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How to Live - Rules for Healthful Living Based on Modern Science
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PREVENT LIFE-WASTE—UPBUILD NATIONAL VITALITY



Directors

Hon. William H. Taft Henry H. Bowman Francis R. Cooley Robert W. de Forest Irving Fisher Eugene Lyman Fisk Harold A. Ley Elmer E. Rittenhouse Charles H. Sabin Frank A. Vanderlip

HON. WILLIAM H. TAFT Chairman, Board of Directors

ELMER E. RITTENHOUSE President

GEN. W. C. GORGAS Consultant, Sanitation

PROF. IRVING FISHER Chairman, Hygiene Reference Board

EUGENE L. FISK, M.D. Director of Hygiene

HAROLD A. LEY Vice-president and Treasurer

JAMES D. LENNEHAN Secretary

The Institute was established by a group of scientists, publicists, and business men, who desired to provide a self-supporting central institution of national scope devoted to the science of disease prevention—a responsible and authoritative source from which the public might draw knowledge and inspiration in the great war of civilization against needless sickness and premature death.

LIFE EXTENSION INSTITUTE, Inc. 25 WEST 45th STREET :: NEW YORK CITY



HOW TO LIVE







HOW TO LIVE

RULES FOR HEALTHFUL LIVING BASED ON MODERN SCIENCE

AUTHORIZED BY AND PREPARED IN COLLABORATION WITH THE HYGIENE REFERENCE BOARD OF THE LIFE EXTENSION INSTITUTE, INC.

BY

IRVING FISHER, Chairman, PROFESSOR OF POLITICAL ECONOMY, YALE UNIVERSITY

AND

EUGENE LYMAN FISK, M.D., DIRECTOR OF HYGIENE OF THE INSTITUTE

NINTH EDITION

FUNK & WAGNALLS COMPANY NEW YORK AND LONDON 1916



COPYRIGHT, 1915, BY FUNK & WAGNALLS COMPANY (Printed in the United States of America.)

* * * * *

Published, October, 1915 Second Edition, November, 1915 Third Edition, December, 1915 Fourth Edition, March, 1916 Fifth Edition, April, 1916 Sixth Edition, May, 1916 Seventh Edition, June, 1916 Eighth Revised Edition, September, 1916 Ninth Edition, September, 1916



FOREWORD

To one who has been an eye-witness of the wonderful achievements of American medical science in the conquest of acute communicable and pestilential diseases in those regions of the earth where they were supposed to be impregnably entrenched, there is the strongest possible appeal in the present rapidly growing movement for the improvement of physical efficiency and the conquest of chronic diseases of the vital organs.

Through the patient, intelligent and often heroic work of our army medical men, and the staff of the United States Public Health Service, death-rates supposedly fixed have been cut in half.

While it is true that to the public mind there is a more lurid and spectacular menace in such diseases as small-pox, yellow fever and plague, medical men and public health workers are beginning to realize that, with the warfare against such maladies well organized, it is now time to give attention to the heavy loss from lowered physical efficiency and chronic, preventable disease, a loss exceeding in magnitude that sustained from the more widely feared communicable diseases.

The insidious encroachment of the chronic diseases that sap the vitality of the individual and impair the efficiency of the race is a matter of increasing importance. The mere extension of human life is not only in itself an end to be desired, but the well digested scientific facts presented in this volume clearly show that the most direct and effective means of lengthening human life are at the same time those that make it more livable and add to its power and capacity for achievement.

Many years ago, Disraeli, keenly alive to influences affecting national prosperity, stated: "Public Health is the foundation on which reposes the happiness of the people and the power of a country. The care of the public health is the first duty of a statesman." It may well be claimed that the care of individual and family health is the first and most patriotic duty of a citizen.

These are the considerations that have influenced me to co-operate with the life extension movement, and to commend this volume to the earnest consideration of all who desire authoritative guidance in improving their own physical condition or in making effective the knowledge now available for bringing health and happiness to our people.

WM. H. TAFT. New Haven, June 12, 1915.



PREFACE

The purpose of this book is to spread knowledge of Individual Hygiene and thus to promote the aims of the Life Extension Institute. These may be summarized briefly as: (1) to provide the individual and the physician with the latest and best conclusions on individual hygiene; (2) to ascertain the exact and special needs of the individual through periodic health examinations; (3) to induce all persons who are found to be in need of medical attention to visit their physicians.

A sad commentary on the low health-ideals which now exist is that to most people the expression "to keep well" means no more than to keep out of a sick-bed. Hitherto, the subject-matter of hygiene has been considered in its relation to disease rather than to health. In this manual, on the other hand, it is treated in its relation to (1) the preservation of health; (2) the improvement in the physical condition of the individual, and (3) the increase of his vitality. In short, the objects of the manual are positive rather than negative. It aims to include every practical procedure that, according to the present state of our knowledge, an athlete needs in order to make himself superbly "fit," or that a mental worker needs in order to keep his wits sharpened to a razor-edge. For this reason some suggestions, which might otherwise be regarded as of minor importance, have been included and emphasized. While it is true that a moderate infraction of some of the minor rules of health is not inconsistent with maintaining good health in the sense of keeping out of a sick-bed, such infraction, be it ever so moderate, is utterly inconsistent with good health in the sense of attaining the highest physical and mental efficiency and power.

Future advances of knowledge will doubtless occasion additions to, or modifications of, the conclusions stated herein, and these will form the subject of subsequent publications by the Institute.

In order that the Institute may have at its disposal the latest and most authoritative results of scientific investigations, its Hygiene Reference Board was created. The present book is the first general statement of the conclusions of this Board after a year of careful consideration. These conclusions are the joint product of the members of the Board, with the active co-operation of the Director of Hygiene of the Institute. They may fairly be said to constitute the most authoritative epitome thus far available in the great, but hitherto neglected, realm of individual hygiene.

The Chairman of the Board has exercised the function of editor, and is responsible for the order and arrangement of the material.

Friends of the Institute may help its work by spreading the ideas given in the following pages and by increasing the number of its readers. Such profits as may be received by the Institute from the sale of this book will be devoted to further philanthropic effort by the Institute.

IRVING FISHER, EUGENE L. FISK.

New York, Sept., 1915.



CONTENTS

PAGE

INTRODUCTION 1

CHAPTER I

AIR

SECTION 1. HOUSING 7 2. CLOTHING 14 3. OUTDOOR LIVING 18 4. OUTDOOR SLEEPING 20 5. DEEP BREATHING 24

CHAPTER II

FOOD

1. QUANTITY OF FOOD 28 2. PROTEIN FOODS 35 3. HARD, BULKY, AND UNCOOKED FOODS 40 4. THOROUGH MASTICATION 44

CHAPTER III

POISONS

1. CONSTIPATION 51 2. POSTURE 57 3. POISONS FROM WITHOUT 64 4. TEETH AND GUMS 78

CHAPTER IV

ACTIVITY

1. WORK, PLAY, REST AND SLEEP 89 2. SERENITY AND POISE 105

CHAPTER V

HYGIENE IN GENERAL

1. THE FIFTEEN RULES OF HYGIENE 119 2. THE UNITY OF HYGIENE 121 3. THE OBSTACLES TO HYGIENE 126 4. THE POSSIBILITIES OF HYGIENE 135 5. HYGIENE AND CIVILIZATION 143 6. THE FIELDS OF HYGIENE 157

SUPPLEMENTARY NOTES ON SPECIAL SUBJECTS

1. NOTES ON FOOD 171 2. NOTES ON OVERWEIGHT AND UNDERWEIGHT 212 3. NOTES ON POSTURE 221 4. NOTES ON ALCOHOL 227 5. NOTES ON TOBACCO 250 6. AVOIDING COLDS 272 7. SIGNS OF INCREASE OF THE DEGENERATIVE DISEASES 281 8. COMPARISON OF DEGENERATIVE TENDENCIES AMONG NATIONS 286 9. EUGENICS 293

INDEX 325



HYGIENE REFERENCE BOARD

OF THE LIFE EXTENSION INSTITUTE, Inc.

IRVING FISHER, Chairman

Professor of Political Economy Yale University

Statistics

WILLIAM J. HARRIS, Federal Trade Commission, United States Government.

CRESSY L. WILBUR, M.D., Director, Division of Vital Statistics, Dept. of Health, State of New York.

WALTER F. WILLCOX, Professor of Economics and Statistics, Cornell University.

Public Health Administration

HERMANN M. BIGGS, M.D., Commissioner of Health, State of New York.

RUPERT BLUE, M.D., Surgeon General, U. S. Public Health Service.

H. M. BRACKEN, M.D., Secretary Board of Health, State of Minnesota.

J. B. GREGG CUSTIS, President Board of Medical Supervisors, District of Columbia.

SAMUEL G. DIXON, M.D., Commissioner of Health, State of Pennsylvania.

OSCAR DOWLING, M.D., President Board of Health, State of Louisiana.

JOHN S. FULTON, M.D., Secretary Dept. of Health, State of Maryland.

S. S. GOLDWATER, M.D., Supt., Mt. Sinai Hospital, New York.

WILLIAM C. GORGAS, Major General U. S. Army.

CALVIN W. HENDRICK, Chief Engineer, Sewerage Commission of Baltimore.

J. N. HURTY, M.D., Secretary Board of Health, State of Indiana.

W. S. RANKIN, M.D., Secretary and Treasurer, Board of Health, State of North Carolina.

THEO. B. SACHS, M.D., President The Chicago Tuberculosis Institute.

JOSEPH W. SCHERESCHEWSKY, M.D., U. S. Public Health Service.

GUILFORD H. SUMNER, M.D., Secretary—Executive Officer, Dept. of Health and Medical Examiners, State of Iowa.

GEORGE C. WHIPPLE, Professor Sanitary Engineering, Harvard University.

C. E. A. WINSLOW, Professor of Public Health, Yale Medical School.

Medicine and Surgery

LEWELLYS F. BARKER, M.D., Professor of Medicine, Johns Hopkins University.

GEORGE BLUMER, M.D., Dean Tale Medical School.

GEORGE W. CRILE, M.D., Professor Clinical Surgery, Western Reserve University.

DAVID L. EDSALL, M.D., Professor Clinical Medicine, Harvard University.

HENRY, B. FAVILL, M.D., Professor Clinical Medicine, Rush Medical College.

J. H. KELLOGG, M.D., Superintendent Battle Creek Sanitarium.

S. ADOLPHUS KNOPF, M.D., Professor of Medicine, Department of Phthisiotherapy, New York Post Graduate Medical School.

WILLIAM J. MAYO, M.D., Ex-President American Medical Association.

VICTOR C. VAUGHAN, M.D., Dean, Dept. of Medicine and Surgery, University of Michigan, Ex-President American Medical Association.

HUGH HAMPTON YOUNG, M.D., Assoc. Professor of Urological Surgery, Johns Hopkins University and Hospital.

Chemistry, Bacteriology, Pathology, Physiology, Biology

JOHN F. ANDERSON, M.D., Director Hygienic Laboratory, United States Government.

HENRY G. BEYER, M.D., Medical Director, U. S. Navy.

WALTER B. CANNON, M.D., Professor of Physiology, Harvard University.

RUSSELL H. CHITTENDEN, Professor of Physiological Chemistry, Director Sheffield Scientific School, Yale University.

OTTO FOLIN, Professor of Biological Chemistry, Harvard Medical School.

M. E. JAFFA, M.S., Professor of Nutrition, University of California.

LAFAYETTE B. MENDEL, Professor of Physiological Chemistry, Sheffield Scientific School, Yale University.

RICHARD M. PEARCE, M.D., Professor of Research Medicine, University of Pennsylvania.

MAZYCK P. RAVENEL, M.D., Director Laboratory of Hygiene, Professor of Preventive Medicine and Bacteriology, University of Missouri.

LEO P. RETTGER, Professor of Bacteriology and Hygiene, Sheffield Scientific School, Yale University.

M. J. ROSENAU, M.D., Professor of Preventive Medicine, Harvard Medical School.

WILLIAM T. SEDGWICK, Professor of Biology and Public Health, Massachusetts Institute of Technology.

HENRY C. SHERMAN, Professor of Food Chemistry, Columbia University.

THEOBALD SMITH, M.D., Director Division of Animal Pathology, Rockefeller Institute for Medical Research.

CHARLES W. STILES, M.D., U. S. Public Health Service; Scientific Secretary International Health Commission.

A. E. TAYLOR, M.D., Professor Physiological Chemistry, University of Pennsylvania.

WILLIAM H. WELCH, M.D., Professor of Pathology, Johns Hopkins University; President Board of Health, State of Maryland.

Eugenics

ALEXANDER GRAHAM BELL, M.D., Board of Scientific Directors, Eugenics Record Office.

C. B. DAVENPORT, Director Carnegie Station for Experimental Evolution; Director Eugenics Record Office.

DAVID STARR JORDAN, Chancellor Leland Stanford Junior University; Chief Director World Peace Foundation.

ELMER E. SOUTHARD, M.D., Professor of Neuropathology, Harvard Medical School; Pathologist to Massachusetts State Board of Insanity.

Organized Philanthropy

MRS. S. S. CROCKETT, Ex-Chairman Committee on Health, General Federation of Women's Clubs.

HENRY W. FARNAM, Professor of Economics, Yale University.

LEE K. FRANKEL, 6th Vice-President and Head of Welfare Department, Metropolitan Life Insurance Company.

LUTHER H. GULICK, M.D., President Camp Fire Girls of America.

THOMAS N. HEPBURN, M.D., Secretary Connecticut Society for Social Hygiene.

WICKLIFFE ROSE, Director International Health Commission.

WM. JAY SCHIEFFELIN, Chairman Executive Committee, Committee of One Hundred on National Health.

MAJOR LOUIS LIVINGSTON SEAMAN, M.D., President The China Society.

WILLIAM F. SNOW, M.D., General Secretary, The American Social Hygiene Association, Inc.

LAWRENCE VEILLER, Secretary and Director, National Housing Association.

Educational

SAMUEL HOPKINS ADAMS, Author.

W. H. BURNHAM, Professor of Pedagogy and School Hygiene, Clark University.

CHARLES H. CASTLE, M.D., Editor Lancet Clinic.

W. A. EVANS, M.D., Professor Sanitary Science, Northwestern University Medical School; Health Editor, Chicago Tribune.

BURNSIDE FOSTER, M.D., Editor St. Paul Medical Journal.

FREDERICK R. GREEN, M.D., Secretary Council on Health and Public Instruction, American Medical Association.

NORMAN HAPGOOD, Editor Harper's Weekly.

ARTHUR P. KELLOGG, Managing Editor, The Survey.

J. N. McCORMACK, Chief Sanitary Inspector, Board of Health, State of Kentucky.

M. V. O'SHEA, Professor of Education, University of Wisconsin.

HON. WALTER H. PAGE, Ambassador to England.

GEORGE H. SIMMONS, M.D., Editor Journal American Medical Association.

HARVEY W. WILEY, M.D., Director Bureau of Foods, Sanitation and Health, Good Housekeeping Magazine.

HENRY SMITH WILLIAMS, M.D., Author.

Industrial Hygiene

JOHN B. ANDREWS, Secretary American Association for Labor Legislation.

THOMAS DARLINGTON, M.D., Secretary American Iron and Steel Institute.

NORMAN E. DITMAN, M.D., Trustee, American Museum of Safety.

GEORGE M. KOBER, M.D., Dean Medical School of Georgetown University.

W. GILMAN THOMPSON, M.D., Professor of Medicine, Cornell University Medical School.

WILLIAM H. TOLMAN, Director The American Museum of Safety.

Mouth Hygiene

W. G. EBERSOLE, M.D., D.D.S., Secretary-Treasurer, The National Mouth Hygiene Association.

ALFRED C. FONES, D.D.S., Chairman Dental Committee, Bridgeport Board of Health.

Physical Training

WM. G. ANDERSON, M.D., Director Gymnasium, Yale University.

GEORGE J. FISHER, M.D., Secretary International Committee, Y. M. C. A.

R. TAIT MCKENZIE, M.D., Professor of Physical Education and Director of the Department, University of Pennsylvania.

EDWARD A. RUMELY, M.D., President The Interlaken School.

DUDLEY A. SARGENT, M.D., Director Gymnasium, Harvard University.

PROF. ALONZO A. STAGG, Director Gymnasium, University of Chicago.

THOMAS A. STOREY, M.D., Professor of Hygiene, College of the City of New York.

Foreign Advisory Board

AUSTRIA

LUDWIG TELEKY, M.D., Department of Social Medicine, Vienna University.

CANADA

JOHN GEORGE ADAMI, M.D., Professor of Pathology and Bacteriology, McGill University, Montreal.

ENGLAND

SIR THOMAS OLIVER, Professor of Physiology, Durham University.

FRANCE

ARMAND GAUTIER, M.D., Professor of Chemistry, Faculty of Medicine, Paris.

GERMANY

PROF. DR. KARL FLUeGGE, Director Hygienic Institute, Berlin.

ITALY

LEONARDO BIANCHI, Professor of Psychiatry, University of Naples.

JAPAN

PROF. DR. S. KITASATO, Chief of the Kitasato Institute for Infectious Diseases, Tokyo.

RUSSIA

IVAN PETROVIC PAVLOV, Prof. of Physiology, Imperial Military Academy of Medicine, Petrograd.



PORTRAITS OF MEMBERS OF THE HYGIENE REFERENCE BOARD



HOW TO LIVE

INTRODUCTION

The purpose of the Life Extension Institute embraces the extension of human life, not only as to length, but also, if we may so express it, as to breadth and depth. It endeavors to accomplish this purpose in many ways, but especially through individual hygiene.

Thoroughly carried out, individual hygiene implies high ideals of health, strength, endurance, symmetry, and beauty; it enormously increases our capacity to work, to be happy, and to be useful; it develops, not only the body, but the mind and the heart; it ennobles the man as a whole.

[Sidenote: Medieval Ideals]

We in America inherit, through centuries of European tradition, the medieval indifference to the human body, often amounting to contempt. This attitude was a natural outgrowth of the theological doctrine that the "flesh is in league with the devil" and so is the enemy of the soul. In the Middle Ages saintliness was often associated with sickliness. Artists, in portraying saints, often chose as their models pale and emaciated consumptives.

We are beginning to cut loose from this false tradition and are working toward the establishment of more wholesome ideals. It is probably true, for instance, that the man or the woman who is unhealthy is now handicapped in opportunities for marriage, which may be considered an index to the ideals of society.

[Sidenote: The Present Health Movement]

A great health movement is sweeping over the entire world. Hygiene has repudiated the outworn doctrine that mortality is fatality and must exact year after year a fixed and inevitable sacrifice. It aims instead to set free human life by applying modern science. Science, which has revolutionized every other field of human endeavor, is at last revolutionizing the field of health conservation.

[Sidenote: Medical Practise]

The practise of medicine, which for ages has been known as the "healing art," is undergoing a gradual but radical revolution. This is due to the growing realization that an ounce of prevention is worth a pound of cure. As teachers and writers on hygiene, as trainers for college athletes, as advisers for the welfare departments of large industrial plants, and in many other directions, physicians are finding fields for practising preventive medicine. Even the family physician is in some cases being asked by his patients to keep them well instead of curing them after they have fallen sick.

Furthermore, the preventive methods of modern medicine are being applied by the people themselves, as witness the great vogue to-day of sleeping out of doors; the popularity, not always deserved, of health foods and drinks; the demand for uncontaminated water supplies, certified milk, inspected meat and pure foods generally; the world-wide movement against alcohol, and the legislation to correct wrong conditions of labor and to safeguard the laborer.

Labor itself to-day is being held in honor, and idleness in dishonor. Ideals are being shifted from those of "leisure" to those of "service." Work was once considered simply a curse of the poor. The real gentleman was supposed to be one who was able to live without it. The king, who set the styles, was envied because he "did not have to work," but had innumerable people to do work for him. His ability to work, his efficiency, his endurance, were the last things to which he gave consideration. To-day kings, emperors, presidents are trying to find out how they can keep in the fittest condition and accomplish the greatest possible amount of work. Even among society women, some kind of work is now "the thing."

[Sidenote: High Ideals]

One of the most satisfying tasks for any man or woman to-day is to take part in this movement toward truer ideals of perfect manhood and womanhood. Our American ideals, though improving, are far inferior to those, for instance, of Sweden; and these, in turn, are not yet worthy to be compared with those of ancient Greece, still preserved for our admiration in imperishable marble. With our superior scientific knowledge, our health ideals ought, as a matter of fact, to excel those of any other age. They should not stop with the mere negation of disease, degeneracy, delinquency, and dependency. They should be positive and progressive. They should include the love of a perfect muscular development, of integrity of mental and moral fiber.

There should be a keen sense of enjoyment of all life's activities. As William James once said, simply to live, breathe and move should be a delight. The thoroughly healthy person is full of optimism; "he rejoiceth like a strong man to run a race." We seldom see such overflowing vitality except among children. When middle life is reached, or before, our vital surplus has usually been squandered. Yet it is in this vital surplus that the secret of personal magnetism lies. Vital surplus should not only be safeguarded, but accumulated. It is the balance in the savings bank of life. Our health ideals must not stop at the avoidance of invalidism, but should aim at exuberant and exultant health. They should savor not of valetudinarianism, but of athletic development. Our aim should be not to see how much strain our strength can stand, but how great we can make that strength. With such an aim we shall, incidentally and naturally, find ourselves accomplishing more work than if we aimed directly at the work itself. Moreover, when such ideals are attained, work instead of turning into drudgery tends to turn into play, and the hue of life seems to turn from dull gray to the bright tints of well-remembered childhood. In short, our health ideals should rise from the mere wish to keep out of a sick bed to an eagerness to become a well-spring of energy. Only then can we realize the intrinsic wholesomeness and beauty of human life.



CHAPTER I

AIR

Section I—Housing

Air is the first necessity of life. We may live without food for days and without water for hours; but we cannot live without air more than a few minutes. Our air supply is therefore of more importance than our water or food supply, and good ventilation becomes the first rule of hygiene.

Living and working rooms should be ventilated both before occupancy and while occupied.

It must be remembered that the mere construction of the proper kind of buildings does not insure ventilation. We may have model dwellings, with ideal window-space and ventilating apparatus, but unless these are actually used, we do not benefit thereby.

[Sidenote: Features of Ventilation]

The most important features of ventilation are motion, coolness, and the proper degree of humidity and freshness.

[Sidenote: Drafts]

There is an unreasonable prejudice against air in motion. A gentle draft is, as a matter of fact, one of the best friends which the seeker after health can have. Of course, a strong draft directed against some exposed part of the body, causing a local chill for a prolonged time, is not desirable; but a gentle draft, such as ordinarily occurs in good ventilation, is extremely wholesome.

[Sidenote: Air and Catching Colds]

It goes without saying that persons unaccustomed to ventilation, and consequently over-sensitive to drafts, should avoid over-exposure while they are in process of changing their habits. But after even a few days of enjoyment of air in motion, with cautious exposure to it, the likelihood of cold is greatly diminished; and persons who continue to make friends with moving air soon become almost immune to colds.

The popular idea that colds are derived from drafts is greatly exaggerated. A cold of any kind is usually a catarrhal disease of germ origin, to which a lowered vital resistance is a predisposing cause.

The germs are almost always present in the nose and throat. It is exposure to a draft plus the presence of germs and a lowered resistance of the body which produces the usual cold. Army men have often noted that as long as they are on the march and sleep outdoors, they seldom or never have colds, but they develop them as soon as they get indoors again. See SUPPLEMENTARY NOTES, "Avoiding Colds."

Of course, one must always use common sense and never grow foolhardy. It is never advisable that a person in a perspiration should sit in a strong draft.

[Sidenote: Windows]

The best ventilation is usually to be had through the windows. We advise keeping windows open almost always in summer; and often open in winter.

One should have a cross-current of air whenever practicable; that is, an entrance for fresh air and an exit for used air at opposite sides of the room. Where there can not be such a cross-current, some circulation can be secured by having a window open both top and bottom.

[Sidenote: Window-boards]

In winter, ventilation is best secured by means of a window-board. This is a board the edge of which rests on the edge of the window-sill, the ends being attached firmly to the window-frame. It affords a vertical surface three or four inches high and situated three or four inches in front of the window, so as to deflect the cold air upward when the window is slightly opened. The air will then reach the breathing-zone, instead of flowing on to the floor and chilling the feet, which is the usual consequence of opening a window in winter. It seems tragic to think that for lack of some such simple device, which anyone can make or buy, there is now an almost complete absence of winter ventilation in most houses.

[Sidenote: Air-fans]

Air should never be allowed to become stagnant. When there is no natural movement in the air, it should be put in motion by artificial means. This important method of practising air-hygiene is becoming quite generally available through the introduction of electric currents into dwellings and other buildings and the use of electric fans. Even a hand fan is of distinct hygienic value.

[Sidenote: Heating Systems]

A wood or grate fire is an excellent ventilator. A heating-system which introduces warmed new air is better than one acting by direct radiation, provided the furnace is well constructed and gas-proof.

[Sidenote: Cool Air]

The importance of coolness is almost as little appreciated as the importance of motion. Most people enervate themselves by heat, especially in winter. The temperature of living-rooms and work-rooms should not be above 70 degrees, and, for people who have not already lost largely in vigor, a temperature of 5 to 10 degrees lower is preferable. Heat is depressing. It lessens both mental and muscular efficiency. Among the employes of a large commercial organization in New York who were examined by the Life Extension Institute, some of the men in one particular room were suffering from an increase of body temperature and a skin rash. On investigation it was found that the room in which they worked was overheated. There was no special provision for ventilation. A window-board was installed, with the result that the men recovered and no other cases of skin rash occurred in that room.

[Sidenote: Dry air]

As to dryness of air, there is little which the individual can do except to choose a dry climate in which to live or spend his vacations. Unfortunately, there is not as yet any simple and cheap way of drying house air which is too moist, as is often the case in warm weather.

[Sidenote: Humidity]

In the cold season, indoor air is often too dry and may be moistened with advantage. This may be done, to some extent, by heating water in large pans or open vessels. But for efficient moistening of the air, either a very large evaporating-surface or steam jets are required. The small open vessels or saucers on which some people rely, even when located in the air-passages of a hot-air furnace, have only an infinitesimal influence. Vertical wicks of felt with their lower ends in water kept hot by the heating apparatus yield a rapid supply of moisture. Evaporation is greatly facilitated if the water or wicks are placed in the current of heated air entering the room. By a suitable construction, the water may be replenished automatically. In very cold dry weather, the air-supply of an ordinary medium-sized house requires the addition of not less than 10 gallons of moisture every 24 hours, and sometimes much more.

Some authorities doubt any ill effects from extreme dryness. This is a subject yet to be cleared by experimental research.

[Sidenote: Freshness]

It is obvious that fresh pure air is preferable to impure air. Air may be vitiated by poisonous gases, by dust and smoke, or by germs. Dust and smoke often go together.

Lighting by electricity is preferable to lighting by gas, as some of the gas is liable to escape and vitiate the air.

[Sidenote: Tobacco Smoke]

A very common and at the same time injurious form of air-vitiation is that from tobacco smoke. Smoking, especially in a closed space such as a smoking-room or smoking-car, vitiates the air very seriously, for smoker and non-smoker alike.

[Sidenote: Dust]

As to dust, the morbidity and mortality rates in certain occupations, particularly those known as the dusty trades, are appreciably and even materially greater than in dustless trades.

An accumulation of house-dust should be avoided. The dust should be removed—not by the old-fashioned feather duster which scatters the dust into the air—but by a damp or oiled cloth. Dust-catching furniture and hangings of plush, lace, etc., are not hygienic. A carpet-sweeper is more hygienic than a broom, and a vacuum cleaner is better than a carpet-sweeper. The removable rug is an improvement hygienically over the fixed carpet.

[Sidenote: Bacteria]

The bacteria in air ride on the dust-particles. In a clean hospital ward, when air was agitated by dry sweeping, the number of colonies of bacteria collected on a given exposure rose twenty-fold, showing the effect of ordinary broom-sweeping.

[Sidenote: Sunlight]

The air we breathe should be sunlit when possible. Many of our germ enemies do not long survive in sunlight.

Section II—Clothing

Air may be shut out not only by tight houses but also by tight clothes. It follows that the question of clothing is closely related to the question of ventilation. In fact it is a reasonable inference from modern investigations that air-hygiene concerns the skin quite as much as the lungs. Therefore the hygiene of clothing assumes a new and hitherto unsuspected importance. A truly healthy skin is not the waxy white which is so common, but one which glows with color, just as do healthy cheeks exposed to the open air.

[Sidenote: Porous Clothes]

The hygiene of clothing includes ventilation and freedom from pressure, moderate warmth, and cleanliness. Loose, porous underclothes are already coming into vogue. But effective ventilation, namely such as will allow free access of air to the skin, requires that our outer clothes—including women's gowns and men's shirts, vests, vest-linings, and coat-linings—should also be loose and porous. Here is one of the most important but almost wholly neglected clothing reforms. Most linings and many fabrics used in outer clothes are so tightly woven as to be impervious to air. Yet porous fabrics are always available, including porous alpacas for lining. To test a fabric it is only necessary to place it over the mouth and observe whether it is possible or easy to blow the breath through it.

[Sidenote: Air-baths]

At times we can enjoy relief from clothing altogether. An air-bath promotes a healthy skin and aids it in the performance of its normal functions. Not every one can visit air-bath establishments or outdoor gymnasia or take the modern nude cure by which juvenile consumptives are sometimes treated (even in winter, after becoming gradually accustomed to the cold); but any one can spend at least a little time in a state of nature. Both at the time of rising in the morning and upon retiring at night, there are many things which are usually done while one's clothes are on which could be done just as well while they are off. Brushing the teeth, washing the hands, shaving, etc., necessarily consume some time during which the luxury of an air-bath can be enjoyed. Exercises should also be taken at these times. Exercising in cold air, if not too cold, with clothing removed, is an excellent means of hardening the skin and promoting good digestion.

[Sidenote: Tight Clothing]

[Sidenote: Shoes]

The constriction from rigid or tight corsets, belts (the latter in men as well as in women), tight neckwear, garters, etc., interferes with the normal functions of the organs which they cover. All such constriction should be carefully avoided. The tight hats generally worn by men check the circulation in the scalp. Tight shoes with extremely high heels deform the feet and interfere with their health. The barefoot cure is not always practicable, but any one can wear broad-toed shoes with a straight inner edge and do his part to help drive pointed toes out of fashion. Such a reform should not be so difficult as to rid the women of China of their particular form of foot-binding. Several anatomical types of shoes, that is, shoes made to fit the normal foot instead of to force the foot to fit them, are now available. In all except cold weather, low shoes are preferable to high shoes. When possible, sandals, now fortunately coming into fashion, are preferable to shoes, especially in early childhood (but the adult, whose calf-muscles and foot-structure are not often adapted to such foot-gear, must be cautious in their use lest flat-foot result).

[Sidenote: Cottons, Linens, Woolens]

Only the minimum amount of clothing that will secure warmth should be worn. Woolens protect most, but they require the least exercise of the temperature-regulating apparatus of the body. While wool is also highly absorbent of moisture, it does not give off that moisture quickly enough. Hence, if worn next to the skin, it becomes saturated with perspiration, which it long retains to the disadvantage of the skin. Consequently woolen clothing is best confined to overcoats and outer garments, designed especially for cold weather. The underclothes should be made of some better conducting and more quickly drying material, such as cotton or linen. In winter light linen-mesh and medium wool over that, or "double-deck" linen and wool underclothes, can be worn by those who object to either linen or wool alone.

[Sidenote: Color]

As to color, the more nearly white the clothes the better. This is especially true in summer, but there is believed to be some advantage in white at all seasons.

Those who have learned to clothe themselves properly find that they have grown far more independent of changing weather conditions. They do not suffer greatly from extreme summer heat nor extreme winter cold. Especially do they note that "raw" or damp cold days no longer tax their strength.

Section III—Outdoor Living

[Sidenote: Out-of-door Air]

But we must not depend altogether on ventilating our houses and our clothes. We must turn our thoughts toward an outdoor life. The air of the best ventilated house is not as good as outdoor air. Those who spend much of their lives in the open enjoy the best health and the greatest longevity. It is a great advantage to go into camp in summer and to live in the country as much as possible.

Climate, of itself, is a secondary consideration. Not every one can choose the best climate in the world, and, after all, the main advantages of fresh air can be enjoyed in almost any locality. Even in a city, outdoor air is, under ordinary circumstances, wonderfully invigorating.

[Sidenote: Dampness]

The common prejudice against damp air greatly exaggerates its evils. While moderate dryness of air is advantageous, it seems nevertheless true that to live in damp, even foggy, air out-of-doors is, in general, more healthful than to live shut up indoors.

[Sidenote: Outdoor Schools]

Observations have shown that the pupils in outdoor and open-window schools are not only kept more healthy but learn more quickly than those in the ordinary schools. It is even claimed that tuberculous children in an outdoor school may make more rapid progress in their studies than the more normal children in a badly ventilated school. Parents should insist on fresh air for their children when at school. They should also insist on outdoor playgrounds.

[Sidenote: Outdoor Recreations]

For themselves, also, they should not neglect outings, picnics, and visits to parks. Whenever practicable, outdoor recreation should be chosen in preference to indoor recreation.

[Sidenote: Occupations]

Above all, outdoor occupations should, when possible, be chosen in preference to indoor occupations, such as working on a farm rather than in a factory. It would help solve some of the greatest problems of civilization, if, in consequence of an increased liking for outdoor life, larger numbers of our population should join the "back-to-the-farm" movement. Leaving the country for the city is often disastrous even for the purpose in view, namely to gain wealth. For wealth gained at the expense of health always proves in the end a bitter joke. The victim proceeds through the rest of his life to spend wealth in pursuit of health.

Section IV—Outdoor Sleeping

Unfortunately most people can not live out of doors all of the time, and many are so situated that they can not even secure ventilation, granted that they want it. But there is one important part of the twenty-four hours when most people can completely control their own air supply. This is at night. We spend a third of our time in bed. Most of us live such confined lives during the day that we should all the more avail ourselves of our opportunities to practise air hygiene at night.

[Sidenote: Tuberculosis]

[Sidenote: Well Persons]

It is the universal testimony of those who have slept out-of-doors that the best ventilated sleeping-room is far inferior in healthfulness to an outdoor sleeping-porch, open tent, or window tent (large enough to include the whole bed). For generations, outdoor sleeping has occasionally been used as a health measure in certain favorable climates and seasons. But only in the last two decades has it been used in ordinary climates and all the year round. Dr. Millet, a Brockton physician, began some years ago to prescribe outdoor sleeping for some shoe-factory workmen who were suffering from tuberculosis. As a consequence, in spite of their insanitary working-places (where they still continued to work while being treated for tuberculosis), they often conquered the disease in a few months. It was largely this experience which led to the general adoption, irrespective of climate, of outdoor sleeping for the treatment of tuberculosis. The practise has since been introduced for nervous troubles and for other diseases, including pneumonia. Latterly the value of outdoor sleeping for well persons of all classes, infants and children as well as adults, has come to be widely recognized.

[Sidenote: Vital Resistance]

Outdoor sleeping increases the power to resist disease, and greatly promotes physical vigor, endurance, and working power.

[Sidenote: Night Air]

Many people are still deterred from sleeping out by a mistaken fear of night air and of the malaria which they imagine this dreaded night air may bring. To-day we know that malaria is communicated by the bite of the anopheles mosquito and never by the air. The moral of this is not to shut out the night air, but, when necessary, to shut out the mosquito by screens. The experiment has been made of sleeping out-of-doors in screened cages in the most malarial of places and no malarial infection resulted, though those who were unprotected and were consequently bitten by mosquitoes contracted malaria as usual. The truth is that night air, especially in cities, is distinctly purer than day air, on account of the fact that there is much less traffic at night to stir up dust.

[Sidenote: Protection From Cold]

It is very important, in any sleeping balcony, to be protected from the wind by a sash on one or two or—in very windy places—three sides. But of course sleeping out-of-doors does not reach its maximum efficiency if there is too much protection, that is, if the sleeping-out place is so shut in that very free currents of air are not secured. An outdoor porch really ceases to be an outdoor porch, when enclosed on four sides.

A roll curtain (preferably rolling from the bottom) can be arranged on the open side or sides, to be used in case of storms only. In cold weather a thick mattress, or two mattresses, should be used. It is not only what is over the sleeper, but also what is under him, that keeps him warm. The body should be warmly clad, and the head and neck protected by a warm cap or helmet or hood. To prevent the entrance of cold air under the bedclothes, one or more blankets should be extended at least two feet beyond the head, with a central slit for the head. Early awakening by the light may, if necessary, be prevented by touching the eyelids with burnt cork, or by bandaging the eyes with a black cloth or stocking. Sheets should be well warmed in the winter-time before being used. They can easily be warmed with a hot-water bag, flat-iron, or soapstone. Blankets next to the skin are not hygienic.

[Sidenote: Sleeping-tents]

Sleeping out is really much easier than most people imagine. In fact, few, if any, of the other cardinal rules of hygiene are so easy to obey. Where a sleeping-porch is not available, an inward window tent can always be had which puts the sleeper practically out-of-doors and at the same time cuts off his tent from the rest of the room.

[Sidenote: Outdoor Tents]

An outdoor tent must be kept well opened. Otherwise it fails of its purpose. The common opinion that a tent is ventilated through the "meshes" of the canvas is erroneous. Canvas is a tightly woven fabric and impervious to air. That is why it makes good sails. One of the most modern boys' camps has given up the use of tents altogether, employing instead open wooden "shacks," because of the difficulty of keeping the tents sufficiently open, especially in rainy weather.

Complete directions for convenient out-of-door sleeping will be furnished, upon application, by the Life Extension Institute.

Section V—Deep Breathing

Ordinarily breathing should be unconscious, but every day deep breathing exercises should be employed. "A hundred deep breaths a day" is one physician's recipe for avoiding tuberculosis. A Russian author, who suffered a nervous breakdown, found—after trying many other aids to health without success—that a retired life for several months in the mountains in which simple deep-breathing exercises practised systematically every day formed the central theme, effected a permanent cure. Deep breathing is a great resource for people who are shut in most of the day. If they will seize the chance, whenever it offers, to step out-of-doors and take a dozen deep breaths, they can partly compensate for the evils of indoor living.

In ordinary breathing only about 10 per cent. of the lung contents is changed at each breath. In deep breathing a much larger percentage is changed, the whole lung is forced into action, and the circulation of the blood in the abdomen is more efficiently maintained, thus equalizing the circulation throughout the body. The blood-pressure is also favorably influenced, especially where increased pressure is due to nervous or emotional causes.

[Sidenote: Breathing Exercises]

Breathing exercises should be deep, slow, rhythmic, and through the nose, not through the mouth. A certain Oriental deep-breathing exercise is particularly valuable to insure slowness and evenness of the breath. It consists of pressing a finger on the side of the nose, so as to close one nostril, breathing in through the other nostril, breathing out of the first nostril in the same manner and then reversing the process. Attention to the slight sound of the air, as it passes through the nose, enables one to know whether the breathing is regular or is slightly irregular. Such breathing exercises can be taken at the rate of three breaths per minute, and the rate gradually reduced until it is only two or even less per minute.

[Sidenote: Muscular Exercise]

Muscular exercises stimulate deep breathing, and, in general, the two should go together. But deep breathing by itself is also beneficial, if very slow. Forced rapid breathing is comparatively valueless, and indeed may be positively harmful. Oxygen is absorbed only according to the demand for it in the body and not according to the supply.

[Sidenote: Singing]

Singing requires deep breathing, and is for that and other reasons an excellent hygienic practise.

[Sidenote: Mental State]

The mode of our breathing is closely related to our mental condition; either influences the other. Agitation makes us catch our breath, and sadness makes us sigh. Conversely, slow, even breathing calms mental agitation. It is not without reason that, in the East, breathing exercises are used as a means of cultivating mental poise and as an aid to religious life.



CHAPTER II

FOOD

Section I—Quantity of Food

The body has often been compared to a blacksmith's forge, the lungs being the bellows and food the coal. The comparison is a good one, for food is actually burned in the body by the aid of the air we breathe.

[Sidenote: Calories]

All food is capable of being used as body-fuel and by far the greater part of it is so used. Consequently, food is measured in fuel-units, called calories. Many people eat too much, that is, too many calories; some eat too little, that is, too few calories. In both cases the person is usually unaware of the fact, because he makes the mistake of measuring his food by its weight or bulk. Some foods are concentrated, that is, contain many calories of food value in a given bulk; others are bulky, that is, contain few calories in a given bulk. For instance, olive oil is concentrated, and most vegetables are bulky. A third of an ounce of olive oil contains 100 calories, which is as much as is contained in a pound or more of tomatoes, lettuce, celery, cucumbers, string beans, asparagus, or watermelon.

It will help to give a picture of food values if, before going further, we note how much it takes of some of the common foods to make a given amount of food value, say 100 calories. It is surprising in how many cases the ordinary amount of food served at table happens to contain about 100 calories. We find 100 calories in a small lamb chop (weighing about an ounce); in a large egg (about 2 ounces); in a small side-dish of baked beans (about 3 ounces); in 11/2 cubic inches of cheese (about an ounce); in an ordinary side-dish of sweet corn (about 31/2 ounces); in one large-sized potato (if baked, about 3 ounces; if boiled, about 4 ounces); in an ordinary thick slice of bread (about 11/2 ounces); in one shredded wheat biscuit (about an ounce); in a very large dish of oatmeal (about 6 ounces); in a small piece of sponge-cake (about an ounce); in a third of an ordinary piece of pie (about 11/2 ounces); in three teaspoonfuls or 11/2 lumps of sugar (about 1 ounce); in a dozen peanuts (about 1/3 of an ounce); in eight pecans (about 1/2 an ounce); in four prunes (about 1 ounce); in two apples (about 7 ounces); in a large banana (about 4 ounces) in half a cantaloup (about 9 ounces); in seven olives (about 11/2 ounces); in a very large orange (about 10 ounces); in an ordinary pat of butter (about 1/2 an ounce); in a quarter of a glass of cream (about 2 ounces); in a small glass of milk (about 5 ounces). (See SUPPLEMENTARY NOTES for "Table of Food Values.")

The ordinary sedentary man needs about 2,500 calories per day. But the larger the person (provided the bulk is due to muscle and active tissue and not to fat) or the more muscular the work he does, the more food he needs. It has been found that the number and activity of cells forming the organs and muscles and blood affect the food requirement.

[Sidenote: Favorable Weight]

Life insurance experience has clearly shown that weight, especially in relation to age, is an important factor in influencing longevity.

Except in the earlier ages of life, overweight (reckoned relatively to the average for that age) is a more unfavorable condition, in its influence on longevity, than underweight.

The question of whether an individual is really underweight or overweight can not be determined solely by the life insurance tables. (See SUPPLEMENTARY NOTES, "Influence of Build on Longevity.") Some types who are of average weight according to the table, may be either underweight or overweight when considered with regard to their framework and general physical structure. Nevertheless, it should be remembered that notwithstanding the effort of life insurance companies to carefully select the favorable types of overweight and underweight, the mortality experience on youthful underweights has been unfavorable, and the mortality experience on middle aged and elderly overweights has been decidedly unfavorable. The lowest mortality is found among those who average, as a group, a few pounds over the average weight before age 35, and a few pounds under the average weight after age 35. That is, after the age of 35, overweight is associated with an increasingly high death rate, and at middle life it becomes a real menace to health, either by reason of its mere presence as a physical handicap or because of the faulty living habits that are often responsible for its development.

[Sidenote: Overweight]

If there is a family tendency to overweight, one should begin early to form habits that will check this tendency. If considerable overweight is already present, caution is necessary in bringing about a reduction. Barring actual disease, this can usually be done without drugs if the person will be persevering and faithful to a certain regime.

Constant vigilance is necessary, yet it is worth while when one considers the inconvenience as well as the menace of obesity.

After the age of 35, 15 to 20 pounds over the average weight should prompt one to take careful measures for reducing weight. Habits should be formed that will keep the weight down automatically, instead of relying upon intermittent attempts that are more than likely to fail. No matter how well one feels, one should take steps to keep out of the class that life insurance companies have found to be undesirable as risks.

[Sidenote: Accessories]

One reason why many people eat great quantities of food without realizing it, is the common delusion that many articles such as candy, fruits, nuts, peanuts, popcorn, often eaten between meals, "do not count." Another common oversight is to overlook accessories, such as butter and cream, which may contain more actual food value than all the rest of a meal put together. Ice-cream and other desserts also have more food value than is usually realized. Nature counts every calory very carefully. If the number of calories taken in exceeds the number used by the body (or excreted unused), the excess accumulates in fat or tissue. Thus, if some 3,000 calories are taken in each day and the calories used up or excreted are only 2,800, then 200 must be retained and accumulated in the body.

[Sidenote: Underweight]

A person who is not heavy enough can usually gain weight by following the general rules of hygiene, especially in the matter of increasing the fuel or energy foods. But he should not force himself to eat beyond his natural capacity to digest and assimilate the food, while overfatigue and exhausting physical exertion should be carefully avoided.

[Sidenote: Diet in Middle Life]

As age advances, the consumption of meat and all flesh foods should be decreased and that of fruit and vegetables, especially those of bulky character and low food value, such as lettuce, tomatoes, carrots, turnips, salsify, oyster-plant, watercress, celery, parsnips, should be increased.

[Sidenote: Diet in Hot Weather]

Generally the quantity of food should be slightly decreased in hot weather, when fewer calories are needed to sustain the heat of the body. In particular, less meat should be eaten in the summer, on account of what is called the "specific dynamic action of protein," that is, the special tendency of meats and like foods to produce immediate heat.

Each individual must decide for himself what is the right amount of food to eat. In general, that amount is right which will maintain the most favorable condition of weight. If the weight, endurance, and general feeling of well-being are maintained, one may assume that sufficient food is taken.

[Sidenote: Brainwork and Eating]

It is physical, not mental work, which uses up the greater part of our food. The common impression that brain-work or expenditure of mental energy creates a special need for food is erroneous. The sedentary brain-worker often gains weight without eating very much. What he really needs is exercise, to use up the food, but if he will not take exercise, then he should reduce his food even below the small amount on which he gains weight.

[Sidenote: Eating When Fatigued]

Which meal in the day should be heavy and which light depends largely on one's daily program of work, the aim being to avoid heavy meals just before heavy work. When very tired it is sometimes advisable to skip a meal or to eat only lightly, as of fruits and salads. A man who eats heartily when he is very tired is likely to be troubled afterward with indigestion.

(See SUPPLEMENTARY NOTES for specific directions regarding diet for underweight and overweight.)

Section II—Protein Foods

[Sidenote: Protein, Fat, and Carbohydrate]

In the last section it was stated that food is fuel. But there is one constituent of food which, while it can be used as fuel, is especially fitted for an entirely different purpose, namely, to build tissue, that is, to serve for the growth and repair of the body. This tissue-building constituent in food is called protein. The two other chief constituents in food are fat and carbohydrate, the last term embracing what are familiarly known as starch and sugar. Fats and carbohydrates are only for fuel and contain carbon as the essential element. Protein contains nitrogen as the essential element in tissue-building. The white of egg and the lean of meat afford the most familiar examples of protein. They consist entirely of protein and water. But meat and eggs are not the only foods high in protein. In fact, most ordinary foods contain more or less protein. The chief exceptions are butter, oleomargarine, oil, lard, and cream—which consist of fat (and water)—and sugar, sirups, and starch, which consist of carbohydrate (and water).

[Sidenote: Proportion of Protein]

Foods should be so selected as to give to the ration the right amount of protein, or repair-foods, on the one hand, and of fats and carbohydrates, or fuel-foods, on the other. A certain amount of protein is absolutely essential. While, for a few days, protein may be reduced to little or nothing without harm, if the body be long deprived of the needed protein it will waste away and ultimately death will result. Therefore, too little protein would be a worse mistake than too much.

The right proportion of protein has been the subject of much controversy. According to what are regarded as the best investigations, it is generally about 10 per cent. of the total number of heat-units consumed. This does not, of course, mean 10 per cent. of the total weight nor 10 per cent. of the total bulk, but 10 per cent. of the total nutriment, that is, 10 calories of protein out of every 100 calories of food.

[Sidenote: Human Milk]

Most persons in America eat much more protein than this. But that 10 calories out of 100 is not too small an allowance is evidenced by the analysis of human milk. The growing infant needs the maximum proportion of protein. In the dietary of the domestic animals, the infant's food, the mother's milk, is richer in protein than the food of the grown animal. Consequently an analysis of human mother's milk affords a clue to the maximum protein suitable for human beings. Of this milk 7 calories out of every 100 calories are protein. If all protein were as thoroughly utilized as milk-protein or meat-protein, 7 calories out of 100 would be ample, but all vegetable proteins are not so completely available. Making proper allowance for this fact, we reach the conclusion that 10 calories out of every 100 are sufficient.

[Sidenote: Excessive Use of High-Protein Foods]

A chief and common error of diet consists, then, in using too much protein. Instead of 10 calories out of every 100, many people in America use something like 20 to 30. That is, they use more than double what is known to be ample. This excessive proportion of protein is usually due to the extensive use of meat and eggs, although precisely the same dietetic error is sometimes committed by the excessive use of other high-protein foods such as fish, shell-fish, fowl, cheese, peas and beans, or even, in exceptional cases, by the use of foods less high in protein when combined with the absence of any foods very low in protein. The idea of reducing the protein in our diet is still new to most people.

[Sidenote: Injuries From Over-abundance of Protein]

Prof. Rubner of Berlin, one of the world's foremost students of hygiene, said, in a paper on "The Nutrition of the People," read before the recent International Congress on Hygiene and Demography:

"It is a fact that the diet of the well-to-do is not in itself physiologically justified; it is not even healthful. For, on account of false notions of the strengthening effect of meat, too much meat is used by young and old, and by children, and this is harmful. But this meat is publicly sanctioned; it is found in all hotels; it has become international and has supplanted, almost everywhere, the characteristic local culinary art. It has also been adopted in countries where the European culinary art was unknown. Long ago the medical profession started an opposition to the exaggerated meat diet, long before the vegetarian propaganda was started. It was maintained that flour foods, vegetables, and fruits should be eaten in place of the overlarge quantities of meat."

When protein is taken in great excess of the body's needs, as is usually the case in the diet of Americans, added work is given the liver and kidneys, and their "factor of safety" may be exceeded.

[Sidenote: Animal Proteins]

Flesh food—fish, shell-fish, meat, fowl—when used in great abundance, are subject to additional objections. They tend to produce an excess of acids, are very prone to putrefaction, and contain "purins" which lead to the production of uric acid. This is especially true of sweetbreads, liver and kidney. The well-known deficiency in flesh foods of lime often needs to be taken into consideration in the dietary. Some of the vegetable foods, such as peas and beans, rich in protein, are likewise not free from objection. Their protein is not always easily digested and is, therefore, likewise liable to putrefaction. Unlike most vegetable foods, they contain some purins. These foods are, however, rich in iron, which renders them a more valuable source of protein for children and anemic people than meat. Also, an excess of protein is not so likely to be derived from such bulky foods as from meat, which is a concentrated form of protein.

We have spoken thus far only of the needed proportion of protein. The remainder of the diet, say 90 per cent. of the calories, may be divided according to personal preference between fats and carbohydrates in almost any proportion, provided some amount of each is used. A good proportion is 30 per cent. fat and 60 per cent. carbohydrate.

Section III—Hard, Bulky, and Uncooked Foods

The wise choice of foods does not consist entirely in balancing the ration as to protein, fat, and carbohydrate.

[Sidenote: Hard Foods]

Hard foods, that is, foods that resist the pressure of the teeth, like crusts, toast, hard biscuits or crackers, hard fruits, fibrous vegetables and nuts, are an extremely important feature of a hygienic diet. Hard foods require chewing. This exercises and so preserves the teeth, and insures the flow of saliva and gastric juice. If the food is not only hard, but also dry, it still further invites the flow of saliva. Stale and crusty bread is preferable to soft fresh bread and rolls on which so many people insist. The Igorots of the Philippines have perfect teeth so long as they live on hard, coarse foods. But civilization ruins their teeth when they change to our soft foods.

[Sidenote: Bulk Versus Concentrated Foods]

Most of the ordinary foods lack bulk; they are too concentrated. For this purpose it is found that we need daily, at the very least, an ounce of cellulose, or "woody fiber." This is contained in largest measure in fibrous fruits and vegetables—lettuce, celery, spinach, asparagus, cabbage, cauliflower, corn, beets, onions, parsnips, squash, pumpkins, tomatoes, cucumbers, berries, etc.

Until recently would-be food reformers have made the mistake of seeking to secure concentrated dietaries, especially for army rations. It was this tendency that caused Kipling to say, "compressed vegetables and meat biscuits may be nourishing, but what Tommy Atkins needs is bulk in his inside."

[Sidenote: Raw Foods]

[Sidenote: Vitamins]

Cooking is an important art; but some foods when cooked lose certain small components called vitamins, which are also found in the skin or coating of grains, especially rice, also in yolk of egg, raw milk, fresh fruit, and fresh vegetables, especially peas and beans. These vitamins are very important to the well-being of the body. Their absence is probably responsible for certain diseases, such as beriberi, scurvy, and possibly pellagra, as well as much ill health of a less definite sort. Some raw or uncooked foods, therefore, such as lettuce or tomatoes, celery, fruits, nuts, and milk, should be used in order to supply these minute and as yet not well-understood substances which are destroyed by the prolonged cooking at the temperature which is employed in order to sterilize canned foods. They are also diminished and often destroyed by ordinary cooking, except in acid fruits and acid vegetables.

[Sidenote: Raw Milk]

It is true that only very clean milk is entirely safe in an absolutely raw state, and that heat is usually needed to kill the germs. But this heat, even at the comparatively low temperature of pasteurization, has been found to destroy the vitamins that prevent scurvy. Orange juice should always be given to infants over one month old who are fed pasteurized milk.

Not all foods can be taken raw with advantage. Most starchy foods, such as cereals and potatoes and unripe fruit must, of course, be cooked in order to be made fit to eat.

[Sidenote: Disinfection]

Raw foods have dangers of their own in carrying germs and parasites, and it is extremely advisable that all raw foods should be very thoroughly washed before eating.

[Sidenote: Acids and Inorganic Salts]

In addition to protein, fat, carbohydrate, and vitamins, there are other elements which the body requires to maintain chemical equilibrium, and for the proper maintenance of organic functions. These are the fruit and vegetable acids and inorganic salts, especially lime, phosphorus, and iron. These substances are usually supplied, in ample amounts, in a mixed diet, containing a variety of fruits and vegetables and an adequate amount of milk and cream. Potatoes, feared by some in acid condition (such as gout), are actually valuable because of their alkalinity.

Section IV—Thorough Mastication

Whether it be from lack of hard foods, requiring prolonged chewing, or from the nervous hurry of modern life, or from other causes, it is undoubtedly a fact that most people in America eat too rapidly. The correction of this habit will go far toward reforming an individual's diet in every way.

Thorough mastication means masticating up to the point of involuntary swallowing. It does not mean forcibly holding the food in the mouth, counting the chews, or otherwise making a bore of eating. It merely means giving up the habit of forcing food down, and applies to all foods, even to liquid foods, which should be sipped.

[Sidenote: Evils of Insufficient Mastication]

The consequences and evils of insufficient mastication are many, and may be enumerated as follows: Insufficient use of the teeth and jaws (and hence dental decay as well as other and worse dental evils); insufficient saliva mixed with the food (and hence imperfect digestion of the starchy substances); insufficient subdivision of food by mastication (and hence slow digestion); the failure of the taste nerves to telegraph ahead, as it were, to the stomach and other digestive organs an intimation of the kind and amount of digestive juices required (and hence indigestion); the overseasoning of food to make it relishable even when bolted (and hence overeating and irritation of the mucous lining); the excessive use of meat and eggs and like foods, which can be eaten rapidly with relative impunity, and the corresponding neglect of other foods, like bread, grains, vegetables, and salads, which require more mastication (and hence intestinal poisoning).

[Sidenote: Prolonged Relish of Food]

The habit of insufficient mastication is subtle, because it has become "second nature" with most of us. To free ourselves of it we must first of all allow plenty of time for our meals and rid our minds of the thought of hurry. A boy's school in which the principal is endeavoring to fight the habit of food-bolting has wisely ordained that no boy may leave the dining-room until a certain hour, even if he has finished eating long before. In this way the boy soon learns that there is nothing to be gained by fast eating, and, in fact, that the pleasantest way of spending the meal-time is to prolong the relish of the food. It would be well if all of us would adopt a similar rule for ourselves. Mr. Gladstone did something of the sort and was noted for the slow mastication of his food. Latterly Mr. Horace Fletcher set such a rule for himself, and revived the interest of the public in the subject.

[Sidenote: The First Three Mouthfuls]

At first one must give some conscious attention to his efforts to reform; but if one will merely attend carefully to the first three mouthfuls of a meal, the slow pace can often be established for the rest of the meal without further thought.

[Sidenote: Careful Tasting]

Slow eating is important not merely as a matter of mastication, but also as a matter of taste and enjoyment. Food must have a pleasing taste and flavor and then must be enjoyed in order to be most readily assimilated.

[Sidenote: Increased Enjoyment]

There is a mistaken notion that the hygiene of food means "giving up all the things that taste good." While it is true that, in many cases, sacrifices have to be made, the net result of reforming one's diet is not to diminish but to increase the enjoyment of food. In general, it is extremely unhygienic to eat foods which are not relished. Experiments by Pavlov and others have shown that the taste and enjoyment of food stimulate the flow of digestive juices.

[Sidenote: Choosing Foods]

Finally, slow eating is a great aid in the proper choice of foods. Some suggestions have already been given as to the wise choice of foods, but no rules can be formulated which will completely insure such a choice. Even the wisest physiologist can not depend altogether on his knowledge of food values, while, to the layman, the problem is so complicated that his main reliance must be on his own instincts. Animals depend exclusively on instinct except when under domestication. Civilized man should not and can not altogether depend upon instinct, but his food instincts are far more keen and correct if he obeys the rule of eating slowly than if he bolts his food.

[Sidenote: "Good" and "Bad" Foods]

In the choice of foods it is as difficult to distinguish absolutely between what are "good" and "bad" foods as it is to classify human beings into "good" and "bad." All we can say is that some foods are better than others, remembering that it is usually more important to be satisfied, even if the foods are not "ideal," than to be unsatisfied with what in the abstract seem "ideal" foods.

Among the best foods for most people are fruits, potatoes, nuts (if well masticated), milk, sour milk, and vegetables. Among the worst foods are putrefactive cheeses, sweetbreads, liver, kidneys, "high" game or poultry.

But a fastidious study of foods will find some faults as well as some virtues in almost any food. The best way to help the ordinary man choose his foods is to advise him to use as much as possible of the "better" and as little as possible of the "worse" without attempting to draw a hard and fast line between the "good" and "bad."

[Sidenote: Salt, Pepper, Spices]

Salt, pepper, and hot condiments should be used very sparingly, if at all.

[Sidenote: Sugar and Candy]

A great cause of ill health is overuse of sugar in concentrated form, candy, etc., especially by the sedentary. One reason why sugar has a high food value is that it is readily utilized for combustion, and if taken between meals greatly increases the calories and may lead to overnourishment.

[Sidenote: Water with Meals]

There is, for normal people, no objection to drinking a moderate amount of water at meals—say one or two glassfuls—provided it is not taken when food is in the mouth and used for washing it down.

[Sidenote: The Digestibility of So-called "Indigestible" Foods]

The science of dietetics will develop rapidly in the future, and in a few years it will probably be possible to be more definite than we have been here. At present there is much unknown, especially as to how far our rules have to be modified for the particular individual. Personal idiosyncrasies have to be taken into account. Sometimes "What is one man's meat is another man's poison." On the other hand, many have mistaken ideas as to their own idiosyncrasies. For instance, many people think that nuts never agree with them, when the trouble really is that they do not masticate them properly. Many think peanuts indigestible, not realizing either the importance of mastication or the importance of avoiding over-roasting. The ordinary peanuts are over-roasted. Peanuts very slightly roasted and very thoroughly masticated seldom disagree with one. Others believe that bananas never agree with them, when the fact is they eat them too green. The banana vender usually finds that the ignorant public buys his fruit best when its color is an even yellow, and he puts aside for himself the only bananas ripe and fit to eat, namely those which are mottled with black.

[Sidenote: Avoidance of Fads]

Each individual must use his own intelligence and common sense, avoiding so far as he can the mistake of following a "fad" and accepting a theory without sufficient evidence; and the opposite mistake of accepting as hygienic the customs about him simply because they are customs, and thus mistaking for fads any conclusions of science which are discordant with current custom.

[Sidenote: Necessity of Medical Examination]

It is a good idea to consult a physician in regard to one's diet, and endeavor intelligently to follow his advice and not insist on one's own diet, selected from the standpoint of mere self-indulgence or custom. Moreover, since many, without being aware of the fact, are affected with Bright's disease, diabetes, etc., in their early stages, in which dietetic precautions are especially necessary, it is well, even for those who are apparently in good health, to be medically examined as a preliminary to a rearrangement of their diet along the best lines.



CHAPTER III

POISONS

Section I—Constipation

If the human body be likened to a steam-engine, its wastes correspond to the ashes.

[Sidenote: Retention of Body Wastes]

The injury which comes from the retention of the body's waste products is of the greatest importance. The intestinal contents become dangerous by being too long retained, as putrefying fecal matter contains poisons which are harmful to the body. Abnormal conditions of the intestines are largely responsible for the common headache malady, and for a generally lowered resistance, resulting in colds and even more serious ailments. Constipation is extremely prevalent, partly because our diet usually lacks bulk or other needed constituents, but partly also because we fail to eliminate regularly, thoroughly, and often.

Constipation, long continued, is by no means a trifling matter. It represents a constant and cumulative tax which often ends in very serious consequences.

[Sidenote: Water-Drinking]

Free water-drinking when the stomach is empty, especially before breakfast, is beneficial in constipation. Free water-drinking at meals may prove constipating. Excess of water should be avoided by the very feeble or those suffering from heart trouble or dropsy.

[Sidenote: Laxative Foods]

The best regulators of the bowels are foods. Foods should possess sufficient bulk to promote the action of the intestines and should contain a due amount of laxative elements. Foods which are especially laxative are prunes, figs, most fruits except bananas, fruit juices, all fresh vegetables, especially greens of all sorts, wheat, bran, and the whole grain cereals. Oils and fats are also laxative but can not be used in sufficiently large quantities to produce very laxative effects without producing loss of appetite. Foods which have the opposite tendency are rice, boiled milk, fine wheat-flour in bread, corn-starch, white of egg.

[Sidenote: Bran and Agar-Agar]

The use of wheat-bran in cereals, in bread, and even in vegetables is a preventive of constipation, as is also the use of agar-agar, a Japanese seaweed product. This is not digested and absorbed, but acts as a water-carrier and a sweep to the intestinal tract. It should be taken without admixture with laxative drugs.

[Sidenote: Mineral Oils]

Paraffin oil is especially good as an intestinal lubricant to assist the food to slip through the intestinal tube at the proper rate of progress, provided the oil is first freed, by long-continued shaking with water, from certain dangerous impurities. Many refined preparations are on the market for use in constipation. Underweight people should not use these oils unless properly prescribed by a physician.

[Sidenote: Avoiding Drugs]

It is advisable, in general, to avoid cathartics except under medical supervision, since certain drugs are often very harmful when their use is long continued and the longer they are used the more dependent on them the user becomes. Laxative drugs, even mineral waters, should never be used habitually.

[Sidenote: Enemas]

The occasional, but not habitual, use of an enema (with warm water followed always by a second enema of cool water, to prevent relaxation) is a temporary expedient.

[Sidenote: Massage of the Colon]

Massage of the abdomen, deep and thorough, with a creeping movement of the ends of the fingers on the left side of the abdomen from above downward, also promotes the process of defecation.

The normal man and woman should find no difficulty in having complete movements regularly two or three times a day by merely living a reasonable life, being careful especially to avoid overfatigue, to include sufficient bulk in the food, to take regular exercise, including, in particular, breathing exercises, and to maintain an erect carriage.

[Sidenote: Low Seated Water Closets]

High-seated water closets, so often found in institutions, hotels and private houses, often favor constipation, as they do not permit of the proper physiological attitude in defecation. They prevent the individual from exercising abdominal pressure so essential for this function. Such seats should be made much lower than they are, or the feet should rest on a foot stool, in order to attain the proper attitude for thorough emptying of the intestine.

[Sidenote: Number of Defecations]

Observations on the manlike apes show that they defecate three or four times a day. Few of the human family have such ideal movements. Millions are conscious of some shortcoming in this regard, and doubtless millions more suffer from some shortcomings of which they are not conscious. Many believe they have free movements when actually they are suffering from a sluggishness in the rectum and other parts of the lower intestine. A rectal examination often reveals unsuspected fecal residues.

[Sidenote: Establishing Proper Habits]

The natural instinct to defecate, like many other natural instincts, is usually deadened by failure to exercise it. Civilized life makes it inconvenient to follow this instinct as promptly as, for instance, a horse does. The impulse to go to stool, if neglected even five minutes, may disappear. There are few health measures more simple and effective than restoring the normal sensitiveness of this important impulse. It may require a few weeks of special care, during which cold water enemas at night, following evacuation by paraffin oil injection, may be needed. It would be an excellent rule to visit the closet immediately after the noon and evening meals, as faithfully as most people do after the morning meal, until the reflex is trained to act at those, the most natural, times for its action.

Before leaving the subject of intestinal poisoning, we may here again mention the importance of avoiding the poisoning which comes from too much protein. This poisoning is probably due largely to the decomposition of protein in the colon.

[Sidenote: Use of Sour Milk]

One proposed method for reducing this decomposition of protein is through the use of sour milk. Lactic acid, the acid of sour milk, constitutes a medium in which putrefactive germs do not thrive. Hence, if sufficient sour-milk germs can be kept in the intestines to constantly manufacture lactic acid, putrefaction will be reduced. But, as Professor Rettger and others have shown, the mere swallowing of a little sour milk or of sour-milk tablets is seldom sufficient. The "good germs" swallowed die of starvation before they do much good. To keep them alive and enable them to multiply, we must feed them. The free use of milk and of milk sugar, a little raw starch, or partially cooked cereal such as Scotch brose (oatmeal cooked only ten minutes) will feed the germs.

[Sidenote: Evidences of Injury]

The odor and character of the stools are indicative of the extent to which our diet is injuring us. The odor is less offensive if the diet is low in protein and thoroughly masticated.

Section II—Posture

One of the simplest and most effective methods of avoiding self-poisoning is by maintaining an erect posture. In an erect posture the abdominal muscles tend to remain taut and to afford proper support or pressure to the abdomen, including the great splanchnic circulation of large blood-vessels. In an habitual slouching posture, the blood of the abdomen tends to stagnate in the liver and the splanchnic circulation, causing a feeling of despondency and mental confusion, headache, coldness of the hands and feet, and chronic fatigue or neurasthenia, and often constipation.

A slouching attitude is often the result of disease or lack of vitality; but it is also a cause.

[Sidenote: The "Consumptive Stoop"]

There is some reason to believe that "the consumptive stoop" leads to tuberculosis partly through the lowering of resistance resulting from the poisoning produced by a chronically relaxed abdomen.

Many persons who have suffered for years from the above-named symptoms have been relieved of them after a few weeks of correct posture, sometimes reenforced by the artificial pressure of an abdominal supporter and by special exercises to strengthen the abdominal muscles.

Lying face downward with a pillow under the abdomen presses the blood out of the congested splanchnic circulation.

[Sidenote: Breathing and Posture]

Breathing exercises are also very useful for correcting the chronic evils of bad posture. Exercises taken when lying on the back, by raising the legs or head, strengthen the abdominal muscles. Slow, deep breathing, through the nose, while lying on the back, with a weight on the abdomen, such as a bag of sand—2 to 4 lbs.—is beneficial.

[Sidenote: Standing and Walking]

In walking, the most common error is to slump, with the shoulders rounded, the stomach thrust out, the head thrust forward, chin up, and the arms hanging in front of the body. To those who walk or stand in this fashion, let it be known that this is the "habitus enteroptoticus," or asthenic droop. It is characteristic of those with weak muscular and nervous systems.

To set the shoulders back and square them evenly, to keep the chest high and well arched forward, the stomach in and the neck perpendicular, like a column, and the chin in, are simple fundamental measures that most people know and many people disregard.

One should have a sense of the firmness or tautness of the abdominal muscles and not of flabby relaxation. When one changes a slouching posture into an erect posture, there is a sense of having reversed the way the body hangs, as it were, on the spinal column.

Whether sitting, standing, or walking, these principles, that involve a correct and pleasing carriage and a healthful relation of the organs and structures of the body, should be observed by both men and women.

This perfect physical poise which places the muscles, organs, circulation, and even the brain and nervous system in harmonious relationship, adjusted for the best achievement, is well expressed in sculpture dating back to 500-600 B. C., when the Spartans attained supremacy in Greece. This same poise and symmetry is shown in modern sculpture of fine types of manhood and womanhood.

[Sidenote: The Feet]

It is not enough to have an erect carriage and a well-poised head. We must also have well-directed feet. It is pitiable to think how the work of a fine head may be spoiled by misdirected feet. Weak foot, and its final stage, flat foot, are more common among women than they are among men, because it is not a purely local condition in the arch of the foot, as so many suppose, but primarily due to a general weakened condition of the leg muscles that support the arch. The more vigorous exercise of boys as compared to that of girls protects them in some degree from this malady.

[Sidenote: Toeing Straightforward]

Weak feet are gradually converted into flat feet by faulty standing and walking posture and lack of leg exercise. Toeing out, whether walking or standing, so commonly noted among girls and women, places a great strain upon the arches of the foot. The correction of this fault by persistent toeing in, Indian fashion, and daily exercise of the leg muscles (rising on the toes twenty to forty times night and morning), will do much to prevent flat foot.

[Sidenote: Chairs]

Not only in standing, but in sitting, erect posture has been found to be a much more important factor in the maintenance of good health than is generally supposed. A rocker, or any other chair which tilts, is restful to the abdominal circulation, if the lower back is properly supported. Bad posture is common among sedentary people. The ordinary chair invites it. Every chair should be modeled like most modern automobile seats, on a curve to fit the back. Almost any chair can be corrected by placing a cushion so as to support the hollow of the back of the sitter. The responsibility for correct posture rests, however, on the individual and not on the chair.

[Sidenote: Sitting]

In sitting at a desk or table, when reading or working, the common fault is to adopt a sprawling attitude, with the shoulders hunched up, the elbows stretched outward, the body too far away from the desk or table, and the weight resting on the buttocks. Very often the desk or table is too high and the arms can not rest easily upon it, thus causing a continuous strain on the structures around the shoulder-joints.

To correct this fault, use if possible a chair with a back that curves forward. Sit well back in the chair, but close to the desk, so that the fleshy inner part of the forearms may rest easily upon its surface without pushing up the shoulders.

When it is necessary to lean over a desk, acquire the habit of inclining the body forward by bending at the hips and not by distorting the chest.

The arms should hang easily from the shoulder and the elbows should not rest upon the table. The shoulders should be evenly square, as in the correct standing posture. In right-handed people, the light should fall over the left shoulder or directly from above. The body should rest upon the full length of the thighs, not solely on the buttocks, and the feet (not legs) be crossed and resting lightly on the ground on their outer edges. In other words, the position should be freed from strain, especially strain of special groups of muscles.

Pains, erroneously ascribed to rheumatism or sciatica, are often due to faulty posture. Writer's cramp and many other needless miseries are caused by neglect to develop proper postural habits in working or reading.

[Sidenote: Posture in Children]

In children faulty posture may mar the future of the individual by causing spinal curvature and physical deformities that interfere with physical and mental efficiency throughout life, and often lower the resistance to disease. Deep breathing through the nose and "setting up" exercises are of incalculable importance in such cases.

The various types of faulty posture are so numerous that they can not be listed here. Having once grasped the meaning of correct posture, however, we can form a standard for ourselves, and any departure from this standard should be looked upon as a menace to health. As in the case of eye-strain, flat foot, work, worry, and drink, much depends on the original physical and mental endowment of the individual as to how much harm results from faulty posture. But always some harm results.

[Sidenote: Teaching Correct Posture]

The teaching of proper standing, proper walking and proper sitting should be a part of all school discipline as it is at military schools, especially as there is the temptation to crouch over the school-desk—which is usually the source of the first deviation from natural posture. An infant before it goes to school usually has a beautiful, erect carriage, with the head resting squarely on the shoulders.

[Sidenote: Posture and Character]

An erect posture is attractive from an esthetic point of view, and for that reason is sure again to become fashionable with women, after a due reaction from the present slouching vagary. It is also closely associated with self-respect. We know that any physical expression of an emotion tends reflexly to produce that emotion. Therefore, not only does self-respect naturally tend to brace a man's shoulders and straighten his spine, but, conversely, the assumption of such a braced-up attitude tends to "brace up" the man's mind also. Tramps and other persons who have lost their self-respect almost invariably slouch, while an erect carriage usually accompanies those feeling their respectability. We jokingly refer to those whose self-respect verges on conceit as "chesty," while we compliment one who is not so extreme by saying, "He is no slouch."

Between the slouch and slink of the derelict and the pompous strut of the pharisee, or the swagger of the bully or the dandy, there is the golden mean in posture, which stands for self-respect and self-confidence, combined with courtesy and consideration for others.

Section III—Poisons from Without

The poisons which hitherto have been mentioned are those developed within the body, especially in the intestine. It is not alone important to keep down the total amount of poisons produced within the body. It is equally important to exclude the entrance of any additional poisons from outside.

[Sidenote: Habit-forming Drugs and Patent Medicines]

Among the poisons which must be kept out of the body should be mentioned habit-forming drugs, such as opium, morphine, cocain, heroin, chloral, acetanilid, alcohol, caffein, and nicotin. The best rule for those who wish to attain the highest physical and mental efficiency is total abstinence from all substances which contain poisons, including spirits, wine, beer, tobacco, many much-advertised patent drinks served at soda-water fountains, most patent medicines, and even coffee and tea. Many so-called patent or proprietary medicines contain habit-forming drugs, especially morphine, coal-tar preparations, caffein, and alcohol, and depend largely for their sale upon the effects of these harmful substances. Harmful preservatives and adulterants in foods, such as saccharin, should also be avoided.

[Sidenote: Reducing the Habit]

For some persons the inevitable mode of improvement will be by substituting the milder drugs for the stronger—beer for spirits, weak tea for beer. The exact extent to which the milder poisons are injurious has not yet been scientifically settled. Tea, for instance, if very weak and used moderately, is, presumably, not injurious to any marked degree to healthy persons. The trouble is, however, that sensitive people do not keep moderate. In fact, the natural tendency of drug-craving is in the opposite direction, from weak drugs to strong ones, as from beer to spirits. In actual fact, it is much easier to abstain than to be moderate. It should also be noted that the lax spirit in which many people make an exception to the rules of health in favor of some mild indulgence is very likely to lead to the making of many other exceptions until they are, without knowing it, carrying a heavy load made up of scores of little items of harmful indulgence. Moreover, experiments at the Pasteur Institute have shown that the long-continued use of very minute doses of poison ultimately produces appreciable harm. Each person must decide for himself how far he chooses to depart from previous habits or common customs for the sake of physical efficiency. The object here is to state exactly what, in our present state of knowledge, is believed to be the truth.

Those with feeble digestions or unstable nervous systems are especially harmed by these poisons. A family history of nervously inclined people calls for rigid care in such matters.

[Sidenote: Alcohol]

Scientific experiments have resulted in the interesting discovery that the alleged "strength" obtained from beer, ales, and all intoxicating beverages is a delusion and a snare. The poison simply gives a temporary feeling of greater strength through paralysis of the sense of fatigue. But the strength does not exist. On the contrary, the user of alcohol in excess is weaker after taking it. Special classes of workmen have been tested as to their efficiency under liquor in small amounts and without it entirely, and it was invariably found that the liquor was a handicap, but that, also invariably, the workmen thought they could work harder by its aid! Alcohol numbs the sense of fatigue and so deceives the user. It is not a stimulant but a narcotic. The habit of taking a cocktail before meals is doubly harmful, because it is often taken on an empty stomach and because it poisons the system more quickly than when mixed with food and retained in the intestines.

[Sidenote: Alcohol and Infectious Diseases]

It is well known that people who indulge in alcohol show less resistance to infectious diseases than abstemious individuals. The paralysis of the white blood-corpuscles is one of the strong arguments against the use of alcohol. The experience of life insurance companies in England and America has clearly shown that even the "moderate" use of alcoholic beverages shortens human life. (See "Alcohol" in SUPPLEMENTARY NOTES.)

Dr. Stockard has also shown in mice, on which he has experimented, that the effect of alcohol on the germ-plasm is distinctly injurious. It is a fair inference that the use of alcohol by parents tends to damage their offspring.

[Sidenote: Tobacco]

The evils of tobacco have not been so much studied and are not so well understood as those of alcohol. But every athletic trainer observes that the use of tobacco lessens physical fitness. The ordinary smoker is unconscious of this and often denies it. He sometimes says, "I'll stop smoking when I find it hurting me; it doesn't hurt me now." The delusive impression that one is well may continue long after something has been lost from the fitness of the body, just as the teeth do not ache until the decay has gone far enough to reach the nerve.

At Yale and at Amherst it has been found, by actual measurement, that students not using tobacco during the college course had gained over the users of tobacco in weight, height, growth of chest, and lung capacity.

Prof. Pack, of the University of Utah, finds that tobacco-using athletes are distinctly inferior to those who abstain. Prof. Lombard, of the University of Michigan, finds that tobacco lessens the power of the voluntary muscles, presumably because of the depressing effect on the central nervous system. There is also much experimental evidence to show that tobacco in animals induces arterial changes. The present well-marked upward trend of mortality from diseases of the arteries offers a good reason for heeding such evidence and taking the safe side in every controversy regarding it. (See "Tobacco" in SUPPLEMENTARY NOTES.)

[Sidenote: Germs]

The poisons so far mentioned are limited to the amounts taken. Infections with germs, however, bring in poisons, the quantities of which tend to increase with the multiplication of the germs. It is, therefore, especially important to avoid infections. We should not depend altogether on the protection of our health officers. We must guard our own individual bodies.

[Sidenote: Colds and La Grippe Germs]

Infections enter the body through the skin or mucous lining. The common cold is believed to enter by the nose. We may avoid exposure to infection from grippe and common colds by keeping away from congested public places when there is an epidemic of grippe or colds, or when we are ourselves fatigued or for any reason likely to catch cold.

The infections of common colds are always to be found in the nasal passages and become active when the individual is subject to fatigue or indigestion or both. The liability of catching cold is greater when the mucous lining is injured. Nasal douches are injurious and impair the protective ability of the mucous membrane. They should be used only on prescription. A very gentle, warm spray of weak salt and water may be used when the nose is filled with soot and dust. The fingers should be kept from the nose. Handkerchiefs should be frequently changed, or small squares of gauze used and subsequently burned.

[Sidenote: Tuberculosis Germs]

The germ of tuberculosis is probably conveyed oftenest through the sputum of consumptives, when this sputum has been allowed to dry, has become pulverized and is breathed into the system. All sputum should be burned. It is well to avoid rooms occupied by consumptives who are not careful with their sputum.

[Sidenote: Mosquito-borne Malaria and Yellow Fever]

Suitable wire netting will guard us from malaria and yellow fever, the infections brought by mosquitoes and flies. The mosquito often carries malaria, and in the tropics carries yellow fever and other diseases. As some one has said: "A yard of screen in the window is better than a yard of crape on the door." The greatest triumph in connection with the building of the Panama Canal was not the engineering but the reduction in the death-rate among the workers, which, on account of these insect-borne diseases, had previously prevented the successful execution of the undertaking.

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