(bpyriglit'N?. COPYRIGHT DEPOSIT. HOW TO MEET THEM SPANISH INFLUENZA PNEUMONIA COMMON COLDS TUBERCULOSIS THE CANCER PERIL CHILDREN'S DISEASES DISEASE PREVENTION A CLEAN BODY HOME TREATMENTS THE SICKROOM ^fc MONTH §X MONTH HEALTH SERVICE in mini limn minium mi urn illinium mi urn mmmimiiimimmmimmiiimimmimm T ^ ) n te r-3 4i^". Sgg^z -^ (^ ,-»•*•»• ILLINOIS STATE BOARD op h EftCTH - CARTOON U?37 THE ORIGINAL BOMBING MACHINE 63 DIRTY — MILK -CLEAN JTS3 THE WRONG WAY — THE RIGHT WAY G4 v EXPOSED \r -, TftfOW Rp?Wdl •*- -A Sink of toiqifty A '-> ILLINOIS STATE BOARD OF HEALT-H ~ CARTOOnN 9 ** . PERHAPS THIS IS THE SECRET ofTHAT " FINE MINERAL FL-AVOfc" YOU NOTICE IN THE WELL WATER. 5 65 66 Epidemics: How to Meet Them of little concern to those who are interested in the wel- fare of children. How Measles Is Spread The immediate cause of measles is supposed to be a certain kind of germ, or microbe, which is contained in the discharge that comes from the patient's nose or mouth. The infectious material may be thrown off in the spray caused by sneezing or in the spittle when coughing. Drinking glasses, cups, dishes, spoons, towels, hand- kerchiefs, napkins, clothing, bedding, and other articles used by the patient may carry the germs, and other per- sons using them before they are well disinfected, may take the germs into the system and thus contract measles. The fingers or hands may convey the germs to an- other in shaking hands or in handling dishes or utensils that have been used by the patient. The infected hands will most likely carry the germs to the nose, mouth, or eyes of their owner, or may be the means of transmit- ting them to some one else. Every one should be willing to help in preventing an epidemic of measles. Children who have been ex- posed to measles should not go to school or to other places where children gather. While they may carefully wash their hands and faces and try to avoid carrying the disease germ, they may themselves become ill with the disease while at school, and thus give it to other children before proper care can be taken to prevent it. Care of the Patient It is safest to have your physician's advice. In his absence, or while waiting for him, put the sick child in a room away from other children. Also take into the room the articles the child has used since showing symp- Children's Diseases 67 toms of the disease ; this is especially important of things that may have been in his mouth. Put the patient to bed promptly in a cheery, well- ventilated room, taking care to keep him warm but not overheated. Provide plenty of fresh air, but avoid drafts. If child help is needed to care for the little patient, select an older child or one that has already had measles. This does not mean one who has had German measles, which is another disease. Whoever helps to care for the child should take pains to wash the hands before touching anything outside of the sick-room, particularly cooking utensils, dishes, or anything that is liable to convey the disease germs to others. It would be advisable for the attendant to wear a loose gown or large apron, easy to slip on and off. All mouth and nose discharges should be received into rags or soft paper, which should be kept in a closed paper bag until burned. Whoever handles these bags should carefully wash his hands. The mother or other attendant should bear in mind that the germs of measles may be carried out of the room by means of the various articles and ways already mentioned, and should carefully guard against it. She should not kiss the sick child, nor kiss other children after being with the sick child. The germs do not live long after leaving the body, but during the short time they do live they are very active in spreading the disease. This is true even be- fore the rash appears. Period of Incubation Measles usually develops in from nine to fourteen days after exposure, and this period should elapse before the exposed person is allowed to mingle with other children. 68 Epidemics: How to Meet Them Treatment Give the child a warm bath daily. A tepid bath or cool sponge should be given to allay the fever. A cool or cold sponge is most refreshing and soothing whenever the child is feverish. Avoid chilling. The diet should be light, consisting chiefly of fruit juices, fruit both fresh and stewed, bread, an occasional egg or custard, rice, simple pudding, and similar foods prepared without much sugar. Milk may be used freely. If the bowels are loose, omit the fruit ; as a rule they are sluggish, and fruits that are laxative are to be recom- mended. With careful nursing, proper attention to the bowels, using the enema if necessary, and frequent bathing, the child will usually make a good recovery. Keep him in bed at least a week after the acute stage is passed, to prevent complications or a relapse. It is the after- effects, such as bronchitis and pneumonia, that are particularly dangerous. For this reason the greatest care should be taken to keep the child warm, yet at the same time to provide an abundance of fresh, pure, invigorating air. The danger of injury to the eyes should be guarded against. While plenty of sunlight is desirable (and it is possible to have it without injury if the eyes are shaded), there may be cases in which it is necessary to darken the room in order to allay the irritation of the bright light. Use a saturated solution of boracic acid as a wash for the eyes. Disinfection Fumigation is not necessary, but all the clothing, bedding, sheets, pillow cases, etc., should be boiled twenty minutes, or soaked for one hour in a 3-per-cent solution of carbolic acid, — three teaspoonfuls of car- bolic acid to one pint of hot water. Put in a little laun- Children's Diseases 69 dry bluing to indicate that it is poisonous. The room which has been occupied by the patient should be given a few days' airing and exposure to sunshine. With proper precautions on the part of parents and with the co-operation of all concerned, both parents and school authorities, measles and other children's epidemic dis- eases could be quite largely controlled. Whooping Cough Another serious disease which many regard as harm- less and which they think the child " must have sooner or later, and the sooner the better," is whooping cough. But it is no more necessary for children to have whoop- ing cough, scarlet fever, or diphtheria, than it is to have pneumonia or any other serious disease. A child will be stronger and healthier if he does not have these dis- eases which weaken the system. Whooping cough is a serious disease. Thousands of children die annually from it. In some States whoop- ing cough kills more children than does measles, serious as we have shown that " harmless " disease to be. Delicate children and those subject to tuberculosis are in great danger from whooping cough. As with measles, the after-effects very often prove fatal. Nine tenths of the children who die from the results of whooping cough die of broncho-pneumonia. The severe attacks of coughing, accompanied by the choking sensations which are typical of this disease, make it difficult to maintain the nutrition necessary to the child's health. Nature of the Disease Whooping cough is a highly contagious disease. It affects the respiratory passages, and is communicated by the secretions from the nose, throat, and mouth. The disease begins as an ordinary cough, and may be difficult to identify as whooping cough until the child 70 Epidemics: How to Meet Them " whoops/' It lasts from six to eight weeks or more. In mild cases the child will have only four or five at- tacks of coughing a day. The cough is especially marked at night, and after about a week increases in severity. In mild cases the whoop may not appear. The germs of the disease, contained in the dis- charges of the nose and throat, are most numerous during the early stage. While they are not considered as being air-borne (that is, carried in the air), they are carried in the little droplets expelled in coughing. In the struggles of the child during the paroxysms of coughing, the germs are liable to get on his hands. Direct contact with others will transmit the germs, and thus spread the disease. Period of Incubation The symptoms usually begin nine or ten days after the germs have entered the body. Isolation The child suffering from whooping cough should be kept away from other children, unless they have had the disease and are therefore immune. If he has been attending school or gatherings of children, proper noti- fication should be given to the parents of those children, that due care may be taken to prevent the spread of the disease. The same requirements for isolation as were given for measles should be observed in whooping cough. Treatment There is no known specific remedy for the disease. The diet should be carefully guarded. Only simple foods should be given, and the child should not be al- lowed to overeat. He should be kept warm, but not too warm. He should have plenty of fresh air. The bedroom should be thoroughly ventilated. In good weather let the child spend as much time as possi- Children's Diseases 71 ble outdoors in the fresh air and sunshine, but not where he will endanger other children. He should be urged strongly to suppress the cough, as coughing aggravates the trouble. Disinfection While the germs of whooping cough are short lived, the room 'occupied by the sick, with its contents, should be given a thorough cleansing, airing, and exposure to sunshine before being used in any way by persons not immune to the disease. Scarlet Fever Scarlet fever is another very contagious disease, and it may become epidemic. Death is caused directly by the disease, and there are also serious after-effects which may end fatally. Isolation The protection of young children from exposure to scarlet fever is particularly important, as it is espe- cially serious in children from one to five years of age. Nursing infants are not so susceptible. In severe cases death may occur within two or three days. The disease varies in severity. Sometimes it is quite mild, the patient being ill only two or three days. Infection from these mild cases may, however, result in a malignant form of the disease. There is danger that in mild cases the child will not receive proper care. Running ears may result in deafness or something worse, due to the lack of care during the acute stages of even a mild case of the dis- ease. Frequently disease of the kidneys results. There is danger, too, that a child with a mild case of scarlet fever may be allowed to go to school or other places where there are children; and others, contracting the 72 Epidemics: How to Meet Them disease, will develop a most severe form of it. The degree of caution exercised in the care of scarlet fever should not be regulated by the severity of the case. A physician is just as necessary in a mild case as in one that is severe. Scarlet fever is transmitted by germs contained in the discharges from the nose and throat. They are given off in coughing and sneezing. The germs may also be conveyed in milk. Epi- demics have occurred in communities where the milk had become infected through improper handling. During a scarlet-fever epidemic all milk should be boiled, espe- cially if used by children. Period of Incubation Scarlet fever develops in from one to seven days, most often in from two to four. This means that, as a rule, a person who receives the germs of the disease in the mouth or the nose will show no effects until from two to four days or possibly not until seven days later. Symptoms The first symptoms are headache, vomiting, sore throat, fever, pains in the back, and faintness. Vomit- ing, caused by the effects of the poison on the nervous system, is quite common. The pulse is very rapid. A scarlet rash appears in from twelve to twenty-four hours after the onset, usually first on the neck and upper part of the chest. Sometimes the rash is not very marked, especially in mild cases. As in measles, the disease may be communicated before the rash appears. This suggests the necessity of carefully watching any child that has been exposed to the disease, and not al- lowing him to mingle with other children until it is .certain that he is not infected.' Children's Diseases 73 Care and Treatment The patient should be confined strictly to one room, with plenty of fresh air but not in a draft. Give tepid sponge baths, cool compresses over the abdomen, and cool enemas to reduce fever. If the erup- tion is slow in appearing, give a warm full bath and sponge the skin with hot water. There is no danger that the eruption will be " driven in." For headache, apply a cold compress to the neck. The mouth should be rinsed frequently with a saturated solution of boracic acid. For foul breath, give a gargle of a solution of one part peroxide of hydrogen to two parts water. This solution may also be used for swabbing the throat. An- other good solution for use with a swab is a half tea- spoonful of permanganate of potash to a pint of water. Should there be earache, apply heat to the side of the head, as hot as can be borne. Use fomentations (see page 98) or a hot water bottle or any other means of applying heat. Symptoms of inflammation of the mid- dle ear are pain in the ear, tenderness over the bony prominence behind the ear, drowsiness, and moaning in the sleep. If possible a physician should be called at once. If the drum membrane is lanced early, it will prevent the forming of an abscess in the bony cells be- hind the ear, which might otherwise break into the cranial cavity. Early attention may mean the preser- vation of the hearing. Inflammation of the kidneys sometimes occurs, at- tended with suppression of the urine and general dropsy. Apply fomentations to the small of the back. Induce free perspiration with the hot pack (see page 103), vapor bath, or warm bath, with abundance of water to drink. Wrap in warm blankets following the bath, in order to continue the sweating. Do not give tea, coffee, 74 Epidemics: How to Meet Them or cocoa, and absolutely withhold meat. No food at all should be given for twelve hours. This is a serious condition, and should have prompt and vigorous at- tention. Those having the care of the patient should give their entire time, and not do anything which will bring them in contact with other members of the household. Disinfection The discharges from the mouth and nasal passages should be received in pieces of cloth or soft paper, and immediately burned. The dishes and all articles taken from the sick-room should be thoroughly disinfected by scalding or boiling. Great care should be exercised to wash the hands frequently with strong soap, and not to come in contact with other children after having handled the utensils of the sick-room or being about the patient. Do not touch the door knob unless the hands have been washed, Of course the child should not be kissed. Scarlatina Scarlatina and scarlet rash are other names for scarlet fever. Scarlatina should not be regarded as a harmless affection. When scarlet fever in any form is in the neighborhood, children should be kept off the streets and away from places where children gather, and particularly from children who are ailing, or have sore throats, or a rash of any kind. A child that has contracted the disease should be isolated, thus prevent- ing its spread to others. No child should return to school from an infected home until permission is given by the health officers. The patient is not well until peeling of the skin has ceased and there is no discharge of pus. Children's Diseases 75 Disinfection Disinfection may be accomplished as follows : Worth- less articles should be burned; clothing, bedding, and such things *as can be boiled, should be boiled for half an hour. Eating utensils should be scalded with boil- ing water. The room should be fumigated with for- maldehyde gas, made by placing formalin in a ten- quart pail and pouring permanganate of potash over it. Use one pint of formalin and one-half pound of potash for every 1,000 cubic feet of air space. The room should remain tightly closed four hours; then open it and allow the gas to escape. Leave the room to air thoroughly for several days. Expose the curtains, rugs, mattress, etc., to the sunshine, and beat them well be- fore using. Diphtheria Another dangerous disease easily communicated is diphtheria. While it is particularly dangerous to chil- dren, adults are also affected. Mild cases are to be feared because infection from them may cause serious cases. Not a great many years ago a single case of diphtheria in a community meant much business for the undertakers. The disease is now being brought somewhat under control Diphtheria is transmitted by direct contact with infected persons or objects. It does not fly about in the air, though it may be conveyed in the spray from the throat in coughing. To avoid infection one should avoid handling or coming in contact with any article* that has been exposed to the infection. The disease germ can be carried in milk and other foodstuffs. It is therefore necessary that great care be exercised to see that a person having the disease does # not come in contact with food that others are to use. Sometimes the disease is conveyed by a person known as a " car- 76 Epidemics: Hoiv to Meet Them rier," — one who carries about with him the diphtheria germs, yet does not have the disease. Any person who has been exposed to the disease may become a carrier. With diphtheria, as with scarlet fever, the greatest vigilance should be exercised. Symptoms The disease begins with sore throat and fever, though the fever may not run high. Sometimes there is prostration, and the glands of the neck at the angle of the jaw are often swollen and tender. Whitish or grayish spots appear in the throat, and sometimes ex- tend so as to form a false membrane on the tonsils or on the back of the throat. Sometimes the membrane forms in the windpipe, causing what is known as mem- branous croup. Very often the nose is affected. This is indicated by a discharge and frequent bleeding. It is difficult to distinguish a mild case of diphtheria from simple sore throat. Care and Treatment If a child has sore throat, it is always best to find out at once what is the trouble. It may be diphtheria, or scarlet fever, or the approach of some other dan- gerous disease. Therefore the doctor should be con- sulted as early as possible. It may be necessary to have a laboratory test made of a specimen from the throat, to determine the character of the disease. Do not wait, however, until the doctor comes before iso- lating the child from other children. You need the doctor to tell you what to do to prevent the spread of the disease, and also to administer diph- theria antitoxin, which is not only a curative measure but a preventive as well. If one person in the house has diphtheria, a small dose of antitoxin given to each of the other members of the household will probably prevent its further development. Children's Diseases 77 The patient should be immediately put in a room by himself, first taking everything out of the room that is not needed. The room should be kept neat and clean, and well ventilated, and no one but the attendants should be admitted. Extreme care should be exercised in the handling of all articles used in the sick-room so that the infection shall not be carried to others. The precautions given for other children's diseases already considered in this chapter are in place in the care of diphtheria. Suggestions It should be remembered that the diseases we have considered in this section are most dangerous to young children, and the longer children can be kept from having them the better. The younger they are when they have the disease the more likely they are to die. If you believe that it is impossible to keep your chil- dren from having these diseases, determine to defer the evil day as long as possible, and thus lessen the chance of their having them at all. Teach children to be on guard against these maladies. Let them know that they do not " catch " diseases in the ordinary sense of the word, but that they " take " them by getting disease germs into the mouth or nose. Teach them that it is possible for people to communicate dangerous disease germs by means of the discharge from the nose, throat, and mouth. Let them learn not to put into the mouth anything that other children have had in theirs, such as lead pencils, slate pencils, chewing gum. This should be especially and frequently im- pressed upon every child, and a good example should be set in the home. (Ss. ?sus&&j\dt Pork Heboltsasandwichandsomebe Apieceortwoof pie ; Andgulpsacupofcoffeed Whileyoucanbatyoureyer IF THE COUNSEL BE GOOD, NO MATTER WHO GAVE IT' 78 Life is not merely to live, but to be well." PREVENTION OF DISEASE Immunity to an epidemic disease, or to any other sickness, requires good blood. The blood, as well as every other organ and tissue of the body, is made from the materials taken into the system. To have good blood one must eat good food, drink pure water, and breathe pure air. Exercise, sleep, and rest enter into the ac- count as well, but food is the principal factor in health building. Good blood cannot be made from bad food. The body has wonderful capabilities, but no provision is made for converting poor food material into healthy blood. Good food may be spoiled by poor milling, adulteration, improper care, decomposition, bad cook- ing, and in various other ways. Some foods are in- ferior to begin with. The digestive apparatus of the human body can only do its best with such material as is furnished it; for the body does not manufacture food material. 79 80 Epidemics: How to Meet Them Good Food and Good Sense The original diet given man was composed of grains, fruits, nuts, and vegetables. These contain all the nour- ishment ordinarily required for the maintenance of health and strength, and are, in their natural state, free from disease elements. The variety to select from is extensive enough to suit all conditions of season, climate, and occupation. Individual natural tastes and needs may be fully met. Good sense and sound judg- ment, free from faddish notions, should lead persons to select from that which is good such foods as are good for them and suited to their needs; for not all persons can eat alike. Simplicity in Preparation Simplicity in the preparation of food is best. Com- plicated mixtures, greasy preparations, highly seasoned foods, and rich pastries are bad for any one. A small variety at a time, but a wide variety in general, should be used. All the elements of nutrition must be sup- plied, or the body will suffer. Other things being right, a properly balanced diet, prepared in a wholesome and palatable manner and then eaten as it should be, will keep one in perfect health. The use of all other health measures will not make up for an inadequate dietary. Full- Value Foods Cereals containing all their original food properties are especially valuable. Fine flour, polished rice, and many of the manufactured cereal products lack certain essential elements which have been eliminated in the process of manufacture. Recent food investigation brings to our knowledge the fact that certain elements called vitamines are pres- ent in the skin, or covering, of grains, fresh fruit, raw milk, egg yolk, and fresh vegetables. A diet lacking in Prevention of Disease 81 vitamines will, it is said, lead to scurvy, beriberi, and pellagra. Other serious disturbances may result. A certain amount of raw foods is necessary to perfect nutrition and health. Milk is one of the best of foods, when secured from healthy cows and properly cared for. Growing chil- dren especially need it. But it is readily contaminated by impurities, and is a favorable medium for the growth of disease germs, as typhoid fever and diarrhea, or "summer complaint." Milk should be kept in a cool place, covered, and always protected from flies; for flies are most active in carrying germs from infected matter to food materials. If to be used for infants, milk should be kept on ice, in the cellar, or suspended in a well. Cottage cheese is a valuable food, and if properly prepared in a cleanly manner from good milk, is whole- some and digestible. It is comparatively inexpensive. Cream is the best form of animal fat. Butter, if used, should be fresh and clean, for bad butter is most objectionable. Spare the Sugar Sugar is a concentrated food. It is ready for im- mediate use in the system, and a certain amount of it is needed. Probably most persons use too much. Starch is converted into sugar in the process of di- gestion, and a properly balanced diet supplies all the sweet that the body really needs. Add to this the extra amount eaten in the form of candy, sirups, in cakes, pastries, jellies, jams, puddings, etc., and it will be seen that there is danger of eating too much sugar. Sugar undergoes fermentation readily, and when taken into the stomach in larger quantities than can be properly absorbed, it is sure to cause acidity, gastric catarrh, and other similar troubles. Overtaxing the liver and kidneys leads to permanent disorders in these 6 82 Epidemics: How to Meet Them organs. The free use of milk and sugar in combination should especially be avoided. Nuts Nuts are food, should be used as such, and should not be eaten between meals. Herein probably lies the difficulty some persons experience in eating nuts. Nuts are rich in fat and protein, and some may find them a little difficult to digest. Improperly chewed or eaten between meals, they often make trouble. Nuts in various forms lend themselves to the prep- aration of wholesome and palatable dishes; but nut foods should not be eaten too freely. Roasted peanuts are often overroasted. Fruits contain acids and inorganic salts needed by the body, and every one should eat some fruit. Some persons cannot eat strongly acid fruits, but may be able to use the subacid or mild kinds. Persons with feeble digestion cannot eat fruits and vegetables to- gether; this is probably the reason why some persons think they cannot eat fruit at all. Errors Regarding Meat Very wrong notions prevail regarding the value of flesh as food and the necessity of using it. Although many eminent medical authorities maintain that meat is not essential, some persons continue to make it their mainstay in food. At best, meat is second-hand food, and as such is not the best. The animal makes food only of what it eats, and adds not a particle of nutri- ment. When man eats the animal, he gets only that which has not been used by the animal for its own life and sustenance, plus the impurities of broken-down animal tissue. Some of these impurities are highly stimulating, but never nourishing. Normally, the eliminative organs have enough to do to eliminate the normal body wastes, which include Prevention of Disease 83 the ever-present products of tissue breakdown. When flesh is eaten, the added waste lays upon the eliminative organs extra work, and militates to that extent against health. Besides, very many animals are themselves dis- eased This increases the risk to man when he partakes of animal products. Some of the diseases we have con- sidered — tuberculosis and cancer, for example — are sometimes directly traceable to flesh eating. Pork is particularly objectionable as human food. The Bible forbids its use because it is " unclean." (See Deut. 14: 8 and Isa. 66: 17.) The natural eating habits of the hog place him in the scavenger class, and his flesh cannot be considered a wholesome food for man. Fish having access to the filthy drainage of sewers are not wholesome. It should be remembered that fish readily decompose, and when marketed some distance from where they are caught, with possibly poor re- frigerating conditions, their use, especially in warm weather, becomes questionable and often positively un- safe. Tea and Coffee The use of tea and coffee is unnecessary so far as nutrition is concerned, for these articles are not foods. Because of their stimulating effects, they are supposed by many to be nutritious. Tea and coffee contain active toxic, or poisonous, substances, which at first exhilarate and excite the nerves of the stomach, then of the brain, the heart, and the entire system. But this stimulation is followed by a corresponding degree of weakness or debility. What seemed additional strength is the drug effect. Whipping a horse does not give him strength. Tea and coffee also possess elements that neutralize the effect of the gastric juice, thus hindering digestion. Instead of adding anything good to the body, they rob it of energy. Their constant use is sure to do harm. Forcing the nerves by stimulation means overwork in- 84 Epidemics: How to Meet Them stead of rest, and gradually draws upon the vitality until general nervousness results, with headache, sleep- lessness, heart palpitation, indigestion, and various other ills. The habit these beverages often fasten upon the user should be a warning that they are not food. It is wise to shun anything that creates a habit, such as tea, coffee, tobacco, and alcohol. The Need of Bulk An important consideration in diet is bulk. Man needs " roughage," or " fodder," the same as other ani- mals. His alimentary tract of about thirty feet is in- tended to work, and when not given work to do, it gets out of working order. Constipation results, and people depend on pills to do the "work." The cellulose, or woody fiber, of vegetables is valuable in giving the in- testines enough mass for doing thorough and perfect work. Lettuce, spinach, celery, cabbage, and most of the vegetables are natural bowel cleansers. Enough hard foods should be eaten to insure thorough mastication. This gives the salivary glands a chance to do their important part in starch digestion. It also provides exercise for the teeth and helps in their pres- ervation. The mouth contains all the teeth; there are none in the stomach. So chewing must be done in the mouth, and the longer time the food spends there — within reason, of course — the less time does it need to spend in the stomach. Swallowing bits of imper- fectly chewed food may mean trouble, — about thirty feet of it, and no telling for how long a time. Good chewing is a part of good digestion. If you have but a little time to eat a meal, eat less but chew well. Regularity The importance of regularity in eating cannot be too strongly emphasized. Eating between meals will Prevention of Disease 85 break down the best kind of digestive system, and this is a long step toward a general breakdown. Irregulari- ties of this sort interfere with digestion, upset the normal appetite, and take away the real enjoyment of eating. Much of the digestive trouble experienced is not due so much to the foods eaten as to the way they are eaten, and what is taken between the regular meals. Many persons would benefit by eating only two meals a day. Moderation Overeating is perhaps one of the greatest causes of disease. It is what is digested that nourishes, not merely what is eaten. An excess of food is not only unnec- essary, but throws upon the system extra work in dis- posing of the surplus. The " all-gone " feeling result- ing from overeating is often mistaken for hunger; when, in truth, it is the cry of a tired stomach calling for rest. More than that, a surplus of food is often the cause of serious illness because of morbid conditions set up by the food's spoiling within the body. There is something else that aids good digestion, — work or physical exercise. Moderate exercise just after eating is usually advisable, but violent exercise is not, for a large amount of blood is required at that time by the digestive organs. The human machine was built to run, and should run to keep in good running order. The divine command is that man is to eat his bread in the sweat of his face. (See Gen. 3: 19.) This means that a man should work enough to sweat if he would be able to take care of his food. Following work comes rest, which includes sleep, during which the recuperative processes are at work. It is during sleep principally that food is assimilated and the body built up and repaired. All this goes to promote health and ward off epidemic diseases. AN EGYPTIAN MOTHER ' Cleanliness is indeed next to Godliness." — John Wesley. A CLEAN BODY Epidemics take the larger share of their victims from among those who are most susceptible to disease because of low vital resistance. Germs thrive best in a body that is full of natural poisons; therefore when the system is already taxed with caring for an abnormal amount of waste, it is not in a favorable condition to resist disease germs. Nature's Cleanser Water is a natural solvent and cleanser, and it oper- ates inside the body as well as outside. It is the nat- ural element for washing the body tissues. It dissolves the waste materials of the system, which are then car- ried out of the body in solution by the various elimi- native organs. Hence it is apparent that a sufficient amount of water must be taken into the body to secure the proper functioning of every organ and gland and to supply the principal medium of elimination. Both as- similation and excretion require water. 88 Epidemics: Hoiv to Meet Them The question as to how much water a person should drink in twenty-four hours, is important. A man can go without food for many days, but he cannot live long without water. Health depends very much on the amount of pure water taken. Young people need more water than adults. Not only is the waste matter washed out by water, but every cell gets its food by means of a watercourse. The plasma, or liquid part of the blood, is a fluid in which the blood cells live very much as fish do in the sea. When the system becomes loaded with poisons, Not too much! Only eight glasses (two quarts) for a hot day. they must be diluted so they can be eliminated, or thrown off, by the excretory organs. The principal or- gans engaged in this work are the kidneys, skin, lungs, and bowels. Elimination by the Kidneys The kidneys remove more water and poisons from the body than any other organ. Under normal conditions they should remove daily one ounce of urine for every three pounds of the person's weight. Dividing the weight of the body by three gives the number of ounces of urine that should be eliminated in twenty-four hours (sixteen ounces equal a pint; eight ounces equal one-half pint, or one glass) ; so the average person in good health with normal kidneys should pass about forty A Clean Body 89 ounces, or two and one-half pints, of urine in twenty-, four hours. A Good Drink Habit The average person should drink daily six glasses of water in cold weather and eight in hot weather. Persons who perspire freely may need more than this. The quantity required depends somewhat on the kind of food eaten. Fruits and certain vegetables supply a large quantity of water. Except in case of persons having heart trouble or dropsy, there is little danger of drink- ing too much water; although too much may be taken at one time. Drinking freely at meals is not a good practice, one serious objection being that the food is washed down without being properly masticated. Elimination by the Skin The elimination of water and poisons by the skin is an important function. The skin is full of little sweat glands, each a small sewer, by which the poisons are eliminated from the system. Even when there is no perceptible perspiration, this elimination is going on, as is easily demonstrated if a part of the body is covered with a rubber garment. A low estimate of the imper- ceptible perspiration eliminated by the skin in twenty- four hours is one-half pint to a pint. When a person sweats freely, the amount is much greater. Elimination by the Lungs The lungs also eliminate a considerable quantity of moisture. This is easily demonstrated by breathing against a cold glass. The* quantity eliminated in this way is not so easily estimated, however, as much depends on the degree of moisture in the air. On rainy days we drink very little water, while on a dry, windy day a large qtiantity is required. A low estimate, then, is one to two glasses of water to be eliminated by the lungs daily. 90 Epidemics: Hotv to Meet Them Amount for Children The above figures for the elimination of water and poisons by the skin, kidneys, and lungs are for grown persons. For children the ratio should be increased. To sum up: A person weighing 120 pounds should drink eight glasses of liquid daily, so that the kidneys can eliminate two and one-half pints, the skin three quarters of a pint, and the lungs about the same quan- tity. A Clogged Sewer System When there is not proper elimination, the power to fight disease is lowered, and the person feels dull and stupid. Or he may be restless, and wake up in the night with a nervous headache or backache or a palpitating heart. The digestive system is out of order. Some con- sider this a sign of biliousness; others lay it to con- stipation; or both conditions may be present, due to a shortage of water in the system. The eliminative organs cannot do their work because of the lack of water. When one or more of the above symptoms appears, it is time to begin checking up on the elimination. Watch the kidneys, double the amount of water drunk, and adopt a light diet with plenty of fruit for a few days. An increase in physical exercise will increase the demand for water, and will also aid all the eliminative organs in their work. A Good Remedy for Colds and Grip Experience has shown that the free drinking of water is valuable in the cure and prevention of colds and grip, and recently water drinking has been used with wonder- ful success in the treatment of influenza. When a person is taken with influenza, the elimi- native organs must be put actively to work at once in order to help the system fight the disease. First take a light physic prepared in the following way: A Clean Body 91 Dissolve one teaspoonful of salt in four glasses of water. This makes what is known as a normal salt solution. Hot water is better than cold, but if it is too nauseating, cold may be used. A glass of this drunk every five minutes until all is taken usually acts as a physic ; if not, it will be absorbed qtiickly, and will start the eliminative organs to working. From two to four cups of hot lemonade, with a small amount of sugar, may be taken to advantage a little while after drinking the salt water, so that from four to eight glasses of water will be taken in about an hour. Such copious water drinking in connection with a hot foot bath and a sweat, and if possible, rest in bed, is a very efficacious treatment. In influenza the water drink- ing should be kept up, no less than one glass being taken every two hours, so as to secure good elimination. Drink as much water as can be taken with comfort. This will aid the body in throwing off poisons, and help in preventing complications. The Tub Bath Water as a cleanser for the inside of the body has been considered, but it must not be forgotten that water is important for the outside as well. Warm baths aid in elimination by opening the pores of the skin. Pro- longed hot baths are weakening; therefore the hot bath should be short, and should be followed by a short ap- plication of cool or cold water for the tonic effect. A brief cool or cold bath, followed by brisk rubbing and quick drying, is an excellent tonic, and most per- sons would benefit by its daily morning use. If a bathtub is used, the water should be run in to the depth of about two inches. The patient, sitting in the tub, should briskly rub the legs, chest, and abdomen; then lie down so that the whole body is wet; then get out of the tub and dry the body quickly with a bath towel. 92 Epidemics: Hoiv to Meet Them The Hand Bath A hand bath may be taken with a small quantity of water in a basin. The water should be applied quickly, and the body dried at once. If the patient is inclined to chilliness, only a part of the body should be bathed at a time, keeping the rest covered, first one arm, then the other, then the chest, the abdomen, each of the legs in Having a Good Time turn, and the back. In every case the room should be warm enough to prevent chilling. If managed carefully, the hand bath should bring a glow of comfort. If a shower bath is available, the same effect may be secured and the bath may be enjoyed more. Whichever way it is taken, this bath will prove beneficial, as it in- vigorates the entire system, — blood circulation, elimi- native organs, and all. The reaction, or warming up, should be immediate. One should not feel languid, de- pressed, or weak after such a bath, but on the contrary should feel refreshed. A Clean Body 93 Constipation Keeping the body free from its natural waste and poisons requires careful attention to the bowels. Con- stipation is not epidemic nor " catching," but it is so common and its effects are so serious that it may be considered almost as bad as some of the epidemic dis- eases. The retention of the bowel contents is productive of great harm, as this putrefying mass contains poisons which are reabsorbed into the system, affecting almost all the organs and impairing their functions. The cir- culation is impeded and the blood quality lowered. Piles often result, sometimes becoming serious enough to re- quire surgical attention. With a lowered vital resistance, the body is unable to resist colds, and thus the way is paved for other serious ailments. Headache is a common accompaniment. One of the most serious results of the poisoning of nerve centers is the mental depression occasioned by it. Little tasks look big, small troubles and grievances are magnified, and hope and cheer are almost lost. Persons suffering in this way are looking out from an interior where everything is dark. Not only the blood and skin, but the thoughts are dingy. Common-Sense Remedies First, cultivate regularity of habit. Going to stool at a certain time daily, even when there is no natural desire, helps to establish bowel regularity. Neglecting the call to move the bowels causes the desire to pass away, for the peristaltic action of the bowels forces the contents of the lower bowel upward, and the fecal mat- ter passes out of the rectum into the bowel and causes much trouble. If the neglect is long continued, the natural desire becomes less and less until it disappears. Fortunately, in most cases, even in those of long stand- 94 Epidemics: How to Meet Them ing, it is possible to re-establish a correct bowel habit. Special care and treatment will be necessary, however. To cure constipation, do not resort to pills and ca- thartics, for they only increase the difficulty. The use of the enema may likewise become objectionable, because of the dependence that is liable to be placed on it in- stead of correcting the trouble itself. Sometimes the graduated enema proves helpful. In taking a graduated enema, begin with an ordinary enema, and then from day to day gradually reduce the quantity and temper- ature of the water, until the bowels have learned to move naturally. Eating an orange or drinking a glass or two of cold water before breakfast is sometimes helpful. The injection of two tablespoonfuls of glycerine at night and retaining it till morning, will serve to soften the bowel contents. Massage, or deep kneading, of the abdomen, administered by another, the patient lying on the back with knees drawn partly up to relax the abdominal muscles, may be given. This massage can be self-administered with some success while seated at stool. Follow the colon up the left side with a kneading motion, cross just above the umbilicus (navel) , and continue down the right side. The idea is to force the contents toward the rectum, making room for it farther up in the colon. The use of mineral oil (liquid paraffin), sometimes called Russian oil, is quite strongly recommended as a harmless laxative, as it does not create a habit and is not absorbed. It merely acts as a lubricant. The use of natural laxative foods is the best remedy for constipation. Figs, prunes, most fruits, ripe olives, fresh vegetables (especially the green-leaf varieties), oat- meal, whole-wheat bread, and bran are especially good. The use of much fine-flour bread, polished rice, and boiled milk should be avoided; also tea and coffee. A Clean Body 95 There is evidently great benefit in using foods that have not been robbed of their natural elements. The mineral salts, vitamines, and perhaps other elements are not present in very large quantities, and this very fact indicates that they are of high value in supplying the body with essential health factors. Persons fre- quently recover from long-standing constipation and gen- eral lowered vitality upon adopting a dietary containing all the food elements. Such foods seem to contain some of nature's true bowel regulators and blood tonics. © u. & u., N. y, **A Human Flower of Childhood" 96 THE OLD WAY 1 The more perfect our health, the more perfect will be our labor.' HOME TREATMENTS The recent siege of influenza brought to our attention in a very definite way the need of knowledge in the home care of the sick. With the heavy war demands on phy- sicians and nurses, the civilian population had to get along with less professional help than formerly. Medical authorities are emphasizing the importance of disease prevention by careful living, and of the home care and treatment of the more simple ailments. The value of proper food, good nursing, and ra- tional treatment is becoming more and more recognized by the medical world. A more conservative use of drugs is advised, with the acknowledgment on the part of many that drugs do not cure disease, but that their effect is rather to change the nature of the disease. It is pointed out that the aim of any treatment should be to help nature in her fight against disease. Nature prefers her own remedies, such as pure air, sunlight, rest, good food, water, suitable exercise. In- deed, one of the most effective curative agencies is water. Its use in the treatment of disease is known as hydro- 7 97 93 Epidemics: How to Meet Them therapy, and this treatment is gaining greatly in favor and popularity. It is a system of treatment readily available in some form in every home. Water treatments are very effective, often accom- plishing results not easily obtainable, if at all, by any other means. The more skill one possesses in the use of water treatments, the better; for it should be borne in mind that because of the very definite and positive effects possible through this means, great harm may be done as well as great good. But some of the methods are very simple, and may be learned by almost any one. This knowledge may be of great value in the home, espe- cially in time of epidemic. The physician will appre- ciate the help that can be given by one fairly intelligent in the administration of some of the simpler measures of water treatment. In the home care of the sick there are a number of treatments that may be given in the absence of the doctor and the trained nurse, by any one who will exer- cise caution and judgment. No unskilled person should attempt to administer treatments which are complicated or which may involve danger to the patient. The aver- age person can learn how to give what are called " sim- ple treatments," which are quite efficacious, and may prove very valuable in affording immediate relief, if care- fully given. The Fomentation The fomentation, or hot compress, — the application of moist heat to local areas of the body, — is serviceable in a great many ways in home treatments. The method of giving a fomentation is quite simple, and this form of treatment can be given almost anywhere. A fomenta- tion is most commonly prepared by wringing cloths out of boiling water, though there are other ways of obtain- ing the moist heat; as, for example, by wrapping a hot Home Treatments 99 brick, a hot stone, a bag of hot sand, or some other hot article in moist cloths, or even in wet paper. The pur- pose is to secure a moist heat at as high a temperature as can be borne by the body. A set of good fomentation cloths is invaluable. The best material is a half-wool-and-half-cotton blanket, not necessarily new. One blanket will make four cloths, two to be used wet and two dry. However, discarded under- wear, an old shawl, or other similar material may be used. Wool-and-cotton-mixture goods is best, the wool serving to retain the heat and the cotton preventing too much shrinkage. Towels may be used if necessary, but are not so good as mixed woolens. In giving fomentations there is needed a vessel suffi- ciently deep to contain enough water to entirely cover the cloth. If heat is available near the patient, it is best to wring the fomentation cloths directly from the kettle or other vessel in which the water is kept boiling. If the treatment is given some distance from the fire, a pail is needed for carrying the hot water to the patient's room. Protect the floor from the heat, and cover the pail to retain the heat. Or the fomentation cloths may be wrung from the boiling water and left tightly twisted, placed in a covered pail, and carried to the room. They should be left tightly twisted until applied to the part to be treated. Spread a dry cloth on a flat surface. It is preferable always to reserve the same cloth, or cloths, for dry use. In wringing the wet one, first fold it loosely, hold by each end, and place the middle part in the boiling water. Wring over the vessel by twisting tightly and then stretching (Fig. 1). If the left hand is placed just out- side the vessel, allowing the cloth to rest on the edge, the cloth can be twisted and pulled by the right hand, as it is wrung, and the water will run down the cloth into the vessel at the edge without burning the hands. 100 Epidemics: How to Meet Them It is best to have cloths long enough to keep the ends dry. Short cloths may be wrung by placing them in a towel and then twisting. A little trick in getting the cloth very hot, and quickly so, is to press the whole sur- face of it on the bottom of the vessel, thus bringing it Fig. 1. Wringing the Fomentation in direct contact with the heat. This is particularly practical when in a hurry. Do not unwring the wet cloth until ready to fold within the dry one. Work quickly when doing this. The shape of the cloth should be according to the area to be treated. It should always be several inches larger than the part treated. If the fomentation is for the spine, make the fold about six inches wide and long enough to cover the full length of the spine. After Home Treatments 101 folding the wet cloth within the dry one (Fig. 2), double it on itself so as to retain as much of the heat as possible. Unfold the fomentation only as it is applied to the pa- tient (Fig. 3). Do not remove the wet cloth from the dry one. When placing the wet cloth within the dry, allow one thickness of dry blanket on one side and two thicknesses on the other. The patient at first may be Fig. 2. Folding the Fomentation sensitive to the heat, and will bear the double thickness of dry, when the single thickness will be too hot. In a few minutes the cloth may be turned over, using the single thickness. In the meantime, however, a towel or other covering should be kept over the entire cloth so as to retain the heat. It should be constantly borne in mind that a fomen- tation cloth should be hot. Harm may be done by using cloths that are only warm, or by allowing hot cloths to get too cool. The fomentation should be changed as soon as it becomes cool, that is, when it is comfortable to the 102 Epidemics: How to Meet Them patient. This is one time when a treatment should not be too comfortable. A good way to secure the full benefit of the heat is to leave the dry cloth on the patient, sim- ply opening it to permit the exchanging of the wet cloth for a newly heated one. In this case the wet cloth is not untwisted until it is directly placed within the dry cloth covering the part treated. If two cloths, folded together, are used for the wet, the heat will be retained longer. Fig. 3. Applying the Fomentation The heat may be prolonged by placing a hot water bottle over the fomentation. The changes should always be made quickly and without undue exposure of the part treated. Care should be taken to guard against chilling. A more intense effect may be derived by alternating cold with the hot cloths. After each application of the fomentation, cold is applied by a towel wrung out of cold water, or by a piece of ice, after which the part is quickly dried. The cold application should be very short ; if with a towel, about thirty seconds; if with ice, only a few strokes should be given. The cold may be applied by the hand dipped in cold water, the colder the better. Home Treatments !03 The hot fomentation cloth should be ready to apply as soon as the cold has been given. This is important. Usually three applications are given, the treatment lasting from fifteen to thirty minutes. The duration of each application is from five to ten minutes, according to the degree of heat and the manner in which the patient bears it. Those who are accustomed to taking fomentations can take them quite hot. At the close of the treatment, quickly apply cold to the part treated, then thoroughly dry, and cover. Care should be taken against burning. If the pa- tient insists that the fomentation is too hot, lift it at once. While desiring to have the application as hot as possible, care must be taken not to have it too hot. Bony prominences, where there is but little flesh, are most susceptible to burning. Unconscious, paralyzed, aged, or very young persons cannot protect themselves against burning, and here, again, special care is neces- sary to avoid such an accident. An emergency fomentation or one for the continued application of heat, may be given as follows: Lay out from fifteen to twenty sheets of newspaper ; on these place several thicknesses of cloth, and pour on boiling water until the cloths are well moistened. Fold the cloths within the newspapers and apply, placing a towel or another cloth between the patient and the papers. The cloths may be dipped in boiling water in- stead of having the water poured on them. They should be left quite wet, but not dripping. This fomentation will retain the heat a half hour or more. The Hot Blanket Pack The hot blanket pack is an application of moist heat to the entire body. The articles necessary to give it are four or five blankets, a pillow, a rubber sheet if avail- able, three or four hot water bottles, cold water for com- 104 Epidemics: Hoiv to Meet Them presses for the head and heart, a tub or pail for the foot bath, and several towels. The treatment may be given on a couch or in bed. It is well first to secure an action of the bowels by an enema, if necessary, then give a hot foot bath. The drinking of hot water or hot lemonade only slightly Fig. 4. Wringing the Blanket for Pack sweetened will facilitate perspiration in the pack to fol- low. Hot drink may also be given while in the pack. • Spread dry blankets on the bed or couch, letting them come up well on the pillow. Fold one blanket single or double (the double retains heat longer) lengthwise, and wring out of boiling water. Two persons can wring the blanket better than one (Fig. 4) , unless a wringer is used. The patient should be undressed and ready to get on the blanket as soon as it is opened. Keep the blanket folded or tightly twisted until ready to place it on the bed. Open quickly to avoid losing heat. If wrung dry, there is little danger of burning. Home Treatments 105 The patient lies down on the blanket as soon as it is opened, and is wrapped in it. It is best to have the arms between folds of the blanket rather than next to Fig. 5. Patient Partially Wrapped in Pack the body. After the wet blanket is wrapped closely about the patient, bring up a dry blanket, one side at a time, and wrap about him (Fig. 5). Place a hot water bag between the legs, one at the feet, and one on each side. Fig. 6. Blanket Pack Completed Then bring up and fold over him the other dry blankets that have been placed on the bed (Fig 6)/ The wet blanket must come in contact with the body up to the chin, and both it and the dry blankets should be well tucked in at the feet and the neck to exclude all ah\ 106 Epidemics: How to Meet Them A towel at the chin will protect it from the chafing of the blankets. A cool compress (a towel wrung out of cold water) should be kept on the head (see Fig. 6), renewing it as often as needed to keep it cool. In case of faintness or weak heart action, indicated by shortness of breath, place a cool compress or an ice bag over the heart. This treatment is exhausting, and should not be too greatly prolonged or given too frequently. From twenty to thirty minutes should be the duration. One such treatment a day is sufficient, with the other treatments recommended. In taking the patient out of the pack, unwrap one blanket at a time. Give a sponge bath or a cold towel rub as the wet blanket is removed, exposing and bathing a portion of the body at a time and drying and covering the same, — first one arm, then the other arm, the chest, the abdomen, then the legs. The back is bathed after the wet blanket is entirely removed. Keep the patient well covered after the treatment, to avoid chilling. The Enema Most people know something about the use of the enema, or rectal injection, but there are a few sugges- tions that may prove of value in the proper adminis- tration of this common treatment. First, it is well to remember that the enema should not be relied upon habitually for moving the bowels. The enema generally gives immediate relief, is fairly easy to take, and its use may become a habit, when by careful bowel training and by proper diet it may be needed less frequently and possibly dispensed with altogether. The hot enema is valuable for the relief of pain in the lower bowel, in diarrhea and dysentery, for irrita- tion or pain in the rectum, and in case of much gas in the bowels. The temperature should range from 103° Home Treatments 107 to 110°. It is always well to follow a hot enema with a small injection of cool water, to restore the tone of the bowel tissues. The temperature of the ordinary enema, given for cleansing purposes, ranges from 95° to 100°. A hot or a cold enema is more effective for stimulating bowel movement. The warm enema is used when it is neces- sary to inject a quantity of water. The addition of two Fig. 7. Giving the Enema and a quarter teaspoonfuls of common salt to two pints of water will help to prevent griping, and the addition of soapsuds will make the enema more effective for cleansing purposes. Only the purest soap should be used — as Castile. Frothy soapsuds contains air, which should not be injected into the bowel. When soap is used, an enema of plain water should follow. The knee-chest position (patient on knees, with chest nearly level with knees) will facilitate the flow of water to the highest point possible in the bowel. Another favorable position is lying on the left side, knees well flexed (Fig. 7). The enema can or fountain syringe 108 Epidemics: How to Meet Them bag should be hung from two to three feet higher than the patient; that is, the fall of water should be about that much. If it is hung too high, the flow will be too strong. Care should be taken not to inject air into the bowel, as that would cause cramping. The first tube- length of water will be cool, and there may be air in the tube ; this cool aerated water should be run off before inserting the hard rubber rectal tube. The desire to relieve the bowel because of the peris- taltic pains caused by the injection of the water, may be overcome by pinching the rubber tube to stop the flow. The desire to evacuate will soon pass away, and more water can be injected. By proceeding carefully and slowly, a large quantity of water may thus be given to persons who think themselves unable to retain any considerable amount. Withdraw the tube carefully. If it is desired to retain the water for a time, the pres- sure of a towel against the anus will be helpful. Here is a point not generally observed: The warm water introduced into the bowel dissolves the retained mass of matter, and when in solution, the poisons are readily absorbed; hence the necessity of securing a thorough cleansing of the bowel; otherwise the enema will be productive of headache or other unpleasant ef- fects. Repeated injections may be necessary in order to secure a thorough cleansing. The warm water will relax the bowel tissues, and therefore it should be fol- lowed by a small cool enema at a temperature of 65° or 70°. The cool enema is sometimes used to reduce fever. When given for this purpose, the water should be re- tained as long as possible, the temperature ranging from 70° to 80°. If given colder, it will be retained with more difficulty, because of the stimulating effect of the cold. Home Treatments The Foot Bath 109 The hot foot bath is a very useful treatment. It is valuable in breaking up a cold, in relieving headache, in dispelling chilliness, and is sometimes effective in in- somnia, by drawing the blood from the head to the ex- tremities. The foot bath may be given in bed, in which case the bed should be properly protected with news- Figr. 8. Foot Bath in Bed papers, a piece of oilcloth, or a rubber sheet. A cover- ing should be thrown over the knees and legs during the treatment. The vessel used should be deep, and large enough to hold both feet comfortably, the water extending at least to the ankles (Fig. 8). The patient may sit in a chair, in which case a cov- ering should be thrown over and around the legs and foot tub to protect the patient from chilling (Fig. 9). The temperature of the foot bath should be about 100°, and may be raised as high as can be borne, by gradually adding hot water. The bath may be continued 110 Epidemics: Hotv to Meet Them as long as thirty minutes. If for more than five minutes, apply a cold towel to the head or neck, or both. On being removed from the bath, the feet should be Fig. 9. Foot Bath Sitting in Chair cooled by a short application of cold water, and then thoroughly dried, care being taken to dry well between the toes. The Hot Leg Bath This is given much the same as the foot bath, ex- cept that the receptacle is deeper, the water reach- Home Treatments 111 ing well up to the knees. In the absence of anything better, a wash boiler may be used. The patient is seated, and should be well covered. A stool two or three inches higher than the bath receptacle is the most con- venient seat. A towel placed over the edge of the tub Fig. 10. For the Home Sitz Bath under the knees is desirable. Begin with a temperature of about 105°, and gradually raise it as high as the patient will bear. The Sitz Bath The hot sitz bath is excellent for the relief of local inflammation ; for pelvic, rectal, or abdominal pains ; and to overcome the retention of urine. It may also be given to produce perspiration. In the home where a regular sitz tub is not available, an ordinary washtub can be used, one side being raised a few inches by a block of wood (Fig. 10). A pail of hot 112 Epidemics: How to Meet Them water, or better yet, a foot tub, for the feet should be provided, and the towel should be placed over the edge of the tub to protect the knees from contact with the wood or metal. Another towel should be placed over the edge of the tub at the back of the patient, so he can lean back without coming in contact with the tub. A basin of cold water should be provided for giving Fig. 11. In the Sitz Bath cold applications to the head, if the sitz bath is pro- longed. When the sitz bath is given to produce perspiration, water at a temperature of about 100° is put in the tub, and after the patient has been seated in it a few minutes, hotter water is carefully added until the temperature is as high as the patient will bear. A blanket or comfort, or a sheet, merely, if the room temperature is warm enough, should be drawn about the patient, including tub and pail (Fig. 11); A cold wet towel should be kept on the head. Hot water drinking will facilitate sweating. The bath may be prolonged from ten to thirty minutes, Home Treatments 113 but should be stopped whenever the patient complains of faintness, especially if acqompanied by shortness of breath. Conclude the bath by adding cold water. In order to do this, it may be necessary to remove some of the hot water from the tub. Fig. 12. The Sponge Bath The patient should be properly cooled and carefully dried, being at all times protected from drafts and from chilling. The Sponge Bath The cool sponge bath is a valuable means of reduc- ing fever. A sponge is not necessary, and in fact, is not very frequently used. The water may be applied with the bare hand or with a cloth. When given to reduce body temperature, the water should be about 60° or lower. The sponge bath nearly always follows any general bed treatment that causes perspiration. 114 Epidemics: How to Meet Them To give a sponge bath, provide a basin of water and several towels. The patient is wholly undressed, but covered with the bed clothing. Only a part of the body is treated at a time. Towels are placed so as to protect the bed. An arm is exposed and the cold water applied its full length, and then dried (Fig. 12). Bathe the other arm, then the chest and abdomen; next the legs, one at a time; and then the back. The whole procedure can be done without dampening the bed in the least, and the patient is left quite comfortable. If a sponge bath is given for the reduction of fever, the bath is prolonged twenty or thirty minutes, and may be repeated several times during the day, or as frequently as seems necessary, care being exercised not to weary the patient or to create nervousness. The Heating Compress This is a compress consisting of several layers of cheesecloth or toweling, wrung out of cold water, and covered with a dry cloth, or better yet, a piece of rub- ber cloth or even common oilcloth. The compress should be left on till it begins to get warm, when it should again be cooled. Hot Water Bottles and Their Care The hot water bottle is an article much used in giv- ing home treatments, and its use is quite familiar to most persons. Nevertheless some caution is in place in regard to it, as severe burns are sometimes caused by lack of proper care. The bottle should be only partly filled, and never with water hot enough to scald, should the bottle burst. Indeed, the bottle itself may be ruined if the water is too hot. A simple way of filling the bottle is to place it flat on the table, neck raised, and pour in water which is hot but not boiling, until it is about half or three Home Treatments 115 quarters full, allowing the air to escape and the water to come to the neck of the bottle before screwing in the stopper (Fig. 13). This will leave the bottle pliable, so that it will fit readily any part of the body to which it is applied. It is well to test the temperature of the bottle by holding it against the cheek, neck, or arm. The water bottle should always be covered either with a covering made especially for it, or with a towel or other cloth. Flannel makes a good covering. Special care should be exercised in using a water bottle on a person who is liable to become unconscious, or who is unable to protect himself against burning. When used for general warmth of the body, it is best to place the bottle at the bottom of the feet, between the thighs, or at the spine. The use of a hot water bottle over a fomentation cloth intensifies and prolongs the heat of the fomenta- tion. The caution against burning the patient with the water bottle is especially applicable when using moist cloths with it, even though the bottle does not seem hot enough to burn. Moisture increases the liability to burning. When not in use, the bottle should be hung with the stopper out and the opening down, so it may drain. Fig. 13. Filling the Hot Water Bottle Health is the richest possession that mortal can have. IN THE SICK-ROOM In many cases the care of the sick falls to the woman in the home. During an epidemic there is always a shortage in the supply of trained nurses, and the need of others' being prepared to do some of the simpler du- ties of the sick-room is greatly emphasized. This chapter is designed, therefore, to give helpful hints to any who may need them. Remember that what may seem trifles are matters of importance when it comes to dealing with the sick, where perhaps a very little thing may mean the turning- point in a critical case. Choice of Room If a choice is possible in the selection of the sick- room, choose a quiet one on the sunny side of the house and near the bathroom. If for a contagious disease, it should be an upper room and one easily isolated from the rest of the house. Have no unnecessary furniture 117 118 Epidemics: How to Meet Them or hangings, which simply make that much more to keep clean and free from dust. Dust is a carrier of disease germs. It should be taken up with a damp cloth, not scattered about by mere " dusting." In sweeping, pin a damp cloth over the broom. Ventilation If all well people need pure air, much more do the sick. Proper ventilation of the sick-room is of the ut- most importance. If there is a fireplace in the room, the impure air may be directed upward by building a small fire or by placing in it a lighted lamp or candle. If the room contains two windows, lower one from the top and raise the other from the bottom, but protect the patient from all drafts. The bed should not be placed between the inlet and outlet of air. A screen, if neces- sary, before the bed will afford protection. A simple method of letting in fresh air is to place a board three to six inches wide under the lower sash, allowing the air current to enter between the two sashes in the middle of the window. This brings the fresh air from above and avoids a draft. Remember that cold air is not necessarily fresh air. Indirect ventilation may sometimes be secured by let- ting the fresh air into an adjoining warm room first. Oil or gas heaters, lighted gas jets, or lamps use up oxygen, making necessary more fresh air for the patient and attendant. All discharges should be removed from the room promptly, as they pollute the air. Ordinarily the room temperature should be 65° F., and from that up to 70° or possibly 75°. Persons with poor circulation need the warmer temperature. Persons with pneumonia and with some forms of fever do better with the lower temperature, the influence of the cold itself being beneficial. Regulate the heat by a ther- mometer. In the Sick-Room 119 The Bed A narrow, high iron bed is the best. Comfortable springs and a good mattress are important. Blankets are preferred for covering, being light, warm, and wash- able. Spreads should be light ; a clean sheet will do. To be comfortable, a bed must be smooth, and for this rea- son the lower sheet must be large enough to permit of its being drawn taut and tucked in well under the mat- tress at top, bottom, and sides. If there is any danger of soiling the bed, use a rubber sheet, either under the lower sheet or between it and the drawsheet. Oilcloth or newspapers may be used. Wrinkles should always be avoided. The drawsheet is a narrow sheet, single or double, placed across the bed under the patient's hips. It should be a yard longer than the width of the bed, permitting it to be drawn to one side or the other, thus affording a cool and smooth place for the patient to lie on without remaking the whole bed. It also prevents soiling the rest of the bed. The drawsheet should be of a firmer material than the ordinary sheets, so it will not wrinkle easily. Do not allow a heavy weight of bedding to rest on the patient's chest; bring the surplus to the foot of the bed. Neither should the covers be tucked in so tightly that an unpleasant weight or pull is felt by the patient. A straight-backed chair, placed so that the back of the chair supports the patient's shoulders and back, will serve as a bed rest if the patient is able to be raised in bed. Place a pillow lengthwise at the small of the back and one crosswise higher up, for the head and shoulders. A cushion at the foot of the bed will prevent the patient from slipping down. To rest the legs or to relax the abdominal muscles, a rolled comfort or pillow may be placed under the knees. 120 Epidemics: How to Meet Them Changing the Bedding When making me bed, have everything at hand. See that the room is warm enough for the patient's comfort. Do not fold or unfold linen nor beat up the pillows over the patient's face. Avoid jerking the bed or jarring it. Never lean against or sit on the bed. The bed clothing should be changed with as little dis- turbance as possible to the patient. To change sheets, turn the patient on his side; roll the soiled sheet up tightly against the patient's back, keeping the soiled portion within the roll ; place the fresh sheet on, tucking in the side nearest you; roll the rest of the clean sheet against the soiled sheet; turn the patient back over the two rolls ; remove the soiled sheet, and finish placing the clean sheet. Changing Garments To remove the patient's shirt or gown, unfasten, bring up well under shoulders, remove one sleeve, slip over the head, and remove the other sleeve. If one side of the patient is paralyzed or injured, begin with the sound arm. To put on a garment, reverse the proceedings, begin- ning with the injured side. Make the sleeve operation short by gathering the sleeve together from wristband to armhole, then slipping the whole sleeve on at once. A convenient gown for a chronic or helpless patient is one open at the back and fastened with tapes. Bedsores A bedsore is considered a mark of poor nursing. Keep the bed clean, free from wrinkles and crumbs, and perfectly dry. Change the position of the patient fre- quently, as bedsores are caused by too long pressure on any one spot, which cuts off the circulation. Bedsores occur at the bony prominences, such as the lower part of the spine, the hips, shoulder blades, heels, elbows, In the Sick-Room 121 and even on the head. Bathe the parts with alcohol, vinegar, or lemon juice to harden the skin. Dusting with talcum, boric powder, bismuth, cornstarch, or borax, is beneficial. Bathe the parts twice a day with warm water and soap, and always dry thoroughly. Very thin persons are especially subject to bedsores. If one forms, use a bed ring or pad of cotton to remove the pressure, and paint the sore part with white of egg if collodion is not available; or dress with oxide of zinc ointment. Care of the Patient The hair should be combed or brushed every day. Do a woman's hair up in two braids, one on either side. This prevents tangling and gets it out of the way, while if it is done up in a knot <*i the back of the head, it makes an uncomfortable lump to lie on. If the hair is matted through neglect, comb out a little at a time, be- ginning at the ends. Rubbing in vaseline or sweet oil' will help in untangling it. The mouth, always a possible entrance to the body for disease germs, should have special care during sick- ness. Brush the teeth at least three times a day. Arti- ficial teeth should be removed and washed after each feeding. Bits of absorbent cotton or squares of gauze, on toothpicks or other small sticks, may be used with a mouth wash to cleanse the mouth, giving attention to the gums, tongue, roof, and every corner. Listerine and water, boracic acid and water, six or eight drops of pure alcohol in half a glass of water, or limewater with a few drops of rose water, make suitable mouth washes. In giving the bedpan, avoid hitting the patient. Pass one hand under the patient and help him to raise the hips a little; slip the pan under, allowing it to rub on your hand instead of on the patient's back. Help the patient, if necessary, to rise, and remove pan without 122 Epidemics: How to Meet Them dragging it. Cover pan and remove from the room at once. If anything very unusual is seen in the condition of the discharges, make a note of it, and report to the attending physician. It may be advisable to save the specimen for his inspection. - Feeding the Patient The question of diet for the sick is too large to con- sider in full here. Every one should study diet princi- ples in general, becoming intelligent as to the body's nutritional needs, both in health and in disease, as well as to food values. These principles may be understood by the average person, and when practised will go a long way toward preventing disease. While a knowledge of £iet principles is necessary to the intelligent feeding of the sick, a few general points may here be stated. Usually if the invalid has any ap- petite at all, it is poor and " finicky.'' The digestive powers are weak, especially in acute fever, and prac- tically absent in severe fever cases. The list of permis- sible foods is generally limited. Sometimes the patient craves forbidden things. All this makes it especially im- portant that the food be prepared and served with care. Attention to details in serving food means much. Have everything clean, — food, dishes, napkin, and tray, as well as the hands of both nurse and patient. Tidy up the room before serving the tray, having it as pleasant as possible. Make the taking of food an enjoyable event, something to be anticipated with pleasure. The Serving Dainty serving will encourage eating. Avoid elabo- rate garnishings or " fixings." A sprig of parsley or watercress or a lettuce leaf will make a suitable garnish. A spray of maidenhair fern, or one or two flowers of a simple variety, laid on the tray, may be used for deco- In the Sick-Room 123 rating. Use pretty dishes, the best you have; do not use cracked or mismatched ones. Avoid use of colors in food, flowers, or dishes that do not harmonize. Use a tray large enough to admit the food without crowding; if necessary, serve a second tray for the des- sert. A small tray is best when serving a drink or only one or two articles. Serve too little rather than too much food; you can get a second serving if needed, of any article the patient wants. Allow the patient plenty of time to eat, and insist on his chewing the solid food well. Use a napkin, not a towel, for wiping the pa- tient's mouth. The Food Try always to serve fresh foods and those of best quality, avoiding if possible using warmed-over food. Serve cold foods cold and hot foods hot, not lukewarm. In diarrhea and most stomach disorders extreme tem- peratures of food should be avoided. Be regular and punctual. Allow time for needed rest to the stomach, but do not let the patient get weak for want of food, or wait so long as to lose his appetite. Keep in mind the meal hour when preparing food, so it will not have to stand long before being served and thus become cold or unpalatable. Prepare foods simply, using very little salt, no spices, seasonings, or strong flavorings. Fried foods are not desirable, and in general fats should be used sparingly. Remove grease from soups or broths. Never serve melted butter. Avoid rich gravies and sauces. In gen- eral, sugar should be used sparingly in sickness. Diet in Fever In acute fever there is a rise of temperature, pros- tration, increased tissue waste, loss of appetite, and deranged digestion and assimilation. In preparing the food, all this should be taken into account. Food in 124 Epidemics: How to Meet Them liquid form is most suitable, as it is more readily ab- sorbed, gives the most nourishment for the least tax on the digestive powers, supplies water which helps to dilute the poisons of the body, and adds a minimum of waste for elimination. In fever the food should be given in small amounts and frequently, every two or three hours. Where the temperature goes up and down, it is best to give most nourishment when it is down, digestion and assimilation being better then. Abundance of water should be given throughout, to replace the loss of body fluid and to help elimination. Milk is a valuable food in fever, when it can be taken. It should be swallowed in sips. Buttermilk is nearly al- ways permissible. Gruels and broths may be given, but some broths are little more than flavored water and con- tain but little nourishment. Albumin water, the white of egg stirred in water, unsweetened fruit juices, orange juice, ripe grapes, free from skins and seeds, strained rice water, barley water, and cream may be used in fever. The Daily Record A daily record should be kept for the benefit of the attending physician. This record should give the pulse rate, temperature, respiration, the frequency and char- acter of urination and stools, the amount and kind of nourishment and when given, medicines, treatments, amount and character of sleep, pain, symptoms, etc. The Temperature The temperature is taken by placing a clinical ther- mometer which has been shaken down until it registers 97° or lower, in the mouth, the bulb under the side of the tongue rather far back. The mouth should be kept closed three minutes. Be sure that neither hot nor cold drinks have been taken within fifteen minutes and that In the Sick-Room 125 the patient is not a mouth-breather. If for any reason the temperature cannot be taken by mouth, it may be taken in the groin, with the thigh flexed ; or in the arm- pit with the arm pressed down and well covered; or in the rectum. At least five minutes should be allowed for the thermometer to register. The normal mouth temperature is 98.6° ; it will be lower than this in the armpit, and higher in the rectum. The Pulse Take the pulse at the radial artery on the thumb side of the wrist by placing the first two fingers on the inside Taking the Pulse surface just below the root of the thumb and next to the tendon which goes to the thumb. The normal pulse ranges from 70 to 80 beats a minute. It is more rapid in the very young; slower in the aged. The Respiration The respiration should run about 18 to 20 a minute, and should be taken by watching the chest rise and fall at a time when the patient is not aware of it. 126 Epidemics: Hoiv to Meet Them Ready for Night In getting ready for the night see that the hands and face are washed, the hair tidied, and the bed made free from crumbs and wrinkles. Rub the back and smooth the gown under the back. Place a fresh pillow, see that the call bell is at hand, adjust the window and shades, and set plants and flowers outside. Attention to these little things will do very much toward giving the patient a comfortable, restful night. THE LAWS OF HEALTH In this little book we have been able to consider briefly only a few of the common diseases and their prevention and treatment. There are many ways of being sick, but the essentials of health are compara- tively few. If one would keep well and maintain effi- ciency for life's service, he should study the general principles of health and apply them intelligently to himself. The laws of health are natural laws. These laws are established by the Creator, in whom we live and move and have our being. The medical world recognizes that the real source of health is outside medicinal treatment ; that health is subject to laws, with which physicians and patients may co-operate, but which they are unable to control. One should do his utmost to conform to the laws of health. Violation of these laws often brings swift retribution upon the offender. In general, the essentials of health are pure air, pure water, sunlight, wholesome food, proper clothing, exer- cise, and rest. In making use of these essentials, we must apply intelligently the principles of ventilation, sanitation, cleanliness, disinfection, cookery, dress, rec- reation, and other demands of rational hygiene. Speaking of healing as the result of co-operation with the laws of nature, brings us directly to the fountain of all life, the God of nature; for nature's laws are all established by Him and are under His control. It is His will that people should have health, and He gives freely of those things that contribute to health. When we have become sick through the transgression of na- ture's laws, we should change our habits of living to bring them into conformity with the natural laws God has established ; then we may come with confidence to the 127 128 Epidemics: How to Meet Them Author of life for healing. Though we may not always acknowledge God as the healer, He is really the only one who can heal. Doctors, nurses, remedies, and cura- tives are only agencies in bringing to the diseased body the divine power of healing. We may go farther, and say that physical healing is only a part of the restorative work which it is the priv- ilege of every individual to know. In the Bible sense, true healing includes the healing of the soul as well as of the body. Complete healing covers the spiritual as well as the physical being. Jesus in His ministry among men connected closely His work for the souls of men with that for the body. In like manner, God would now bless the sick, not only with recovery of physical health, but also with soul salvation. The two go naturally to- gether, and both are attainable if men will lay hold of them by faith. " Bless the Lord, O my soul : and all that is within me, bless His holy name. Bless the Lord, O my soul, and forget not all His benefits: who forgiveth all thine iniquities; who healeth all thy diseases; who redeemeth thy life from destruction; who crowneth thee with loving-kindness and tender mercies; who satis- fieth thy mouth with good things; so that thy youth is renewed like the eagle's." Ps. 103: 1-5. " Beloved, I wish above all things that thou mayest prosper and be in health, even as thy soul prospereth." 3 John 2. "When the even was come, they brought unto Him many that were possessed with devils: and He cast out the spirits with His word, and healed all that were sick: that it might be ful- filled which was spoken by Esaias the prophet, saying, Himself took our infirmities, and bare our sicknesses." Matt. 8: 16, 17. World's Crisis Series Current Numbers OE ao Epidemics: How to Meet Them. World Peace in the Light of Bible Prophecy. His Glorious Appearing: An Exposition of Matthew 24. Our Paradise Home. The Other Side of Death. The Shadow of the Bottle. Spiritualism vs. Christianity. The Christian Sabbath: Is It Saturday or Sunday? The Food Question: Health and Economy. World Destiny. Bible Prophecy Unfolding. 128 and 96 pages, well illustrated. Price, 25 cents each REVIEW AND HERALD PUB. ASSN. Takoma Park, Washington, D. C. South Bend, Ind. New York City. OUR BABY Only a tender flower, Sent us to rear; Only a life to love While we are here ; Only a baby small, Never at re£t; Small, but how dear to us, God knoweth be£t. M. Barr. If m i * ^ LB D '19