature. It should not be allowed to become heated, and then cooled again. Some meat shops still keep the meat on open counters or hooks and replace it in the refrigerators at the close of the day. These shops should be carefully avoided. Modern methods provide gla.s.s-covered refrigerating counters which keep the meat cool while it is on display.

Meat should be kept at as low a temperature as possible. The ordinary refrigerator is at a little above freezing and temperatures at or below zero are preferable.

SCIENTIFIC DRESSING.--By dressing scientifically it is possible to minimize the effect of the heat. The heat from the sun must be kept away from the body and the heat generated by the body permitted to escape.

These results can best be accomplished by having the clothes very loose fitting, so as to leave ample air s.p.a.ce, and by having the outer clothes of a good non-conductor of heat. The cloth, of course, should be as light in weight as possible, but it is more important to have it a good non-conductor of heat and of porous weave.

Not enough attention is paid to the selection of colors for resisting the heat. Two cloths identical except in color will show a great difference in the comparative amount of heat they let through. Light shades should be chosen, but care should be taken to see that they are not glaring, so as to irritate the eye and increase the mental effect of heat.

Linen and silk are better non-conductors than wool. And the weave of a cloth has a great deal to do with the amount of heat it lets through.

Smooth, hard weaves absorb much less heat than fuzzy weaves. For this reason, serge is much cooler than worsted of the same shade and weight.

A mistake is often made, however, in getting serge of a dark blue. It should be of as light a color as possible; gray is much cooler than blue. A white serge is much cooler than white flannel, because it is less fuzzy.

Linen is much cooler than woolens, because it is a better non-conductor and is of more porous weave. The linen thread is rough, which causes inequalities in the weave, permitting a more thorough circulation of air. Cotton is a still better non-conductor than linen, and would be preferable for summer clothes but for the fact that it neither wears nor holds its shape so well.

Mohair is very light in weight and cool looking. As a matter of fact, however, it is a fairly good conductor of heat, is closely woven, and usually comes in dark shades. It is a woolen cloth, and any woolen has its threads woven more closely on account of the process of manufacture than linens, cotton, and silk cloths. Linen is perhaps the best material for summer wear. It is porous in weave, light in color, and of fairly light weight.

It is well to remember that the safety valve of the body in hot weather is the evaporation of perspiration, not the act of perspiring. If the hand is put in a glove, for instance, it will perspire much more than if in the open air, but it will not be as cool. It is the evaporation that is a cooling process. If the perspiration is absorbed it cannot evaporate. That is why loose fitting undergarments are cooler than tight ones. It is also the reason why cotton is cooler next to the skin than linen or silk; it absorbs moisture less freely.

DRINK PLENTY OF WATER.--Water, and a great deal of it, is desirable at any time during the summer. It should be drunk freely during the day.

Lemonade also is good, the slight acid being an aid to digestion. It is best to have beverages cooled only to a moderate temperature. Ice water is not bad, but it would be preferable if it were not at so extreme a temperature. Ice is resorted to only as a convenient means of securing a palatable temperature; the system does not crave extreme cold. Water at the temperature of the air is nauseating, so ice is put into it and the other extreme secured. Sixty degrees is the ideal temperature for drinking water. If this could be conveniently obtained it would be preferred to a greater degree of cold. Not only is it less harmful to the system, but it is more satisfying and thirst-quenching. Water put in bottles and left in a refrigerator until properly chilled is the best way of preparing a summer beverage. When any beverage is sufficiently cold to cause a pain in the head or throat when drinking it the result may be harmful. Cold water poured on the wrist or head has a cooling effect and tends to reduce the ice water habit.

If one could afford it, it would be well to drink nothing but mineral water in the summer. Not only does it a.s.sure purity, but the gas is an aid to digestion and serves to render the water more palatable. This results in more of it being drunk than if it were flat water, and it is desirable to drink as much water as possible in hot weather. By mineral water I mean carbonated bottled waters intended for table use. Care should be taken that the water is only lightly impregnated with salt.

It is much safer to drink a well-known water. The water may not be bottled at the spring or it may be bottled under unsanitary conditions.

In many cases mineral water is not all that it should be in cleanliness.

Unless one is sure of the purity of a bottled water good hydrant water supplied through the city pipes is safer.

In traveling, however, and at summer resorts it would be well to drink nothing but mineral water of a well-known brand. Only by doing this and by being certain that the bottle has not been refilled can one be safe.

The supplied on trains and in resorts frequently is not as pure as that supplied in large cities.

On the whole, however, mineral water has no particular advantage over ordinary water except that the well-known brands are sure to be pure, and the carbonization makes it more tasty and so increases the amount consumed. It is much safer and more healthful to drink a well-known mineral water than the so-called soft drinks, many of which are unclean and harmful.