TREASURY DEPARTMENT UNITED STATES PUBLIC HEALTH SERVICE RUPERT BLUE, Surgeon General KEEPING FIT V. D. BULLETIN NO. 1. S. B. of H. C. Issued in cooperation with the Department of the Interior Bureau of Education Revised October, 1918 WASHINGTON GOVERNMENT PRINTING OFFICE 1918 WHAT FITNESS DEMANDS 1. Muscular Strength 2. Endurance 3. Energy 4. Will Power 5. Courage 6. Self- Control 2 KEEPING FIT Manpower is the thing most needed in the world to-day. Our sup- ply is not limitless. We shall need it all at full capacity, not only for service at the front but for service in factory, mine, and farm and in constructive and healing scientific and professional pursuits. It is important that every man and boy in America keep his body in fighting and working trim-. Whether you are at school, at work, or go to war in the next few years, it is necessary that you should know the laws of physical and mental efficiency and live up to them. That means not only the avoidance of diseases and defects, but positive efforts on your part through self -discipline and healthy activities to put your mind and body in prime- condition. FOUR GREAT HANDICAPS. Army records show that among the causes producing the greatest number of military " ineffectives " and rejections, aside from wounds, are defective eyesight, poor teeth, bad feet, and venereal diseases. The same causes probably handicap industry just as much or more than they do actual fighting. The following facts and warnings are aimed to reduce inefficiency due to these four causes, by means of edu- cation and prevention. DEFECTIVE EYES. The human eye is one of the most marvelous and delicate mecha- nisms known, and, next to the vital organs, the most important part of the body. Yet most of us abuse our eyes unmercifully. Close your eyes and for a half minute imagine yourself blind. . . . In modern warfare false eyesight would- be almost as useless as blindness. No wonder Uncle Sam must watch the eyes of his soldiers who shoot and of his workers who grind munitions to a fraction of a millimeter. The most frequent kinds of poor eyesight causing rejection from the Army are near and far sightedness and astigmatism. The same conditions will, of course, handicap a man almost as much in civilian service. Certain defects in the- original structure of the eye itself can not be cured, and can only be corrected by glasses properly fitted by a competent oculist. Certain other defects, due to mistreatment of the eyes, can be cured by proper glasses, which, so to speak, " train " the eye back to normal. Some kinds of defects, such as certain cases of " cross-eyes,," 85329°— 18 3 4 KEEPING FIT. may be helped by a slight operation. Slight muscular defects often cause severe eyestrain without the patient's knowing what is wrong. Still other eye troubles affect chiefly the lids, or attack the lids first and only later alfect the eyesight itself. Proper medical treat- ment will usually cure these conditons, although certain infected cases may leave permanent scars. There are so many varieties of eye trouble that they can not be described here, nor would it be wise for you to try to treat yourself, for the symptoms of very different complaints are often so nearly alike — headache, redness, dimness, etc. — that only a physician can prescribe properly. For any continued discomfort, go to a reliable eye specialist (opthalmologist or oculist). It is unwise to ask an optician to prescribe for eye defects. An optician is, or should be, merely the man who makes the glasses ordered by the physician, and it is no safer to go directly to the optician than it would be to go to a druggist for surgical treatment. It is possible, however, to tell you how to avoid preventable eye trouble, which has handicapped many a man's career because he neglected these apparently simple rules: 1. When reading, writing, etc., be sure to have good, clear light, preferably over the left shoulder if writing, and not directly in the eyes nor reflected sharply from the paper. 2. Do not hold the eyes less than 12 inches from your work. 3. Do not use the eyes too long continuously — rest them a few minutes, occasionally, by closing them or looking into the distance to relax them. One should do this at least every hour, especially if reading fine type or doing intense, delicate work. 4. Do not use your eyes much on a vibrating train or car, nor go too often to motion pictures. They strain the eyes. 5. Keep away from places where stone chips, sparks, or emery dust is flying, or wear goggles. 6. If strong light bothers you, wear slightly brown non-magnifying glasses outdoors, with a broad-brimmed hat. 7. Avoid the common towel and do not rub the eyes with dirty hands. Contagious eye disease is spread in these two ways. DEFECTIVE TEETH. It should hardly be necessary, in this day, to emphasize the impor- tance of clean teeth. In the Army bad teeth are not only important as producers of toothache but also as harborers of disease germs. The mouth is the gateway to the throat and stomach, and it pays to keep it clean. Poisons absorbed from diseased" teeth may cause in- tense suffering and loss of health. The correct way to brush teeth is with a medium soft brush, with an up-and-down stroke, bearing away from the gums toward the points of the teeth, so as to get the food from between the teeth with- out violently pushing back the gums. KEEPING PIT. 5 Even if you keep teeth properly cleaned daily, it pays to have them examined and cleaned by a good dentist once in six months, to prevent decay and avoid disease. DEFECTIVE FEET. In battle an army gets from where it is to where it is going on feet. A good general takes almost as much care for his men's feet and stomachs as he does for their powder and shot. Men are not rejected for corns and bunions, unless they interfere with wearing a military shoe, or with weight-carrying power; but they are a nuisance, and they can be avoided by having properly fitted shoes, snug but not pressing or stubbing the joints or toes. The Army " last " is a safe and good-looking shoe. Cleanliness is of the utmost importance in keeping the feet in condition. Unless this is attended to systematically, the skin becomes softened and irritated by cast-off particles of skin, dirt, and perspira- tion; hence blisters and abrasions are more likely to form. The most frequent foot trouble serious enough to cause rejection and real handicap is the fallen arch, or " flat foot." This may be prevented by wearing shoes which do not put too heavy a strain on the " arch " of the foot, but give it mild support. Many things be- sides shoes may cause flat foot, and a doctor should always be con- sulted for any continuous foot discomfort. Foot strain is also a cause of some kinds of backache and other nervous trouble. The straight position of the foot — that is, with the feet parallel — is the proper one for both standing and walking. If a shoe threatens to injure your foot, it is poor economy to keep it. Don't buy a misfit just because it is cheap or fashionable — it doesn't pay. Eemember the doctor's bills! VENEREAL DISEASES. In former wars germ diseases killed more soldiers than bullets, but such diseases as smallpox, yellow fever, and typhoid have been successfully controlled in the present war. Of all the diseases that now handicap men in the Army and in the essential industries like agriculture, mining, lumbering, muni- tions making and shipbuilding, the venereal diseases (syphilis, gonorrhea, and chancroid) cause the greatest loss of time, money, and efficiency, besides untold misery. Surg. Gen. Gorgas has said that if it were possible to get rid of all wounds or of all venereal disease he would rattier be rid of the venereal cases. If the Kaiser were to hire an army of spies to scatter disease germs among our soldiers and thus to keep them from the front, the Nation would wrathfully protest. If an American general were to permit infected persons to mix freely with our soldiers, he would, in effect, be aiding the enemy. Venereal diseases are as bad as smallpox and 6 KEEPING FIT. almost as " catching." Yet every day many men and boys are exposing themselves to venereal diseases, largely through ignorance of the laws of health and lack of self respect and decency. False modesty has caused silence about venereal diseases because they are usually caught from immoral relations with women and girls, who in turn have caught one or the other of the diseases from" some other man. Practically all prostitutes, and' many girls and women who may not be prostitutes but who permit men to have sexual relations with them, have one or more of these venereal diseases. Many of them are feeble-minded. They are to be pitied and avoided. Here are a few more facts about venereal diseases which you should know for the protection of yourself and others : 1. Gonorrhea (sometimes vulgarly called "clap" or "a dose") can sometimes be cured, if promptly and thoroughly treated, without apparent loss of health, but it always has serious possibilities. In many cases it causes chronic pain and distress in the sexual organs, with severe mental depression. It often produces conditions, which later may cause loss of health or even death ; it injures sexual power and fertility in many cases, and it occasionally cripples a man for life (gonorrheal rheumatism). The loss of health, time, and money caused by these sequels and their treatment may far exceed that caused by the original disease, which is bad enough in itself. The widespread notion among the uninformed that gonorrhea is a mere annoyance, "no worse than a cold," is based entirely upon lamentable ignorance, and it is absolutely false. 2. This disease persists in the deeper parts long after it is appa- rently cured. It thus often happens that a man may, years later, give the disease, without knowing it, to his wife, who thereupon enters upon a period of ill-health that may end in an operation involving the mutilation of her sexual organs in order to save her life, or per- haps actually killing her. Much of the surgery performed on the reproductive organs of women is made necessary by gonorrhea con- tracted from the husband. Often such women can never have children. Should the wife while infected with this disease give birth to a child, the baby's eyes may be attacked by gonorrhea germs and blindness result. 3. The other serious venereal disease, syphilis, infects the blood and therewith all parts of the body. It is as bad as gonorrhea, if not worse. For months after infection with this disease, a person may communicate it even by personal contact, such as^ja kiss ; and articles touched by his saliva or uriae or skin — ^towels, drinking glasses, pipes, etc. — may sometimes carry the infection to others. Although the disease, under proper treatment, is not dangerous to life in the earlier years of its progress, the possibilities of transmitting it should forbid the marriage of the individual until a competent physician certifies to his freedom from disease. KEEPING FIT?. 7 4. The most serious results of syphilis may appear years after its beginnings, when the individual has been lulled into a false sense of security by long freedom from its manifestations, and considers him- self cured. It may attack any organ of the body ; among the diseased conditions produced in various cases are a^ooplexy,^ paralysis,^ in- sanity,^ and locomotor ataxia,* and these often appear after the man has a f arfiily dependent upon him for support. 6. The injury to the individual caused by syphilis is shown in the attitude of the leading, insurance companies toward those so in- ^ KEEP FIT - fox War or Peace by adopting these 5 Rules; 1. Exercise Wisely 2. Eat Wholesome Food 3. Gel All the Fresh Air Possible 4. Take Sufficient Rest 5. Keep Clean QUACK DOCTORS Try to frighten men by untruthful advertisements. They get large sums of money for treating diseases that do not exist. Patent Medicines and "Favorite Prescriptions" ARE DANGEROUS fected — a purely business matter, devoid of all sentimental considera- tions. They refuse to insure the life of a syphilitic person for four or five years after the disease has been contracted, and then only upon special terms; for their records prove that syphilis tends to shorten life, and that the death rate for those who have had syphilis is double the rate for those who have never contracted it. 6. That the syphilitic parent may transmit the disease to his off- spring is common knowledge ; some of his children are destroyed by the disease before birth ; others are born to a brief and sickly span of life ; others attain maturity, seriously handicapped by a burden of ^ Apoplexy refers to sudden paralysis and deep stupor caused by bleeding Into the brain or spinal cord. ^ Paralysis means a loss of motion or sensation in some part of tbe body, 8 Insanity means disorder of the mind, more or less permanent, but without loss of consciousness or will. * Locomotor ataxia means failure of muscular control and other changes due to degeneration of certains parts of the spinal cord and nerves. 8 KEEPING FIT. ill health, incapacity, and misery produced by the inherited taint; others apparently escape these evil effects. 7. The above facts show why a father has a right and duty to demand a health certificate from any man who asks for his daughter in marriage. 8. The only safe way to avoid venereal diseases is to keep away from prostitutes and loose girls.- Between syphilis and gonorrhea, choose neither. 9. If a man contracts gonorrhea or syphilis he wUl save money and time by consulting a competent physician as soon as symptoms of the infection appear. Medical institutes and quack doctors are far more interested in your pocketbook than in your health. To rely on drug-store remedies for self -treatment is equally dangerous. They do not eradicate the infection, and it should always be remembered that merely to cover up a disease is not to cure it. A complete cur© is never effected until the system has been entirely freed of the infec- tion. Otherwise it may smolder and break out years later. In many cases attempted self -treatment permits the infection to secxire such a hold on the system that a cure becomes impossible. The sufferer's condition eventually drives him to a reputable physician, only to find that he has come too late. For the individual to rely on drug- store remedies or quack doctors is to gamble his whole future, with the odds all against him. 10. Do not be fooled by " quacks " and " medical institutes." In many cities these unscrupulous quacks advertise to cure " lost man- hood," " nervous debility," " spermatorrhea," " pimples," and things which have nothing to do with sexual health. They try to frighten the ignorant into paying large sums of money for the " cure " of diseases which do not exist, and the lies they disseminate help to spread venereal diseases. They have been actually run out of some parts of the country. TRAINING RULES. To be really fit for service, however, it is not enough to be free from disabling defects. Many men are rejected simply because of "poor physique." You must be in good general condition all the time if you want to win out, whether in war or in peace. To achieve the maximum of physical and mental efficiency you must follow five common-sense rules: (1) The first of these is sufficient exercise of the right kind. Head- ing the sporting page, yelling in the grandstand, and- watching the baseball bulletin boards may be enjoyable, but will never make a man vigorous. He himself must take daily exercise. Hiking, baseball, rowing, and canoeing, skating in the open air, swimming, tennis, team- games, general gymnasium work, boxing and wrestling, where the air is fresh, are among the most beneficial forms of exercise. Any useful work using the big muscles actively is as good as sports. KEEPING PIT. 9 Your daily exercise should be vigorous enough to cause you to perspire freely. This helps the body to throw, off certain waste products which will ac.t as poisons if they are allowed to accumulate. After exercise take a bath. A shower is better than a tub bath. A washbowl or any other contrivance is better than nothing. Warm* water should be used first, then cold. The bath should he followed by a vigorous rub* down with a coarse towel, the whole process taking no longer than 4 or 5 minutes. The bath and rub down should produce a healthy glow of the body ^nd a general feeling of well-being. (2) Second, sleep in the fresh air, work and exercise in the fresh air as much as possible, and be sure to have the indoor air kept fresh during the day. Fresh air is almost a cure-all. It is usually more valuable than any quantity of medicine. (3) In the third place, you probably need at least eight hours' sleep every night. A man can get along on less, but he can not, keep himself in tiie best possible physical and mental condition. Do not lie in bed after waking up, but jump out, bathe, and dress imme- diately. Avoid soft mattresses, feather beds, and too much- covering. (4) Proper food is another requirement. The system needs not only the kind of food that is rich in nourishment, but vegetables and other coarser food to give bulk and stimulate the .bowels. When this is not done, one becomes constipated and is likely to have headaches and general ill health. Regular movements of the bowels are aided by an abundance of exercise and by eating plenty of fruit and drinking plenty of pure water. The " Hoover " diet is a well- balanced and common-sense ration. (5) Finally, if one is to gain maximum efficiency and retain it, it is important that he should understand the relationship of the reproductive, or sex organs, to the development of vigor. This needs to be carefully explained, because, while the facts are im- portant, they are not generally understood. SEX HEALTH. Sex is what makes a man a man and a woman a woman. It ac- counts for the differences and attractions in mind as well as body be- tween men and women. The ways a person behaves in relation to such matters are called his sex habits. A man's sex habits have much to do with his health and efficiency. Most men have received their first information about sex from lies, half-truths, and smutty stories, from pictures or shows, or from other boys or men who thought they knew it all, but had only filthy ideas about sex, and laughed at it. Most people were never told in a serious way, by their parents or by a doctor, what maturity, mar- riage, and having children really mean. All that is best in modern life and civilization has grown mainly put of the sex impulses. Hunger and sex are the two great driving 10 KEEPING FIT. forces in the world. The hunger motives have given rise to our economic or self-seeking life ; the sex or love motives have given rise to the spiritual and social aspects of life, aspects which find their highest satisfaction in the happiness and service of others. Human, atfection, which is the finest and often the most powerful motive in life, is the highest product of sex in the world. That is why defiling of the affections so completely destroys character and manhood. With sex destroyed or debauched we should lose nearly all that is beauti- ful in art, poetry, music, and literature — for courtship, marriage, WHAT GLANDS ARE FOR Glands make secretions needed in a healthy body. !.yecreti