American Red Cross Text-Book on Home Hygiene and Care of the Sick by Isabel McIsaac (best affordable ebook reader txt) π
FOR FURTHER READING
A History of Nursing--Dock and Nutting, Volume I.
The Life of Florence Nightingale--Cook.
The Life of Pasteur--Vallery-Radot.
The House on Henry Street--Wald.
Public Health Nursing--Gardner, Part I, Chapters I-III.
Origin and Growth of the Healing Art--Berdoe.
Medical History from the Earliest Times--Withington.
Under the Red Cross Flag--Boardman.
Report on National Vitality--Fisher, (Bulletin 30 of the Committee of One Hundred on National Health. Government Printing Office, Washington).
CHAPTER I
CAUSES AND PREVENTION OF SICKNESS
Diseases of two kinds have long been recognized: first, those transmitted directly or indirectly from person to person, like smallpox, measles, and typhoid fever; and second,
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Even more attention should be paid to the hands of the cook. They should be washed always before handling food, and always after visiting the toilet, using the handkerchief, or otherwise coming in contact with nose, mouth, or other bodily secretions. Theoretically coughing and sneezing ought not to occur in the neighborhood of food, especially of food to be eaten raw; and persons with coughs, colds, or other communicable disease, however slight, ought not to handle food. If this rule were observed in practice, more persons would go hungry, but fewer would be sick.
Thorough cleaning of rooms involves soap, water, sunshine, air, and elbow grease, just as it did before germs were discovered. Cleaning means actually removing dirt and dust, not merely stirring it up to settle again; consequently dry sweeping and dusting are ineffectual. Vacuum cleaning, and sweeping and dusting with damp or "dustless" mops and dusters are good. Deodorants and disinfectants do not take the place of ordinary cleanliness.
Dust does not carry living disease germs to an appreciable extent; the fact is now well established that diseases formerly thought to be transmitted by dust or even supposed to travel directly through the air, are carried on tiny particles of moisture and mucus expelled in coughing and sneezing. This mode of transmission is called droplet or spray infection; it is one of the most active agents in spreading certain kinds of communicable diseases.
Nevertheless dust in motion is harmful; it irritates the lining membranes of the nose, throat, bronchial tubes, and lungs, even causing tiny wounds through which disease germs enter. Thus tuberculosis is especially prevalent among stone cutters, felt workers, and others engaged in dusty trades. Metallic dust is especially harmful, because it is harder and sharper than dust from organic substances like wool and cotton. Furthermore, presence of dust indicates a low standard of cleanliness. People who tolerate it generally tolerate uncleanliness in other forms, more serious though less apparent.
Cleaning would not be so great a problem if most houses were not littered with such dust catchers as carpets, so-called ornaments, carved and upholstered furniture, banners, draperies, and a vast collection of articles that can only be classified as Christmas presents. In actual practice things that are difficult or expensive to clean seldom are cleaned; carpets for example are considered unhygienic, not because they cannot be cleaned, but because they are not. William Morris' advice to exclude from houses all articles not known to be useful or believed to be beautiful would, if followed, add years to the lives of housekeepers.
, has little bearing on health, except in so far as it affords a breeding place for flies. If it contains disease germs it may be dangerous, but statistics show that garbage handlers, although they can hardly be called especially careful, are not more subject to sickness than other men of their class. Garbage disposal is chiefly a question of preventing a public nuisance; it is a matter of cleanliness and public decency.
βFlies, cockroaches, and other scavenging insects may carry disease germs on their feet and thus infect food on which they walk. Typhoid, cholera, dysentery, and other diseases have been carried by flies. Flies are always a menace, and should not be tolerated; moreover, the thought of their coming to food directly from manure piles and privy vaults is disgusting. Houses should be thoroughly screened in the fly season, but it is better to destroy the nuisance at its source. The chief breeding places of flies are garbage cans and manure piles. If the garbage can is water tight, closely covered, frequently emptied, and thoroughly cleaned, flies will not develop in it; about ten days must elapse from the time when the egg is laid until the insect is ready to fly. Fly traps to fit on the garbage can are useful. Manure should be screened and removed frequently, or it can be treated chemically. Methods for treating it are given in "Preventive Medicine and Hygiene."βRosenau, p. 255, and in Bulletin No. 118, of the U. S. Dept. of Agriculture, July 14, 1914.
(U. S. Dept. Agri.)
Other diseases carried by insects are malaria and yellow fever, each by a special species of mosquito; typhus fever, by lice; and bubonic plague, by rat fleas. Various diseases less common in this country are carried by other insects. Even when mosquitoes are not carrying disease germs their bites may be harmful since they are often rubbed, especially by children, until the skin is broken, and various infections may enter through the wounds. Insects of every kind, rats, mice, and vermin should be excluded from houses.
βDischarges from the bowels and bladder contain various germs, and constitute one of the most important routes by which germs of typhoid fever, cholera and certain other diseases travel from person to person. Keeping sewage out of the water supply is consequently of great importance. Where a system of sewage disposal exists, the responsibility of making the system adequate and thus safeguarding public health rests upon the community as a whole. Communities ordinarily get just as much, or just as little typhoid fever as they are willing to endure.
Fig. 9.βHow a well may be polluted. (From "The Human Mechanism." Copyright by Theodore Hough and William T. Sedgwick. Ginn and Company, publishers. Used by permission.)
In places having no system of drainage privies must be used. They can be made harmless, as army camps prove, but they require scrupulous care. Fecal matter must be prevented from draining into wells and other water supplies, and must be screened from flies. The privy should be located at a distance from the well. The minimum distance that is safe depends in each case upon the nature of the soil and the direction of the natural drainage. Even when the privy is situated below the well on sloping ground, drainage may still occur from the privy to the well; however, a well-made, properly located pit privy is safe unless it is near a limestone formation. The dry earth system is satisfactory in places having an efficient public scavenger system; in this system pails or cans are used to receive the discharges, which are then covered with sand, ashes, earth or, preferably, chloride of lime. The buckets are frequently emptied and the contents buried at least one foot below the surface of the ground. The objection to this method for more extended use is that proper care of the cans is a disagreeable duty of which most households soon tire.
βThe main functions of the skin are three: to protect underlying tissues, to excrete waste matter, and to regulate bodily heat by checking or allowing the evaporation of perspiration. After perspiration has evaporated solid matter is left upon the skin, and oily matter also is deposited on it by the glands that keep the skin lubricated. Removing these and other materials at least once a day is desirable to improve the bodily tone and sense of well-being. Real cleanliness is impossible without frequent use of warm water and soap.
Cold baths are stimulating, though not very efficacious for cleansing purposes. They are valuable tonics if properly used, but delicate or elderly persons should use them only by a physician's advice. Chilly feelings or depression following should be the signal for any person to discontinue cold bathing or swimming in cold water.
Warm baths are soothing in their effects, and are appropriate at bed time, particularly for persons inclined to sleeplessness. Very hot baths, especially if prolonged, may be harmful, and should not be taken often.
There is no clear connection between general cleanliness and disease. Frequent bathing does not protect a person from any particular disease, except in so far as bathing necessarily includes washing the hands. If typhoid germs for example have actually been swallowed, a clean bodily exterior is of no avail in preventing typhoid fever or in diminishing its severity. The same is true of other diseases.
But it is impossible to emphasize unduly the importance of clean hands. Hands are prime offenders in distributing fresh bodily secretions, and germs both innocent and harmful. All health authorities agree on this point.
"Perhaps 90% of all infections are taken into the body through the mouth. They reach the mouth in water, food, fingers, dust, and upon the innumerable objects that are sometimes placed in the mouth. The fact that the great majority of infections are taken by way of the mouth gives scientific direction to personal hygiene. Sanitary habits demand that the hands should be washed after defecation and again before eating, and fingers should be kept away from the mouth and nose, and that no unnecessary objects should be mouthed. All food and drink should be clean or thoroughly cooked. These simple precautions alone would prevent many a case of infection."β(Rosenau: Preventive Medicine and Hygiene, p. 366.)
As Dr. Chapin says:
"Probably the chief vehicle for the conveyance of nasal and oral secretion from one to another is the fingers. If one takes the trouble to watch for a short time his neighbors, or even himself, unless he has been particularly trained in such matters, he will be surprised to note the number of times that the fingers go to the mouth and the nose. Not only is the saliva made use of for a great variety of purposes, and numberless articles are for one reason or another placed in the mouth, but for no reason whatever, and all unconsciously, the fingers are with great frequency raised to the lips or the nose. Who can doubt that if the salivary glands secreted indigo the fingers would continually be stained a deep blue, and who can doubt that if the nasal and oral secretions contain the germs of disease these germs will be almost as constantly found upon the fingers? All successful commerce is reciprocal, and in this universal trade in human saliva the fingers not only bring foreign secretions to the mouth of their owner, but there exchanging them for his own, distribute the latter to everything that the hand touches. This happens not once, but scores and hundreds of times during the day's round of the individual. The cook spreads his saliva on the muffins and rolls, the waitress infects the glasses and spoons, the moistened fingers of the peddler arrange his fruit, the thumb of the milkman is in his measure, the reader moistens the pages of his book, the conductor his transfer tickets, the "lady" the fingers of her glove. Every one is busily engaged in this distribution of saliva, so that the end of each day finds this secretion freely distributed on the doors, window sills, furniture and playthings in the home, the straps of trolley cars, the rails and counter and desks of shops and public buildings, and indeed upon everything that the hands of man touch. What avails it if the pathogens do die quickly? A fresh supply is furnished each day."β(Chapin: The Sources and Modes of Infection, p. 188.)
βCleanliness and proper care of the mouth and teeth can hardly be over emphasized. Their bearing upon health is
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